Air Date: Week of January 30, 1998

Author and cancer survivor Sandra Steingraber's recently published book Living Downstream: An Ecologist Looks at Cancer and the Environment, is a journal of her personal search for the causes of cancer. The book places the blame for most cancers on the widespread use of certain synthetic chemicals, including pesticides and petroleum products and it's drawn her into a controversy with the prestigious New England Journal of Medicine which published a negative review, by a reviewer with a now admitted conflict of interest. She has also drawn praise from cancer activists for her focus on the human rights aspect of the disease. Steve Curwood speaks with Ms. Steingraber.

Transcript

CURWOOD: It's Living on Earth. I'm Steve Curwood. Sandra Steingraber battled cancer as a college student. She went on to write a book of poetry and to earn a doctorate in plant science. She recently published Living Downstream: An Ecologist Looks at Cancer and the Environment: a journal of her personal search for the causes of cancer. The book places the blame for most cancers on the widespread use of certain synthetic chemicals, including pesticides and petroleum products, and it's drawn a strong response. The prestigious New England Journal of Medicine published a negative review, saying that she failed to prove her case.
But later the Journal admitted it was a conflict of interest for the medical director of the chemical giant W.R. Grace to write the review.
Dr. Steingraber has also drawn praise from cancer activists for her focus on the human rights aspect of the disease. I recently spoke with her and asked her to start our discussion by reading a passage from her book.

STEINGRABER: 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'll just leave it at that. But if I am up for blank stares, I'll add, "I'm 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. To quote, "Deaths of adoptive parents from cancer before the age of 50 increased the rate of mortality from cancer 5-fold among the adoptees. Deaths of biological parents from cancer had no detectable effect on the rate of mortality from cancer among the adoptees."

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 than they are plates used in a busy diner. Cracks, chips, and scrapes accumulate. Accidents happen.

CURWOOD: Sandra Steingraber, your book leads us on, well, sort of a journey through your childhood in Illinois and your life as an adult, the struggle with cancer. The death from cancer of your friend Jeannie. It teaches is about cancer registries, air pollution, and epidemiology, those sorts of things. And then you conclude that we're in the midst of a cancer epidemic caused by synthetic chemicals. Can you tell me a little bit why you came to this conclusion?

STEINGRABER: Because I was diagnosed with cancer at such a young age, and because that cancer was considered one of the classic environmental cancers, namely bladder cancer, I used my own life experience to begin a search as a biologist for the environmental root causes of the disease.
And I spent 3 years looking at the data, ranging from studies of cancer in wildlife, rising rates of cancer among various communities, as well as the actual genetic data in which scientists can actually see which carcinogens modify which genes, placing cells on the pathway to tumor formation. The National Cancer Institute publishes maps in which mortality rates of different cancers are displayed in graph form, and it's clear that certain kinds of cancers tend to cluster around heavily industrialized areas. So for example, in the United States, you would light up in red the Eastern seaboard from Maine down to about Washington, DC, for cancers like colon cancer, breast cancer, and bladder cancer, as well as the Great Lakes Basin, which are also high in these cancers. And these 2 regions of course represent the most industrialized areas of our country. By contrast, other synthetic chemicals are used more in agriculture than they are in industry. So if you're interested, for example, in non-Hodgkins lymphoma and you look at the map of that cancer, you would light up in red the Midwestern and Great Plains states, which is where pesticide use is most intense in agriculture. Now, I don't argue that these correlations alone constitute absolute proof. But what I do argue is that they give us grounds for further inquiry. And when you look further and deeper, the evidence starts getting stronger and stronger.

CURWOOD: Every day we hear about yet another gene that makes people more susceptible to cancer, somebody. I mean, is it fair to blame cancer on chemicals?

STEINGRABER: Well, our genes do not work in isolation. They work in intimate contact with things streaming in from the larger environmental world. So all cancer is genetic, insofar that a gene has to go awry before a cell becomes a tumor. The question is, how does the gene go awry? And we believe that the inheritance of defective genes plays a role in a very tiny percent of cancers. Five to maybe at most 10% of all cancers. Which means that the majority of us, 90 to 95% percent of us, are born with a perfectly healthy set of genes to which something bad happens some time during our lives. So what I wanted to do was focus on that process for the majority of us. What goes wrong? What intervenes with a gene at various points in our life? Is it contact with carcinogens like on drycleaning fluids and our drinking water? That was what I discovered when I went back to my own home town as a kind of environmental detective. Is it exposure to pesticide residues on food?
Is it formaldehyde coming off of things like synthetic chemicals in carpeting in our homes? Each one of those exposures, however trace and tiny they are and seemingly insignificant, they're like the straws on the camel's back. You can't quantify our answer, which is the straw that broke the camel's back? But they're all contributing and the damage is cumulative. So we need to really be looking at the whole changing kaleidoscope of chemical exposures that we experience, without our consent very often, from prenatal life up to old age.

CURWOOD: Sandra Steingraber, you recommend in your book Living Downstream, that the public and regulators should be more skeptical about synthetic chemicals. And you suggest that regulators adopt some new principles to protect us from chemical risks, including what you called cautionary principle: that indication of harm, not proof of harm, should be the trigger for action. And also the reverse onus principle: that chemicals should be proven safe before they can be used, rather than letting them go into commerce until proven harmful. Now, this certainly seems to make sense, but wouldn't this be very difficult, almost impossible to do in practice? I mean, we'd pretty much have to stop using most of the products that have come out of the synthetic chemical plants in this half of the century. I'm thinking of plastics, pesticides, petrochemical fuels, the list goes on.

STEINGRABER: The beauty of the precautionary principle actually is its practicality. If we don't know if something causes harm, then it's morally wrong to expose us, to use people as living test tubes, and too often chemicals are rushed onto marketplace without any advance testing of how they might interfere with our hormones, or our enzyme systems, or interact with our DNA in some sort of harmful way. Happily, everywhere I looked when I found some kind of process, whether it's an industrial one or an agricultural one, depended on the use of some cancer-causing substance, I also found somebody somewhere who had figured out a way to do it differently. And herein, I think, lies our hope.

CURWOOD: One things statistics would tell us is that just about everybody listening to us talk right now has lost a person close to them to the disease of cancer. And listening to this conversation, they might say, "Well, what can we do?" What do you suggest that they might do?

STEINGRABER: Well, I hope Living Downstream is an important blueprint for that. Because I do think of this as a very hopeful book and a very hopeful project. But this is not a matter of going out, for example, and buying one product over another. I think maybe the only exception to that might be organic agriculture. What I think needs to be done is to recognize that we're not going to be able to shop our way out of this crisis, and my best example, I think, of this is drinking water. A lot of people feel that if they drink bottled water or filtered water, they're going to save themselves from contaminants in drinking water, and therefore they can make a lifestyle switch to save them from an environmental exposure. But it turns out most of our exposure to contaminants in drinking water doesn't even come from drinking. It comes from bathing and showering. So that a half an hour, ten-minute shower, or a half an hour bath, is the exposure equivalent of drinking a half gallon of tap water. So, what is the answer going to be? I think it's going to be getting together with people in your community, finding out what the threats to your watershed are, and then taking action as a community to protect that water source, recognizing that this is a sacred, important resource that should not be contaminated.

CURWOOD: Sandra Steingraber, at the end of your book, you say that we should adopt a human rights stance with respect to the relationship between chemical contamination and the environment. What do you mean by that?

STEINGRABER: Well, I mean that cancer-causing chemicals in the environment eventually seep into our own bodies without our consent. And this is a phenomenon a lot of us are talking about as toxic trespass.
Not only have we not consented to that, nobody knows the accumulated harm of all of these chemicals inside of our bodies. Moreover, someone is making a profit off of doing this while we're asked, without our consent, to bear the risks. My hope is that the Environmental Health movement, like the Civil Rights movement, like the Suffrage movement, like the Labor movement, will be a new manifestation of people seizing their rights to be safe, their rights to be alive, and their right to live in an environment free of anxiety about exposures that others have subjected them to.

CURWOOD: Well, thanks so much for taking this time with us.

STEINGRABER: Well, you're welcome. It was my pleasure.

CURWOOD: Sandra Steingraber is author of Living Downstream. Ms. Magazine named her as one of 10 Women of the Year for 1997.