Budget Office Impedes U.S. Health Studies, Report Says

The Office of Management and Budget “has delayed, impeded and thwarted governmental research efforts . . . on serious public health questions” in attempting to block projects of the federal Centers for Disease Control, a report by a group of scientists charged Sunday.

“OMB is clearly interfering with the substance of CDC research,” said the report, which was requested by the House Energy and Commerce subcommittee on oversight and investigations. “The health policy implications are serious.”

The OMB “either significantly delayed, seriously altered in scientific design, or disapproved entirely” six major studies from the Atlanta-based health agency between January, 1984, and March, 1986, according to the report, which was compiled by three occupational health scientists from the Harvard School of Public Health and one from Mt. Sinai School of Medicine.

Despite repeated attempts, officials from the OMB could not be reached for comment Sunday.

The report alleged that the OMB, an agency of the White House, abused its authority under the Paperwork Reduction Act of 1980. That act requires the OMB to review and clear all information collected by federal agencies, including scientific and medical studies conducted by such agencies as the CDC.

The report charged that, in a review of all 51 research projects submitted to it by the CDC during that time period, the OMB also showed a “demonstrable bias” against studies dealing with environmental and occupational hazards and “was seven times more likely to reject” these studies, as compared to studies dealing with infectious or “conventional” diseases.

“Studies with a reproductive focus, such as birth defects or venereal disease, also were more likely to be rejected by OMB,” the report said.

In releasing the report, Rep. John D. Dingell (D-Mich.), chairman of the subcommittee, said the OMB’s paper work review process resulted “in a significant diversion of tax dollars from productive public health research into non-productive paper-pushing and unnecessary contracting expenses.”

Evaluated by Peers

Typically, before a scientific study is published, it undergoes a procedure known as “peer review,” that is, it is evaluated by other experts in the same field. The report to the subcommittee charged that--prior to OMB review--six major CDC studies “all had received a thorough and appropriate review from panels of nationally recognized experts, and all were approved by the respective peer review group.”

However, the report said, “the OMB review, which was superimposed on the peer review process, generally relied on single consultants, rather than a panel of experts.” Further, the OMB’s review was “poorly documented” and often demonstrated “a dismaying ignorance” of science.

The report said that three of those studies were initially rejected by the OMB, then “subsequently approved by OMB following congressional inquiries.” The studies involved the health effects of dioxin, a component of the defoliant Agent Orange known to be extremely toxic; video display terminals; and MBOCA, a potent carcinogen in animals that is believed to cause bladder cancer in humans.

The dioxin study, approved by the White House Agent Orange Working Group and a panel of peer reviewers, was to examine workers in New Jersey and Missouri who had been exposed to the chemical. However, “conditions imposed by OMB during its paper work review of the dioxin study have delayed initiation of the study substantially, have increased contracting costs by at least $270,000, and may even totally block the completion of this important study,” the report said.

Twelve reported “clusters” of abnormal births in women working with video display terminals have “caused considerable public alarm,” the report said, adding: “industry, labor, and public health professionals all agreed on the need for a definitive study. . . .” But the OMB initially disapproved of the study, the report said. After two congressional hearings, the OMB gave the study “partial approval, but required the removal of important questions related to fertility and stress.”

‘Weakened the Study’

The report added: “Numerous experts agreed that OMB’s tampering . . . has significantly weakened the study. . . .”

A study of 500 workers in Adrian, Mich., exposed to the chemical MBOCA was also initially rejected by the OMB, the report said. Following an inquiry by Dingell, a more limited study was finally allowed, but the OMB’s paper work review resulted in “a six-month delay in undertaking important cancer screening in a large population at risk,” the report said.

Members of the committee who compiled the report were Dr. Philip J. Landrigan, professor of occupational medicine at the Mt. Sinai School of Medicine, and Dr. Barbara Boardman, Dr. Ian A. Greaves, and Charles Levenstein, all of the Harvard School of Public Health.