Subject:  #565: Living Downstream

=======================Electronic Edition========================
.                                                               .
.                   ---September 25, 1997---                    .
.                          HEADLINES:                           .
.                       LIVING DOWNSTREAM                       .
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LIVING DOWNSTREAM

In 1964, two senior scientists at the National Cancer Institute,
Wilhelm Hueper and W.C. Conway, wrote, "Cancers of all types and
all causes display even under already existing conditions, all
the characteristics of an epidemic in slow motion."  The
unfolding epidemic was being fueled, they said in 1964, by
"increasing contamination of the human environment with chemical
and physical carcinogens and with chemicals supporting and
potentiating their action."[1,pg.43]

Their words were met with silence.

The World Health Organization (WHO) maintains and analyzes cancer
mortality (death) data from 70 countries.  WHO research shows
that industrialized countries have far more cancers than
countries with little industry (after adjusting for age and
population size). One-half of all the world's cancers occur among
people living in industrialized countries, even though such
people are only one-fifth of the world's population.[1,pg.59]
>From these data, WHO has concluded that at least 80 percent of
all cancer is attributable to environmental influences.[1,pg.60]

In the U.S., the cancer epidemic described by Hueper and Conway
in 1964 has been progressing steadily.  In 1950, 25 percent of
adults in the U.S. could expect to get cancer during their
lifetimes; today about 40 percent of us (38.3 percent of women,
48.2 percent of men) can expect to get cancer.  Omitting lung
cancer from the statistics, the incidence (occurrence) of cancer
increased 35% in the U.S. between 1950 and 1991. If we include
lung cancers, then cancer incidence increased 49.3% between 1950
and 1991.[1,pg.40]

Viewing the same phenomenon from another vantage point: white
women born in the U.S. in the 1940s have experienced 30 percent
more non-smoking-related cancers than did women of their
grandmothers' generation (women born between 1888 and 1897).
Among men, the differences are even sharper.  White men born in
the 1940s have more than twice as much non-tobacco-related cancer
as their grandfathers did at the same age.[1,pg.45]  (Historic
data are missing for non-whites.)

In the U.S. today, in the age group 35 to 64, cancer is the
number one killer.  Because of this fact alone, one might expect
that the nation would welcome a book by a qualified scientist
examining all the lines of evidence linking cancer to chemical
contamination of the environment AND OFFERING SOLUTIONS.

But one would be disappointed in that expectation.  Sandra
Steingraber's new book, LIVING DOWNSTREAM --AN ECOLOGIST LOOKS AT
CANCER AND THE ENVIRONMENT, has been greeted with nearly total
silence. Appearing under the imprint of an important house,
Addison-Wesley, the book is a major publishing event --hard back,
270 pages, including 77 pages of references in small type at the
back.  At age 38, the author is an accomplished researcher,
writer and teacher with a Ph.D. in biology from University of
Michigan who has obviously spent years preparing the manuscript,
visiting special libraries, interviewing cancer researchers, and
applying her scientific training to the diverse evidence linking
cancer to environmental contamination.

Furthermore, the book is beautifully written.  Steingraber (who
has previously published a volume of poetry, POST-DIAGNOSIS) has
the rare gift of combining poignant, lyrical prose with
scientific exactitude and clarity.  She is among the rarest of
scientists --those who see the extraordinary among the ordinary
and who can write so well that her readers are transported
effortlessly through the complexities of an arcane topic like
cancer cell biology.  Indeed, Steingraber displays an
encyclopedic knowledge of cancer biology, yet she conveys it in
terms than anyone can grasp and appreciate.  Simultaneously, she
is careful to note the limitations of scientific knowledge.  She
never oversteps the bounds of what is really known, what is
suspected but unproven, and what is merely informed speculation.

By any measure, LIVING DOWNSTREAM is an extraordinary work
--extraordinarily easy (even pleasurable) to read,
extraordinarily thoughtful and evenhanded (even gentle, generous
and forgiving) in its treatment of a politically charged topic,
and extraordinarily informative, thought-provoking, and useful.

Yet the book has been ignored.  It appeared in May of this year,
but a search this week of several hundred of the nation's
newspapers (via the online Dow Jones News Service) reveals that
Steingraber's book has been reviewed in only four places --in the
Portland OREGONIAN, the CHICAGO TRIBUNE, USA TODAY, and deep
within a "new science books" column in the WASHINGTON POST.  In
essence, the existence of this book has been blacked out by most
of the nation's press.  Like Wilhelm Hueper before her, Sandra
Steingraber has (so far) been met with a stony silence.

The book is simultaneously a detective story --Steingraber
investigating Tazewell County, Illinois, where she grew up,
looking for clues to the rare bladder cancer that she herself
contracted at age 20 --and a thorough scientific treatise
(thankfully, one that is easy to read) on the relationship of
cancer-causing chemicals to human and animal health.

Steingraber examines the following lines of evidence indicating
that certain chemicals (and radiation) can cause cancer in living
things:

** cancer in workers exposed to chemicals;

** studies of non-worker human populations exposed to chemicals
out of ignorance or by accident or by misguided public policy
(for example studies of humans who contract cancers from exposure
to chlorinated drinking water);

** cancer in immigrants who soon exhibit the cancer rates of
their adopted countries, rather than the cancer rates of the
place where they were born;

** maps showing more cancers in urban areas than in rural;

** maps showing more cancers in rural counties with heavy
pesticide use vs. rural counties with low pesticide use;

** individual studies revealing cancer clusters near chemical
factories and near particularly-polluted rivers, valleys, and
dumps;

** rising rates of childhood cancer. The lifestyles of children
have not changed much in 50 years; they do not smoke, drink
alcohol, or hold stressful jobs, yet childhood cancers are
steadily rising;

** cancer in fish and shellfish living in polluted bodies of
water.  In North America there are now liver tumor epizootics
(the wildlife equivalent of epidemics) in 16 species of fish in
at least 25 different fresh-and salt-water locations, each of
which is chemically polluted. In contrast, liver cancer among
members of the same species who inhabit nonpolluted waters is
virtually nonexistent.

** many kinds of cancer that can be induced in laboratory animals
by exposing them to certain chemicals;

** cellular studies indicating that certain chemicals can cause
cell growth and division;

** studies showing that chemicals can damage the immune system
and the endocrine system, promoting cancers.

Yet, despite the abundance of evidence, science can never prove
beyond all doubt that the chemicalization of the human economy is
responsible for a substantial fraction of the cancer epidemic we
are experiencing. As Steingraber puts it, "Like the assembling of
a prehistoric animal's skeleton, this careful piecing together of
evidence can never furnish final or absolute answers. There will
always be a few missing parts..."[1,pg.29]  She then goes on to
explain in detail why science can never provide proof positive
when confronted by a problem as complex as environment and health.

However, the limitations of science do not render us helpless. In
her introduction, Steingraber notes that, as she was writing the
last pieces of the book in late 1996, the news broke that
scientists had finally found the agent in cigarette smoke that
causes lung cancer. Yet, she points out, she herself grew up
protected from cigarette smoke by her parents and teachers, and
by public policies that kept cigarette smoke out of restaurants,
hospitals and many other public spaces --actions taken and public
policies created by people "who had the courage to act on partial
evidence."  The courage to act on partial evidence.  This is a
key concept.  It underlies the principle of precautionary action.

Yet many scientists and policy makers exhibit a hushed complicity
tantamount to cowardice, afraid to speak out about what they
themselves believe to be true: that cancer is caused by exposure
to carcinogens and that enormous suffering could be avoided if we
would reduce our exposures to cancer-causing chemicals in air,
water, and food.

Steingraber says again and again cancer cells are created, not
born. Current science tells us that, at most, 5 to 10 percent of
cancer is caused by defective inherited genes.  This means that
90 to 95 percent of cancer is created by encounters with
carcinogens during a person's lifetime.  Yet the modern trend is
to focus on the genetic causes of cancer.  This deflects
attention away from the preventable causes of cancer.  As
Steingraber says, "Shining the spotlight on inheritance focuses
us on the one piece of the puzzle we can do absolutely nothing
about."[1,pg.260]

She personalizes this as follows:  "I had bladder cancer as a
young adult.  If I tell people this fact, they usually shake
their heads.  If I go on to mention that cancer runs in my
family, they usually start to nod.  SHE IS FROM ONE OF THOSE
CANCER FAMILIES, I can almost hear them thinking.  Sometimes I
just leave it at that.  But, if I am up for blank stares, I add
that I am adopted and go on to describe a study of cancer among
adoptees that found correlations within their adoptive families
but not within their biological ones....  At this point, most
people become very quiet.

"These silences remind me how unfamiliar many of us are with the
notion that families share environments as well as chromosomes or
with the concept that our genes work in communion with substances
streaming in from the larger, ecological world.  What runs in
families does not necessarily run in blood.  And our genes are
less an inherited set of teacups enclosed in a cellular china
cabinet that they are plates used in a busy diner.  Cracks,
chips, and scrapes accumulate.  Accidents happen."[1,pg.251]

Steingraber says we will have to adopt a new way of thinking
about chemicals. "This requires a human rights approach," she
says.  "Such an approach recognizes that the current system of
regulating the use, release, and disposal of known and suspected
carcinogens --rather than preventing their generation in the
first place --is intolerable." Such a practice shows "reckless
disregard for human life."[1,pg.268]

And: "When carcinogens are deliberately or accidentally
introduced into the environment, some number of vulnerable
persons are consigned to death.  The impossibility of tabulating
an exact body count does not alter this fact."[1,pg.268]

We, being more blunt than Sandra Steingraber, draw from this that
murder is murder even if the victim is anonymous.  And
scientists, risk assessors, and regulators who grease the wheels
for such a system --even if only by their complicit silence
--have blood on their hands. They are the enablers of a system
that profoundly violates the human rights of the thousands (or
millions) whom it victimizes.
                                                --Peter Montague
                (National Writers Union, UAW Local 1981/AFL-CIO)
===============
[1] Sandra Steingraber, LIVING DOWNSTREAM; AN ECOLOGIST LOOKS AT
CANCER AND THE ENVIRONMENT (New York: Addison-Wesley, 1997).

Descriptor terms:  cancer; bladder cancer; sandra steingraber;
chemicals & health; book reviews; living downstream; human
rights; wilfred hueper; world health organization; carcinogens;
aromatic amines; perchloroethylene; drinking water;

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