The tobacco industry and pesticide regulations: case studies from tobacco industry archives

Tobacco is a heavily pesticide-dependent crop. Because pesticides involve human safety and health issues, they are regulated nationally and internationally; however, little is known about how tobacco companies respond to regulatory pressures regarding pesticides. In this study we analyzed internal tobacco industry documents to describe industry activities aimed at influencing pesticide regulations. We used a case study approach based on examination of approximately 2,000 internal company documents and 3,885 pages of U.S. Environmental Protection Agency documents obtained through Freedom of Information Act requests. The cases involved methoprene, the ethylene bisdithiocarbamates, and phosphine. We show how the tobacco industry successfully altered the outcome in two cases by hiring ex-agency scientists to write reports favorable to industry positions regarding pesticide regulations for national (U.S. Environmental Protection Agency) and international (World Health Organization) regulatory bodies. We also show how the industry worked to forestall tobacco pesticide regulation by attempting to self-regulate in Europe, and how Philip Morris encouraged a pesticide manufacturer to apply for higher tolerance levels in Malaysia and Europe while keeping tobacco industry interest a secret from government regulators. This study suggests that the tobacco industry is able to exert considerable influence over the pesticide regulatory process and that increased scrutiny of this process and protection of the public interest in pesticide regulation may be warranted.     

The context of ethics in the health care industry

Examines ethics in the health care industry from the perspectives of investors, employees, patients, competitors and the environment. Ethical behaviour in the health care industry is essential and desirable; however, determining which behavioural actions are ethical and which are unethical is difficult. Although never will everyone agree on specific ethical standards, everyone should agree that setting ethical standards is vital. Therefore, administrators of health care institutions and health care providers should work together to establish codes of ethics which define boundaries for ethical behaviours in the health care industry.     

Primary infertility in nuclear industry employees: report from the nuclear industry family study

OBJECTIVE—To determine whether men and women who are occupationally exposed to ionising radiation are at increased risk of primary infertility.
METHODS—A cross sectional analysis of reproductive outcome was reported in an occupational cohort of nuclear industry workers from the Atomic Energy Authority, Atomic Weapons Establishment, and British Nuclear Fuels in the United Kingdom. Data on employment and radiation monitoring supplied by employers were linked to data obtained from self administered questionnaires sent to all current employees and a sample of past workers. A total of 5353 men and 603 women aged 40 years or more at the time of survey whose first pregnancy, or attempt at pregnancy, had occurred after first employment in the nuclear industry were recruited to the study. Primary infertility was defined as consultation with a doctor about the failure to achieve at least one viable (24 weeks gestational age or more) pregnancy.
RESULTS—2.6% Of men and 3.7% of women reported primary infertility. For men, this proportion did not differ by amount of radiation monitored or by dose received. The prevalence of infertility was higher among monitored women than non-monitored women, but not significantly so and the numbers were too small to draw any firm conclusions.
CONCLUSIONS—No support was found for a hypothesis linking exposure to low level ionising radiation among men with primary infertility. There was weak evidence of an association in women, but the relatively few monitored women prevented detailed examination of these data.


Keywords: infertility; nuclear industry     

The exposure to tobacco smoke of the employees of a telephone company]

Smoking habits were studied in a group of employees of a telephone company. The smokers were 34% of the subjects interviewed. The non-smokers said that they were bothered by other people smoking everywhere and also to a considerable extent at the workplace. Differences between smokers and non-smokers and between exposed and non-exposed non-smokers were studied by measuring expired CO and urinary cotinine. An expired CO concentration of 10 ppm discriminated between smokers and non-smokers. A mean urinary cotinine concentration of about 16 ng/mg was found in the exposed non-smokers, corresponding to the direct smoking of 1/10 of a cigarette per day. The search for the metabolic phenotype of destromethorphane, which was taken as an indicator of susceptibility to contract lung cancer due to IPA, showed that there were no differences between smokers and non-smokers since the rapid metabolizers, and therefore subjects potentially exposed to risk of lung cancer due to tobacco smoke, prevailed in both groups.     

Professional ethics: the case of neonatology

Neonatal professionals encounter many ethical challenges especially when it comes to interventions at the limit of viability (weeks 22–25 of gestation). At times, these challenges make the moral dilemmas in neonatology tragic and they require a particular set of intellectual and moral virtues. Intellectual virtues of episteme and phronesis, together with moral virtues of courage, compassion, keeping fidelity to trust, and integrity were highlighted as key virtues of the neonatal professional. Recognition of the role of ethics requires a recognition that answering the obvious question (what shall we do?) does not always suffice. Acknowledging the tragic question (is any of the alternatives open to us free from serious moral wrongdoing) and recognizing the ethical dilemmas, where the lines between right and wrong are blurred, leads to actions taken towards establishing ethics frameworks to support decision-making. In neonatology units, such organizational support can help in allowing the team members to recognize the ethical dilemmas, avoid moral distress, and improve team cohesion and the quality of care provided. Only when the organizational structure allows ethical dilemmas to be recognized, adequate decisions can be made.

     

烟草控制的责任伦理

烟草控制事关公民的生命健康,从个人、群体到政府都要有伦理责任和道德担当.其中,个人责任是基础,个人要有健康责任意识、消费责任意识和权利责任意识;群体责任是关键,医生、媒介、消费、烟企等群体责无旁货;政府责任是根本,政府要通过健康教育、人才培养、科学研究、立法干预等多种方式担负起烟草控制的伦理责任.     

The case for codes of ethics

Medicine, Health Care and Philosophy -     

Economic incentives to reduce employee smoking: a health insurance surcharge for tobacco using state of kansas employees

Abstract Cigarette smoking has been clearly established as the single most important, preventable cause of morbidity and mortality. Employers are actively working to reduce smoking among current employees, and a growing number will not hire smokers. While most efforts have focused on either 1) helping smokers overcome their habit, or 2) banning or severely limiting worksite smoking, very little has been done to provide strong economic incentives for current employees to give up smoking. This paper reports on the planning and implementation of a $10 per month surcharge added to employee contributions for health insurance for persons employed by the State of Kansas. Family coverage is not affected. Also discussed is a similiar effort in the Colorado state employee group health plan.     

The creation of industry front groups: the tobacco industry and "get government off our back"

We investigated how industries use front groups to combat public health measures by analyzing tobacco industry documents, contemporaneous media reports, journal articles, and press releases regarding "Get Government Off Our Back," a coalition created by the tobacco industry. RJ Reynolds created Get Government Off Our Back in 1994 to fight federal regulation of tobacco. By keeping its involvement secret, RJ Reynolds was able to draw public and legislative support and to avoid the tobacco industry reputation for misrepresenting evidence. The tobacco industry is not unique in its creation of such groups. Research on organizational background and funding could identify other industry front groups. Those who seek to establish measures to protect public health should be prepared to counter the argument that government should not regulate private behavior.     

The "global settlement" with the tobacco industry: 6 years later

On June 20, 1997 a group of attorneys and health advocates proposed a "global settlement" of all public and private litigation against the tobacco industry. This agreement was controversial, and the subsequent implementing legislation was defeated. We sought to determine whether the global settlement represented a "missed opportunity" or a dead end. We compared the global settlement with subsequent laws, regulations, settlements, and judgments against the tobacco industry and found that other than Food and Drug Administration regulation of tobacco, tobacco control advocates have achieved many of the policies included in the global settlement and several beyond it. The policies that have been developed since 1997 have advanced tobacco control substantially, often beyond the provisions of the global settlement.     

Community perceptions about the tobacco industry and tobacco control funding

OBJECTIVES: To determine community views about the believability and standards of honesty and ethics of tobacco companies, related policy options, and mechanisms for tobacco control funding. METHOD: A representative population survey of 808 South Australians aged 18 years and older, contacted by telephone, using an electronic white pages sampling frame, with a response rate of 72%. RESULTS: 80% of respondents and 74% of smokers thought tobacco companies mostly did not or never told the truth about smoking and health, children and smoking and addictiveness of tobacco. With regard to perceived standards of honesty and ethics, tobacco company executives were rated the lowest of all professional groups, with 74% of respondents judging them to have low or very low standards. 89% of smokers would support full product information on the pack about chemicals and additives in cigarettes. 77% thought shopkeepers should pay back the amount they gain from children smoking cigarettes and 80% thought tobacco companies should do so, or be fined or taxed accordingly. 53% agreed the government should spend an amount equal to the amount gained from children's smoking and 21% indicated a higher expenditure. CONCLUSION: Tobacco companies are held in low regard by the public and by smokers who are their customers. There is a high degree of support for tobacco control efforts to be financed by being indexed to the level of children's smoking in the community, through the amount made by shopkeepers, manufacturers and the government from children's cigarette consumption.     

Creating customer-oriented employees: the case in home health care

Little empirical research has examined the organizational factors that influence the extent to which health care providers engage in customer-oriented behaviors. The authors examine the influence of role ambiguity, role conflict, and job satisfaction on the customer-oriented behaviors of home health care representatives. Managerial implications based on the study findings are discussed.     

Genotoxic effects of pesticide-treated vegetable extracts using the Allium cepa chromosome aberration and micronucleus tests

The presence of chemical residues in vegetables and fruit is a source of human exposure to toxic and genotoxic chemicals. The mutagenic and carcinogenic action of herbicides, insecticides and fungicides on experimental animals is already known. Several studies have shown that chronic exposure to low levels of pesticides can cause adverse health effects and that many pesticides are mutagenic/carcinogenic. In the present research we monitored concurrently the presence of pesticides and genotoxic compounds extracted from 21 treated vegetables and 8 types of grapes sampled from the markets of a region in Southern Italy. The extracts were analysed for pesticides by gas-chromatography and HPLC, and for genotoxicity with two plant tests in Allium cepa roots: the micronucleus test and the chromosomal aberration test. We found 33 pesticides, some of which are outlawed. Genotoxicity was found in some of the vegetables and grapes tested. Allium cepa tests were sensitive for monitoring genotoxicity in food extracts. The micronucleus test in interphase cells gave much higher mutagenicity than the chromosomal aberration test in anaphase-telophase cells.