Lawrence Martin, M.D., FACP, FCCP
9000 Mentor Avenue
UPCP-Pulmonary
Mentor, OH 44060
September 15, 2005
Peter D. Wagner, M.D.
President
American Thoracic Society
61 Broadway
New York, NY 10006-2755
Dear Dr. Wagner,
Events of the past year have validated criticisms of the ATS-AJRCCM review on nonmalignant
asbestos diseases (2). You were not ATS president at the time, and probably had nothing
to do with the article's preparation or publication. However, you are ATS's current leader,
and in a position to effect important change.
The United States Asbestos Litigation Scam (USALS) is arguably the most notorious public
health scam in the history of this country (1, 4-10). In this scam, hundreds of
thousands of people were given manufactured diagnoses of asbestosis -- all for the profit of
plaintiff attorneys and their hired physicians (6-9, 14, 21-23, 25, 34, 36, 38, 41-44).
Diagnoses were manufactured in the sense that they were not "a product of good faith medical
judgment but rather a function of the millions of dollars a year in income" that the physicians
received. Furthermore, pulmonary function tests were often administered "in knowing violation
of standards established by American Thoracic Society" (9).
The scam has bankrupted dozens of businesses, clogged the courts, adversely affected
healthy people and delayed compensation for workers truly harmed by asbestos (1, 10-11, 15, 47-48).
Even so, the 2004 ATS review supported the wholly discredited process that created these
phony diagnoses. The support may be subtle to the uninitiated, but it is readily apparent to anyone
involved in asbestos litigation (doctors and lawyers). The ATS review selectively quoted the
medical literature to make the scam seem legitimate and blatantly ignored peer-reviewed studies to
the contrary. Most egregious, however, was the way in which the ATS review carefully crafted sentences and
paragraphs to support plaintiff attorneys who profit from the scam (28-33).
That 2004 ATS review was really the culmination of biases long held by two past ATS
presidents, and a wholly lopsided panel of 11 physicians chosen as authors (28, 33, 39). After its
publication, in response to my web sites and letters in AJRCCM (16, 31, 46, 53), ATS adopted a
do-no-wrong mentality, providing only tangential or non-responses to major questions (19-20, 40).
Only 7 months later did ATS even provide the authors' conflict-of-interest disclosures (19),
and that listing omitted the extraordinary plaintiff-oriented bias of the past presidents and several authors (28).
A "Special Session" in San Diego last May to discuss the contentious issues was not even recorded,
unlike every other session held that week.
Last month, ATS News lauded an academic physician who authored a USALS-based study (3).
In order to show the importance of her work, ATS News favorably cited this study, one that she
co-authored for Chest (35). Unfortunately her Chest article made unsubstantiated conclusions from
diagnoses generated solely by the asbestos scam, and for that reason alone qualifies it as
"junk science" (26). Moreover, published criticisms of that article by myself and others have
never been answered by the authors (13, 24, 27, 45).
Notwithstanding ATS's bizarre (for a scientific organization) support of the USALS, since
September 2004 a wealth of information has begun to expose the scam to a wider
public (12, 21, 37, 49-52). At least one physician and one plaintiff lawyer have
admitted that many of the diagnoses were fabricated (21, 37, 52). By doing so they --
and other physicians involved in a sister scam on mass silicosis diagnoses
(12, 21, 37) -- have acknowledged what practically every one involved (on both sides of
the litigation) already knows. Last spring a New York Grand Jury began investigating phony
asbestos diagnoses affecting that district (18).
Despite all this information, ATS -- the world's preeminent scientific pulmonary organization --
continues to support the USALS! Support is implicit in its official communications
(2-3, 19-20, 40), as well as in ATS's continued silence over the medical corruption in asbestos
diagnoses. I can only ask - Why? Why does ATS allow bias to trump science on this single issue?
Why does ATS remain silent, when it should really be at the forefront of organizations seeking
honest diagnoses and credible lung function testing?
I don't expect ATS to amend its wrong-headed support of the USALS during your brief term.
But someone at ATS should review Judge Jack's 249-page legal opinion (21).
It provides a real eye opener to the sordid details of the scam
that ATS, through its publications and pronouncements, and continued silence
over the medical corruption, has supported de facto.
Slowly, inexorably, real science, detailed legal review and solid reporting
are bringing truth to the fore (7-9, 17, 21-22, 36-37, 43, 49-52). At some point a new
generation of ATS officials will look back and admit that, yes, ATS was
co-opted on this issue by a bunch of unscientific, wholly-biased physicians, physicians
who chose to pursue a personal agenda rather than offer objective analysis.
Anti-science should not be published or supported by ATS, but there it is, for
all (including plaintiff lawyers, who love this stuff) to see and read (2-3, 19-20, 32).
I look forward to the day that ATS objectively reviews the asbestos scam, stakes
out an honorable position, and expunges this blot on its otherwise remarkable history.
Lawrence Martin, M.D., FACP, FCCP
Associate Professor of Medicine
Case Western Reserve University School of Medicine
Cleveland
References
1.
American Bar Association Commission on Asbestos Litigation. Report to the House of Delegates, February 2003.
Available at www.abanet.org/leadership/recommendations03/302.pdf.
2.
American Thoracic Society. Official Statement: Diagnosis and
initial management of nonmalignant diseases related to asbestos. Am J Resp Crit Care Med 2004;170:691-715.
Available at http://ajrccm.atsjournals.org/cgi/content/full/170/6/691.
3. ATS News. Vol. 31, No. 8, August 2005, page 5.
4. Berenson A. A surge in asbestos suits, many by healthy plaintiffs. New York Times, April 10, 2002; page A1.
5.
Bernstein DB. Keeping junk science out of asbestos litigation.
Pepperdine Law Review, Volume 31, No. 1, 2004; 11-28.
Available at www.lakesidepress.com/Asbestos/AdobeDocuments/Bernstein.pdf.
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Dust and FELA Issues. February 2, 2005.
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19.
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Criteria for the Diagnosis of Nonmalignant Asbestos-Related Disease. Diagnosis and Initial Management of
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Click here for summary
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Available at www.lakesidepress.com/asbestosjunkscience/overview.htm.
27.
Martin L. Asbestos literature does not support study conclusions (e-letter).
May 7, 2004.
Available at www.chestjournal.org
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Available at www.lakesidepress.com/Asbestos/ATS-2004Statement-biases.pdf
29.
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31.
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Available at www.lakesidepress.com/Asbestos/asbestosdeposition1.htm
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Available at www.lakesidepress.com/Asbestos/ATS-2004Statement-rebuttal.pdf
34.
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38.
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41.
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Available at www.wsj.com
51. Wall Street Journal editorial: "Case of the Vanishing X-rays." August 31, 2005.
Available at www.wsj.com
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53.
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