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#565 - Living Downstream, 24-Sep-1997

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;