The U.S. EPA’s new Protections for Subjects
in Human Research rule, which came into force on
7 April 2006, was born of a need to tighten the ethical
guidelines controlling nonmedical human experimentation.
The rule was ostensibly designed to offer people
greater protection in pesticide toxicity experiments.
But just two weeks after its coming into force, a
coalition of labor and environmental interest groups
filed suit against the EPA, challenging the rule’s
legality and ethics. Against a backdrop of claims
of industry influence, financial interests, and bipartisan
rhetoric, the Second Circuit Court of Appeals in
New York City must now determine whether this rule
safeguards Americans against unethical experimentation
or sells them out to big business.
The plaintiffs—the Natural Resources Defense
Council (NRDC), Pesticide Action Network North America,
San Francisco Bay Area Physicians for Social Responsibility,
and Northwest Treeplanters and Farmworkers United,
Oregon’s union of farm, nursery, and reforestation
workers—filed their suit on 23 February 2006.
They claim the new rule does not meet the demands
of Congress to afford the fullest protection to human
subjects—especially pregnant women and children—in
pesticide experiments, and charge that the rule is
undercut by numerous loopholes that ultimately encourage,
rather than deter, human testing.
“EPA is giving its official blessing for
pesticide companies to use pregnant women, infants,
and children as lab rats in flagrant violation of
[the EPA Appropriations Act of August 2005] cracking
down on this repugnant practice,” said Erik
Olson, senior attorney for the NRDC, in a 23 January
2006 press release from that organization. “There
is simply no legal or moral justification for the
agency to allow human testing of these dangerous
chemicals. None.”
The Need for a New Rule
The new rule expands on the existing Federal Policy
for the Protection of Human Subjects (or “Common
Rule”), which covers the ethics of medical
trials and governs human research sponsored or regulated
by federal agencies. The Common Rule largely reflects
the aims of the Nuremberg Code, a document drawn
up after World War II providing the basis for modern
human experimentation ethics. But according to Human
Pesticide Experiments, a June 2005 report drawn
up for Senator Barbara Boxer (D–CA) and Representative
Henry Waxman (D–CA), the Common Rule offers
insufficient protection against pesticide companies
that pay people to be intentionally exposed to their
products.
Why would a pesticide company even want to conduct
experiments on humans in the first place? One key
reason can be found in the provisions of the 1996
Food Quality Protection Act, which was passed to
provide greater protection for vulnerable populations
(such as children) against pesticide exposures via
food. The act applied a 10-fold safety factor to
permissible levels of pesticide residues in food
to account for children’s greater vulnerability.
Under the act, pesticides could be granted a lower
safety factor “only if, on the basis of reliable
data . . . [the lower factor] will be safe for infants
and children.” According to a 2004 National
Academy of Sciences report titled Intentional
Human Dosing Studies for EPA Regulatory Purposes:
Scientific and Ethical Issues, several pesticide
manufacturers conducted human dosing studies in pursuit
of lower safety factors.
But human testing raises important ethical questions
that need to be answered. For example, although the
subjects in these pesticide dosing studies were supposed
to have given their consent to participate, was it
ethical to have asked them in the first place? Would
the benefits of these studies outweigh the risks
to the subjects (as recommended by the 1964 Declaration
of Helsinki on human medical experimentation), or
just help the bottom line of the companies involved?
Given the dilemma surrounding human experimentation,
in 1998 the Clinton administration placed a moratorium
on the EPA reviewing human experiments for setting
permitted exposure levels. When the moratorium was
lifted by the Bush administration after a court found
procedural errors in its establishment, Congress
reacted by way of the 2005 EPA Appropriations Act,
demanding that the agency draw up new ethical guidelines
governing itself and all third parties wishing to
submit results to the agency for regulatory purposes.
Championing this cause was Representative Hilda Solis
(D–CA), along with Boxer and Waxman, whose
2005 report claimed that 22 human pesticide experiments
submitted to the EPA for possible use in regulatory
decision making were in violation of ethical and
scientific standards, for reasons such as failure
to obtain fully informed consent, dismissal of adverse
outcomes, and the use of unethical liability waivers.
In obedience to Congress, the EPA drew up a proposed
rule, which evolved into the final rule published
on 2 February 2006 after a 90-day public comment
period. During this time the EPA received thousands
of criticisms that it took into account for preparing
the final draft—a document that ended up little
to the liking of the litigating coalition or indeed
of the politicians who had demanded it.
The coalition members allege that the rule’s
wording—with what they perceive to be inherent
loopholes—now actually encourages rather than
prohibits human experimentation, and suggest that
pesticide companies could take advantage of this
to further their interests. “EPA’s rule
allows pesticide companies to use intentional tests
on humans to justify weaker restrictions on pesticides,” said
Margaret Reeves, a senior scientist and program coordinator
with Pesticide Action Network North America, in a
press release from that group announcing the filing
of the lawsuit. In the same press release, Robert
Gould, president of San Francisco Bay Area
Physicians for Social Responsibility, was quoted
as saying, “Pesticide companies should not
be allowed to take advantage of vulnerable populations
by enticing people to serve as human laboratory rats.”
In a press release issued by his office the same
day, Waxman commented: “Unethical human pesticide
experiments must be stopped. It is morally wrong
to encourage chemical companies to dose humans with
pesticides in order to argue for weaker public health
standards.”
Question of Intent
One of the major intentions for the new rule—and
now a major bone of contention—was that it
ban the experimental use of pregnant women and children.
Indeed, the EPA insists the rule does just that. “This
rule provides far-reaching protections for all Americans
and absolute protections for children and expectant
mothers,” explains senior policy advisor William
Jordan of the EPA Office of Pesticide Programs. “It
categorically inhibits EPA or any researcher from
using [such subjects] in intentional dosing studies.
The rule further extends those protections by banning
any researcher for pesticides from using pregnant
women or children as participants in any intentional
dosing study intended for submission to EPA.”
Jordan says the rule also prohibits the EPA from
relying on any intentional pesticide dosing study
involving pregnant women or children regardless of
the intent of those conducting the study or the country
where the study was conducted. Finally, he says,
the rule directs the EPA to waive that prohibition “only
if the agency were to become aware of information
that would indicate the need for stricter regulatory
controls for a pesticide.”
The coalition, however, points to what it considers
to be several exceptions to the rule. They note that
while Americans may be offered some protection from
intentional dosing studies, the rule does nothing
to prevent U.S. pesticide companies from performing
experiments on nationals in other countries.
The term “intended for submission to the
EPA” worries them too. “The wording of
the rule means you are not allowed to do a study
on pregnant women or children that you admit was
intended from the beginning for submission to the
EPA,” explains Olson. “If that was not
your original idea—or if you say it wasn’t—then
you apparently could do those experiments. A second
scenario could be where a company performs a study
on infants or pregnant women and submits it to a
state or, say, a European country, saying that it
does not intend to submit it to the EPA. We have
plenty of experience to show that decisions made
by other bodies are very influential on the EPA.
[So], you can avoid the EPA rule and still get the
result you want.” In addition, pesticide studies
on pregnant women and children submitted under clean
water, drinking water, clean air, hazardous waste,
or other laws are not covered by the new rule’s
restrictions, Olson explains.
Jordan rejoins that the rule does not, in fact,
permit a registrant to claim at the outset of a study
that they have no intent to submit a human pesticide
study and then later submit that study. “If
the agency were ever to receive such a study done
in this deceptive fashion,” he insists, “the
rule prevents EPA from using it.”
Children’s Consent
Another major area of contention is consent. In
the proposed rule, section 26.408 of the text clearly
stated that “if the [institutional review board]
determines a research protocol is designed for conditions
or for a subject population for which parental or
guardian permission is not a reasonable requirement
to protect the subjects (for example, neglected or
abused children), it may waive the consent requirements
in subpart A of this part and paragraph (b) of this
section.” Subpart A refers to the requirement
that a child must assent to be included in an experiment
(although this was apparently not necessary “if
the capability of some or all of the children is
so limited that they cannot reasonably be consulted”),
while paragraph (b) refers to soliciting permission
from parents or guardians. Many critics believed
this waiver suggested that abused or mentally impaired
children could be freely used in commercial pesticide
experiments.
In comments published with the final rule, the
EPA says such a sinister reading is incorrect: “Many
commenters misinterpreted EPA’s proposed language.
Contrary to public comments, none of the alleged ‘loopholes’ ever
existed, because the prohibition in proposed Sec.
26.420 stated ‘Notwithstanding any other provision
of this part, under no circumstances shall EPA or
a person when covered by Sec. 26.101(j) conduct or
support research involving intentional dosing of
any child.’”
According to the EPA, the words “Notwithstanding
any other provision of this part” meant that
the provisions in proposed Section 26.420 overrode
all other provisions of the entire regulation, including
those in 26.408. So even though the latter section
would have appeared to give the EPA the authority
to waive certain requirements, it did not, the agency
claims, authorize any departure from the ban declared
in Section 26.420. In Jordan’s words, no child
is going to be used in intentional dosing studies—period.
“But if this is what it means, why doesn’t
it simply say that?” asks Olson. “It
sure appears that if there is no ‘intent to
submit’ to EPA then you could use such children.”
The wording in the final rule is scarcely different
from that in the original version. The proposed Section
26.408, now named Section 26.406, remains virtually
intact, while the promise in the proposed Section
26.420 has been consolidated into a blanket statement
in the final Section 26.203 that “under no
circumstances shall EPA conduct or support research
involving intentional exposure of any human subject
who is a pregnant woman (and therefore her fetus)
or child.”
Other concerns voiced by the coalition include
claims that the ethics review board established by
the new rule is powerless to prevent experiments
it deems unethical (its role is merely advisory),
that nowhere is any sanctioning power mentioned,
and that a clause in the text requires that any studies
presented need only “substantially” comply
with the rule—a quantity of compliance that
is never defined.
Given the EPA’s funding of the now-cancelled
CHEERS study (which would have paid parents to let
EPA and industry scientists observe the effects on
their children of spraying their homes with pesticide,
but which was abandoned by the agency in the face
of overwhelming criticism; the EPA declined to comment
to EHP on the study), the fundamental
question arises as to whether the agency should be
allowed to write its own rules. It is now the job
of the courts to decide whether the EPA has done
a good job. Briefings will begin 5 June 2006, but
a ruling could take a year or more to come through.
In the meantime, the new rule is in force.