=============Electronic Edition========================
.
    .
.           RACHEL'S ENVIRONMENT & HEALTH WEEKLY #565
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.                   ---September 25, 1997---
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.                          HEADLINES:
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.                       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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  ***************************************************
  From new transmitters came the old stupidities.
  Wisdom was passed on from mouth to mouth.
            -Bertolt Brecht
  ***************************************************

Dennis Raphael, Ph.D.
Associate Professor and Acting Director,
Masters of Health Science Program in Health Promotion
Department of Public Health Sciences
Graduate Department of Community Health
University of Toronto
McMurrich Building, Room 101
Toronto, Ontario, CANADA M5S 1A8