Overcoming censorship to publish publicly important research
Clapp RW. Mortality among US employees of a large computer manufacturing company: 1969–2001. Environ Health. 2006.
Environmental Health: http://www.ehjournal.net
“People dying at excess rates of certain types of cancer that are preventable? Come on! That’s what public health is supposed to be about,” says Professor Richard Clapp. “This was a way of getting that word out widely.”
Clapp’s talking about his 2006 paper on mortality rates among IBM workers and its publication in the open access journal Environmental Health. Making the paper publicly accessible to all – other academics, IBM employees, other microelectronics workers, the wider interested public – may seem obvious now, but it took a two-year-long battle for the Boston University professor of public health to publish his own work, a battle which encompassed a full editorial boycott of an Elsevier journal, media spotlight on right-to-publish issues, and court cases in California and New York State.
The first challenge Clapp and his paper faced was legal. In early 2004 the study was due to be included in a court case brought against IBM by two former employees who were suffering from cancer. Ruled inadmissible by the judge, the study was never used and the plaintiffs lost the case, described by one of their attorneys as being “fought with one hand tied behind my back”  because of his inability to use Clapp’s evidence.
Nonetheless, the attorneys and Clapp felt reassured that at least when the study was published, as intended, in a special issue of the scholarly journal, Clinics in Occupational and Environmental Medicine, then the evidence would finally be out in the open.
However, on hearing the news that Clapp planned to publish his work, IBM’s lawyers swung into action. They warned Clapp that publishing the paper would violate a court order specifying that the internal IBM data be used only in litigation; Clapp’s lawyer maintained that the study was in the public domain. Boston University’s legal department upheld Clapp’s lawyer’s stand, and he was all set to proceed with submission and publication.
Until he hit the next challenge – the refusal of Elsevier, the publishers of Clinics, to allow Clapp’s work to see the light of day. A spokesperson claimed that the paper could not be published because it was original research material and Clinics only published review articles. “A made-up excuse,” dismisses Clapp, pointing out that in the two years before the special issue his paper was due to appear in, there had been six original research studies published in Clinics, and nothing in Elsevier’s instructions to guest editors stated that original research should not be published.
“Academic freedom requires access to publication for scientific studies whether a journal publisher likes the content or not. If the material is worthy, and the editor is satisfied the piece meets the journal’s scientific standards,
the publisher’s interference smacks of censorship or pandering to its advertisers or sponsors. Elsevier censored the Clapp and Johnson paper after Boston University indicated it would back these authors in all necessary ways,” report Bailer et al in an article about the furore .
The other authors due to publish in the special edition of Clinics responded magnificently. All 13 stood shoulder-to-shoulder with Clapp and declared that they would not publish until he did. The boycott made the news.
“It was a right to publish, academic freedom issue that became quite a cause celebre,” says Clapp. “It was covered by media in the UK, South Africa, Malaysia and all around the US, including the Chronicle of Higher Education.”
It also led to another court case, this time in New York State, which clarified that there was no public interest served by keeping the study confidential and that Clapp had the right to publish his work.
At this point Clapp turned to the open access journal Environmental Health. It’s been open access from the very start, over 10 years ago now, when it was one of the first independent Biomed Central journals and it is one of the most important journals in its field with a high impact factor and excellent reputation. Editor-in chief Philippe Grandjean, of the University of Southern Denmark, was delighted to accept the paper.
It was Clapp’s first publication in an open access journal but he felt strongly that making this piece of work accessible was crucial.
“It was publicly important information. It’s not that it wouldn’t have got published in something like the American Journal of Industrial Medicine which is not open access but there were a lot of workers at IBM and in this industry in other parts of the world were interested in this and they don’t necessarily have access to academic print journals that are only available in medical libraries. Open access makes it much more widely available,” he explains.
The paper proved popular, quickly, and continues to be so. It remains in the top five most accessed articles in the journal, even after five years, with more than 25,000 hits. When hits from PubMed are also taken into account, the paper has been accessed more than 50,000 times. The paper generated news coverage which in turn meant that the research reached a wide audience.
“I would definitely call it a success,” says Clapp. “I got quite a bit of response from colleagues which, to me, meant that it was worthy to publish and I was also contacted by IBM workers which is really what it’s all about. It made me even more of a fan of open access publishing. It made me think ‘yeah, wow, this is a good thing to do’.”
He adds, “legal attempts to suppress things that have to do with workers’ health is a terrible thing and so to the extent that this has shone a spotlight on that effort to suppress this particular study is a cautionary tale for any future efforts to suppress this kind of information. I think that’s a good outcome.”
 Bailar JC 3rd, Cicolella A, Harrison R, LaDou J, Levy BS, Rohm T, Teitelbaum DT, Wang YD, Watterson A, Yoshida F.
IBM, Elsevier Science, and academic freedom.
Int J Occup Environ Health. 2007 Jul-Sep;13(3):312-7.