BOOK REVIEW/Bill Knight
Living and dying through chemistry
LIVING DOWNSTREAM: An Ecologist Looks At Cancer and The Environment
By Sandra Steingraber
Addison-Wesley, 357 pp., $24
Breast Cancer Awareness Month was launched a decade ago by the pharmaceutical
company Zeneca, which makes a common breast-cancer drug, tamoxifen. Working
with Monsanto, Zeneca also helps make a pesticide. Pesticides, herbicides
and other agricultural, industrial, commercial and residential chemicals
should be blamed for a troubling rise in cancer, argues Living Downstream:
An Ecologist Looks At Cancer and The Environment, by Sandra Steingraber.
People are advised to watch what they eat, exercise, and get regular checkups.
Little has been said about environmental links to cancer -- until now.
Many cancers are caused by chemicals used widely since the 1950s, according
to author Steingraber. A poet, a cancer survivor and a biologist, Steingraber
has written a book that resonates with eloquence, passion and reason.
It's also timely and revealing.
After all, many toxins are taken for granted. Toxins aren't just poisonous
or hazardous materials released from smokestacks or discharge pipes as byproducts
in manufacturing. Toxins are weed killers and insecticides routinely applied
in farming.
For instance, the familiar weed killer atrazine is found at dangerously
high levels in tap water in 245 Midwestern communities, affecting 4.3 million
Americans, according to the Environmental Working Group, a not-for-profit
organization based in Washington. Most of the contaminated towns are in
Steingraber's home state of Illinois, where 77 communities have tap water
that meets government standards -- 3 parts per billion -- but exceeds a
new recommended level of 0.15 parts per billion.
"No individual should face cancer risks from their water," commented
EWG's Brian Cohen. "The standards on safe drinking water need to be
tight."
In fact, he says, they'll be tightened when the U.S. Environmental Protection
Agency implements the Food Quality Protection Act -- with some standards
20 times greater than current levels.
"The law used to weigh public health against profits. There was no
set standard," Cohen said. "This is a dramatic improvement."
Nevertheless, Steingraber notes, widespread use of carcinogens continues.
"I was shocked to learn that atrazine is used in the majority of Illinois
cornfields," said Steingraber, a native of central Illinois. "It's
in almost all rivers and streams in the Midwest."
Cancer's rising incidence rate tends to occur not just at a certain time,
then, but certain places. For Steingraber, the place was her home area of
central Illinois, the time was during her childhood in the '50s and '60s,
and the disease was bladder cancer.
Steingraber grew up in Pekin, where industrial wastes released into the
environment mixed with farm chemicals and landfill dumps. Emissions from
incinerators, exhaust from vehicles, and pollution from distilleries, chemical
plants, a coal-fired power plant, a foundry and a grain processor all combined
in a suspect soup of soil, water and air.
"Rural central Illinois still amazes me," Steingraber writes.
"Buried under the initial appearance of ordinariness ... the unexceptional
nature of central Illinois ... are great mysteries. It receives my scientific
attention not because its history is so unusual, but because it is so typical."
Stengraber -- who this past fall appeared on the HBO special Rachel's
Daughters: Searching for The Causes of Breast Cancer -- believes poisons
in the environment of her youth contributed to her cancer at age 20.
The area still features farms and factories, lone figures on tractors, and
groups of workers on assembly lines. Her home was "in the transitional
zone between the two," she writes.
The culture also is between extremes, caught in a vise between economic
and environmental demands. There were profound changes in the country's
agricultural and industrial bases after World War II -- transformations
that had many unforeseen consequences for the environment and the people
who live here.
As a poet, the young woman still called "Kath-urn's girl" by locals
who recall her family and her mother, Kathryn, describes her family's 160-acre
homeplace: "the open earth lies like a black sail from horizon to horizon."
As a scientist -- a University of Michigan biologist -- she uses the appropriate
method of inquiry.
"Because it is my home, I am driven to pursue the question of the past
and ongoing contamination of Illinois and its possible link to the increasing
frequency of cancer there," Steingraber writes. "Studying cancer
time trends is like ascending a glacial moraine in central Illinois. The
rise is gradual, steady and real.
"All types combined, the incidence of cancer in the United States rose
49.3 percent between 1950 and 1991," she writes. "This is the
longest reliable view we have available. If lung cancer is excluded, overall
incidence still rose by 35 percent. Or, to express these figures in another
way: at mid-century a cancer diagnosis was the expected fate of about 25
percent of Americans -- a ratio [Silent Spring author Rachel] Carson
found so shocking that it inspired the title of one of her chapters -- while
today, about 40 percent of us (38.3 percent of women and 48.2 percent of
men) will contract the disease sometime within our lifespans. Cancer is
now the second leading cause of death overall, and the leading cause of
death among Americans aged 35 to 64."
Indeed, that seems much more than coincidence. And Steingraber herein follows
"lines of evidence" linking the increase of cancer and increased
contamination of air, water and soil. Genetic connections exist, according
to the National Cancer Institute, but they make up a very small percentage
(and in Steingraber's own family, several relatives shared common lifestyles
and geographies, but not blood ties). And the context of environmental impact
can be appreciated by considering a number. If just 2 percent of cancer
deaths can be tied to environmental factors, she argues, that's still some
11,000 fatalities a year -- more than the number of female victims of hereditary
breast cancer, more than the number of nonsmokers who die from the effects
of second-hand smoke, more even than the number of children killed by guns.
"It is the annual equivalent of wiping out a small city," she
notes. "It is 30 funerals a day."
Cancer-causing chemical contamination isn't merely industrial or agricultural
use, of course. Household toxins, lawn and garden chemicals, and commercial
applications such as dry cleaning all pose harmful health risks, too.
But it's less "risk" than "real" for Steingraber, who
says she believes that her disease was caused by common contaminants.
"I can say I got cancer, and the chemicals that cause cancer are in
the drinking water where I grew up," says Steingraber, who sees her
book as a work filled with "a sense of optimism and a sense of outrage."
Regulations are surprisingly recent, she notes.
"Maximum contaminant levels for most organic chemicals were established
only with the amendments of 1986, and maximum contaminant levels for many
common insecticides and herbicides were promulgated as recently as 1991,"
she writes.
Illinois was a leader in compliance and monitoring of farm chemicals in
drinking water, but it started just six years ago. Steingraber's hometown
of Pekin just two years ago passed a local ordinance protecting its groundwater
-- restricting or prohibiting hazardous materials near seven wellheads from
which the city draws drinking water. However, it's unclear whether the local
law will help protect the huge aquifer, deep beneath the water table, from
toxic runoff from fields and city sewers, or from contaminants falling to
earth in precipitation
The scientist/writer concludes with a calm call to action to make changes
individually and socially before the consequences of overuse of chemicals
and environmental damage worsen further.
It's time to determine what other ways there are, and to take them, she
concludes, recommending that citizens acquire environmental data on their
own, from state or federal agencies, or advocacy groups such as the Center
for Health, Environmental and Justice in Falls Church, Va., the Environmental
Research Foundation in Annapolis, Md., the John Snow Institute's Center
for Environmental Health Studies in Boston, the Right-To-Know Network at
the Unison Institute in Washington, and the Working Group on Community Right-To-Know
in Washington.
Getting information isn't the ending, she warns readers, but the beginning:
"From the right to know and the duty to inquire flows the obligation
to act.
"People are dying because some other people are making money,"
she says. "We don't have to live with this."
Bill Knight is a journalist and radio commentator who teaches at Western
Illinois University. His books include R.F.D. Notebook and The
Eye of The Reporter.
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