A 2018 study in the "American Journal of Public Health" found that in the first six months of Pruitt's tenure as EPA head that the agency had adopted a pro-business attitude unlike that of any previous administration. The study argued "that the Pruitt-led EPA has moved away from the public interest and explicitly favored the interests of the regulated industries." The study found that the agency was vulnerable to regulatory capture and that the consequences for public and environmental health could be far-reaching. According to a 2018 Harvard University analysis, the Trump administration's rollbacks and proposed reversals of environmental rules under Pruitt would under the most conservative estimate likely "cost the lives of over 80 000 US residents per decade and lead to respiratory problems for many more than 1 million people."