Summer Reading - June 2000
By Carolyn Raffensperger
In the northern latitudes we are celebrating summer - warm weather, vacations, harvest. But summer is also an exceptionally good time to monitor environmental conditions. In North Dakota I pay attention to how much more herbicide damage we have because of aerial pesticide spraying on herbicide-resistant, genetically engineered crops. I ask frogs to show a little leg because I want assurance that they are whole and in one piece. (I haven't seen one frog this year around all our wetlands.) And of course the local weather is always an indicator of global conditions. El Nino or global climate change?
Local observations of people who know their land, climate, and fellow creatures add up to useful insights for science. The best science is pattern recognition or connecting the dots in a meaningful way.
We offer this issue of the Networker as something you can tuck into your beach bag and read at your leisure. It is a potpourri of ideas and articles that lay out some of the patterns other people are seeing: toxic chemicals and learning disabilities, religion and science, alternatives to damaging practices, and the relationships of behavior, radon, and smoking. We hope that these articles not only lay out patterns of problems but offer creative and innovative solutions. Enjoy!
By Michael Lee, Ph.D.
Radon: a radioactive gas produced by the decay of uranium, found in most soils and capable of collecting inside buildings. The second leading cause of lung cancer after smoking. Interacts synergistically with tobacco smoke.
The Alarm Sounds
In December 1984 Stanley Watras, a nuclear engineer at the Pennsylvania Limerick nuclear power plant, set off the alarms as he passed through the radiation detection gates on the way home. This would not have been terribly unusual except for the fact that the nuclear materials had not yet arrived at the newly constructed plant. The search for this radioactive contamination
led to the Watras home, where radiation levels caused by environmental radon were found to be 700 times greater than that considered safe for human exposure. Residing indoors at the Watras home posed the same health risk as smoking 280 packs of cigarettes each day.
These events gave radon a human face in the media and soon, not only was the Watras home fixed, but EPA began a massive public education and research program in an effort to deal with radon risk.
The campaign was justified. Radon is probably the most dangerous pollutant on planet Earth. This is certainly true for the approximately twenty million smoking households in the United States, since radon interacts in a synergistic way with tobacco smoke inside dwellings. And yet, after 15 years of radon research and policy development, the public response has settled into
apathy and public health goals have not been met. It is time to determine if a very large boat indeed was missed in the attempt to treat radon merely as a force of nature, rather than in its behavioral, political, and sociological context.
Since the Watras home could be fixed, it seemed obvious that fixing homes (structural mitigation) would be the core of any campaign to reduce radon risk. The radon campaign stressed the following:
- Research on mitigation of radon in homes
- Encouraging the home testing of radon
- Certifying testing companies
- Educating and certifying individuals and companies to mitigate radon in homes
- Mapping geographical areas high in radon
- Developing public health educational materials
These projects, promoted by the EPA and state health departments, were logical and needed. And yet, it is clear now that the projects proceeded with a bias to home owners in the middle class and their families. Fixing structures for around $1,500 was not an option for most renters, and basic research on multi-family structures took a back seat to research on detached owner-occupied homes.
Soon new evidence was mounting of a dangerous interaction between radon and tobacco smoke, In addition to the work by the EPA, the National Academy of Sciences was collecting and evaluating radiation risk data, including radon, documented in a series of reports on the biological effects of ionizing radiation (BEIR). These reports show overwhelming evidence of synergy, that
is, the interaction of two substances producing a result that is greater than the two added together.
This interaction might range from sub-multiplicative to 18 fold in terms of added risk. Using the multiple of 10 fold as a conservative estimate, smoking in a home with average levels of radon (2 picocuries per liter) would produce the risk equivalent of over 1000 X-rays per year, far greater than either risk alone.
And yet smokers were not singled out for being at much greater risk than average, even when it was found that 43% of all the children in the United States reside in those 20% of homes where smoke is present. In sum, the radon programs of the past 15 years, while doing some good, have failed to address the greatest hazard.
Using Synergy: Our Approach
We started with the basic premise that because of the synergy between tobacco smoke and radon, every smoking household had a radon problem, even those here in Eugene, Oregon, which has precious little radon. The purpose of our study was to promote and measure risk-reducing behavior.
In order to reach everyone in a given geographical location we used the billing system of a local electrical utility to distribute "bill stuffers" offering a free radon kit to smoking households. The response was impressive. Nearly 1,200 of the estimated 2,400 smoking households in the utility district requested a free kit. Thus the project started, but did not end, with
Participants who requested a kit were randomized into three groups comparing written materials and phone counseling on the risks of smoking and radon. Participants were cooperative, with 91% providing three-month follow-up data, and 82.5% providing data at 12 months on their smoking habits and household
rules limiting smoking.
Outcome measures were quitting smoking, not smoking in the house, and establishing household rules against smoking indoors. Overall quit rates were modest, but about what would be expected in a low-intensity intervention - especially with participants lost to follow-up counted as smokers. About a quarter of households had indoor smoking bans at baseline, and the telephone
counseling led to a significant increase in such bans.
More important, the methodology itself added new information about the risks of smoking, presumably at a "teachable moment" for risk-reducing behavior.
Recognizing that smoking plus radon is a deadly combination, the CDC has called for the testing of 50% of all smoking households by the year 2000. At this writing there is no way this goal will be reached, since the testing of such households is still in the single-digit percentage. We have demonstrated how this goal might be reached, especially when the goal is just the
first step - testing. Our research has been funded for a second round and we are currently replicating the study while adding a video tape as another way of communicating the risk of radon and smoking.
In our latest study we have added a formal cost-benefit analysis, which will indicate how much risk reduction is achieved per dollar in the two approaches. We believe that concentrating on the approximately 20 million smoking households is not only sound from an environmental justice point of view, but will also achieve much improved levels of risk reduction per dollar.
Synergy Still Controversial
Synergy is an integral part of our methodology. A majority of scientists support the concept of a radon/tobacco smoke synergistic interaction that is more than additive; we used the conservative 10-fold estimate. Apart from the documentation of synergy between radon and tobacco smoke, however, synergy is largely ignored or virulently contested
Work in the laboratory of endocrinologist John McLachlan at Tulane University, reported by Steven Arnold and others (Science, 7 June 1996, p. 1489) found dramatic synergistic interaction between "hormonelike" chemicals in the environment. They reported that when two pesticides were tested together, their estrogenic activity shot up 160 to 1600 fold. They also found five-fold
synergy with polychlorinated biphenyls (PCBs), which would have
profound environmental implications.
The reaction to the work at Tulane was swift and aggressive. Few papers provoke the kind of response that followed in the scientific community. New studies were promptly done that failed to replicate the synergistic results found by McLachlan. In an unusual move, Dr. McLachan withdrew the synergy paper. From press reports one might conclude that synergy was proven not to
exist. However, in the retraction letter that appeared in the July 25th issue of Science (1996) it is clear that the basic idea of synergy was not withdrawn, but rather the pronounced levels initially reported.
If synergy is indeed common between chemicals and other substances introduced into the environment, the EPA has a very big job on its hands. If substances cannot be evaluated completely in isolation, their interaction requires new methodologies considering the interactions and their effects on the human
body. We ignore and belittle the concept at our peril.
Michael E. Lee, Ph.D.
Radon and Smoking Project
Oregon Research Institute
See Also: Lee, M.E., Lichtenstein, E., Andrews, J.A., Glasgow, R.E., & Hampson, S.E., (1999). Radon Smoking Synergy: A Population Based Behavioral Risk Reduction Approach. Preventive Medicine 29, 222 - 227.
By Dorothy Anderson
On May 10, 2000, the General Conference of the United Methodist Church voted 679 - 11 to pass a resolution explaining and affirming the precautionary principle (see below).
The General Conference, which meets every four years, consists of about a thousand elected delegates from United Methodist conferences around the world. This year the delegates considered over 2,000 resolutions and had, for instance, the option to "commend Dr. Laura Schlesinger " (No), "begin discussion of including evolution and creationism in school textbooks" (also No), and ban handguns and human cloning (Yes).
The process is highly democratic. Any United Methodist can submit a resolution by getting it to the proper person at the proper time. If passed, it becomes part of "The Book of Resolutions," which states the position of the church on current social issues and concerns.
United Methodists are to find guidance in the Wesleyan Quadrilareral- Scripture, Tradition, Experience, and Reason." And so, if resolutions stand the test of time, they become part of the guiding ethic for the actions of church members - in theory, at least. The fact is that most church members are blissfully unaware of the existence of this book or willfully ignore its
precepts, for example, by using styrofoam dishes at potlucks.
Nevertheless, having the precautionary principle on the books is helpful in engaging the church in environmental advocacy on the local, national, and international levels. A pronouncement by an entire church body carries some weight in political decision making.
I decided to seek the blessing of the church on the precautionary principle because I was disturbed by the chronic roadblock to action posed by the lack of scientific certainty on many issues. If a scientist anywhere disputed, say, global warming, that was the end of the discussion. Nothing could be done until all scientists agreed. The notion that in these times we must consider who is paying the scientist, or that there are vast PR campaigns to obfuscate the truth, is received dubiously. Any discussion of actual science causes instant glazing of eyes.
And so, while churches endorse the idea that "as God's people we are called to stewardship of the earth and all that dwells therein," they are highly timid about taking more specific stands on issues of environmental justice and safety.
The purpose of passing this resolution is to enable boldness on issues that are relatively clear to an educated onlooker. Staff at the national office of Church and Society can use it in educational materials and as support for taking stands on issues. Individuals and grassroots organizations can use this resolution for backing in a fight against siting a toxic facility or in letters to their elected officials.
The process of passing the resolution on the precautionary principle exposed the delegates and onlookers at the United Methodist General Conference to the idea. The act of affirming the principle gives all of these leaders ownership of the concept and a responsibility to take appropriate action when life calls upon them to do so.
Working through religious organizations may not be as vital to those who function outside the Bible Belt. Here it is the most efficient way to get the word out. I would encourage those who have access to other religious systems to give it a try.
In many churches there are increasing numbers of socially and theologically conservative folk, but many of those people still see themselves as environmentalists. It can actually be an issue that causes people on opposing sides of controversial church battles to work together.
Dorothy Anderson is a child psychiatrist in private practice in Mason City, IL. (pop. 2500). She serves on the national boards of Physicians for Social Responsibility and Methodist Federation for Social Action.
Phone: (217) 482-3014
As God's people we are called to stewardship of the earth and all that dwells therein. At this point in human history, the human race is experiencing warning signs that our bodies and the natural environment have limits to their abilities to absorb and overcome the harm from some of our actions, technologies and substances. These warning signs include the dying off of plant and animal species, the depletion of stratospheric ozone, global climate instability and increased rates of some learning disabilities, reproductive disorders, cancers, respiratory diseases including asthma, and other environmentally related illnesses.
In addition to the issue of pollution, the earth is experiencing environmental problems such as global climate instability, the loss of biodiversity, and the destruction of marine fisheries, which may threaten food supplies and lead to disastrous human health consequences.
There is continuing controversy in the promotion of world trade regarding the appropriate level of caution and protection of the environment. Where the preponderance of evidence would indicate that an activity will be harmful to the earth's environment, producers of pollution have insisted that there be "scientific certainty" on each point in question before caution is
exercised. This policy results in very substantial harm occurring to the earth and its creatures in order to prove that an activity is dangerous.
Current environmental regulations are aimed primarily at controlling pollution rather than taking the preventive approach of limiting the use, production or release of toxic materials in the first place. Under the current system, enterprises, projects, technologies and substances are in effect "innocent until proved guilty," and the vast majority of chemicals in production
have not been adequately tested for their effects on humans and ecosystems.
Producers of pollution have repeatedly used their influence to delay preventive action, arguing that the immediate expense of redesign to achieve pollution prevention is unwarranted in the face of any uncertainty about eventual harmful health effects.
The Precautionary Principle is considered to be an emerging general principle of international environmental law. The United States signed and ratified the Rio Declaration on Environment and Development which states: "In order to protect the environment, the precautionary approach shall be widely applied by States according to their capabilities. Where there are threats of
serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective to prevent environmental degradation." (Rio Declaration on Environment and Development, June 14, 1992, 31 ILM 874).
Likewise the International Joint Commission in 1994 stated that" the burden of proof concerning the safety of chemicals should lie with the proponent for the manufacture, import or use of at least substances new to commerce in Canada and the United States, rather than with society as a whole to provide absolute proof of adverse impacts...The onus should be on the producers
and users of any suspected toxic substance to prove that it is, in fact, both 'safe' and necessary, even if it is already in commerce." (International Joint Commission, Seventh Biennial Report Under the Great Lakes Water Quality Agreement of 1978 to the Governments of the United States and Canada, 1994)
Likewise the Wingspread Statement of January 1998, formulated by prominent members of the environmental community, states: "When an activity raises threats of harm to human health or the environment, precautionary measures should be taken even if some cause and effect relationships are not fully established. In this context the proponent of an activity rather than the public should bear the burden of proof. The process of applying the Precautionary Principle must be open, informed, and democratic and must involve potentially affected parties. The process must include a comprehensive, systematic examination of the full range of alternatives, including no action."
We urge all United Methodists in their daily lives and official capacities to hold society to this higher standard of care for God's creation; that where the preponderance of evidence indicates the probability of harm from some action, even in the absence of full scientific certainty, an alternative path must be found.
In this context we advocate for significant increases in efforts toward pollution prevention, for identifying goals for reducing exposure to toxic chemicals, for incentives to replace known toxic chemicals with the least toxic alternatives, and we support the practice of organic farming methods in order to reduce the use of toxic chemicals in agriculture.
We encourage government at all levels to promote and abide by the Precautionary Principle in order to protect human health and the environment.
We urge the United States to honor the Precautionary Principle during the negotiations of international agreements and to work toward the establishment of the Precautionary Principle as a guiding principle of international law.
Books Under Review
Making Better Environmental Decisions
by Mary O'Brien
2000, Environmental Research Foundation/MIT Press, 286 pages
In Harm's Way: Toxic Threats to Child Development
by Ted Schettler, Jill Stein, Fay Reich, Maria Valenti
2000, Greater Boston Physicians for Social Responsibility, 137 pages
The subjects of these two books may not seem like beach reading. In Harm's Way is about how toxic chemicals are playing havoc with children's nervous systems. Making Better Environmental Decisions is about risk assessment and what should replace it. But both books are fast, easy reads. You may finish them on the plane before you get to your vacation spot. And then you
may lie awake thinking about them.
Making Better Environmental Decisions by Mary O'Brien
"Speak plainly," Mary O'Brien advises at the very end of Making Better Environmental Decisions. No one speaks more plainly than O'Brien herself in this cogent, thorough debunking of the premises and practice of risk assessment.
Risk assessment has been under attack for some time, and O'Brien's criticisms are not unfamiliar: risk assessment asks the wrong questions; it quantifies harms but cannot prove safety; its focus is too narrow, its science, faulty; it is slow and expensive, a delaying tactic, easily manipulated by the powers that be; it lends a false aura of scientific authority to politically and economically motivated decisions; and so on.
O'Brien lays all these out and more, fleshing them out fully with examples, case studies, and arguments. This is a marvelous primer on why risk assessment as we know it is a very bad idea. The lessons are easy to grasp, with chapter titles like "When Scientists Shut Their Eyes: Pretending That the Safety of Hazardous Activities Can Be Estimated," and "Who Loves, Uses, or Cooperates with Risk Assessment?"
O'Brien is not unkind to risk-assessment practitioners who, she acknowledges, might feel "criticized or dismissed by the ideas in this book." She invites them to "contemplate whether the risk-assessment frame is large enough for you. Are you being allowed the room to learn about and calculate the pros and cons of all reasonable alternatives to the activity whose risks you
are calculating?" "Alternatives assessment" is the alternative O'Brien poses to risk assessment - simply put, calculating pros and cons of all reasonable alternatives to risky activities and products, and choosing accordingly. This sensible idea has been put forth elsewhere in variations such as "comparative assessment," "substitution principle," and "technology options analysis."
One of O'Brien's most important contributions is demonstrating how it can be implemented. She offers a convincing array of examples and arenas in which we can make better environmental decisions by asking better, more basic questions: Do we need this technology? Why accept harm when safer alternatives are available?
"We Already Know How to Do Alternatives Assessment," announces the title of one chapter in which O'Brien cites the National Environmental Policy Act, the Endangered Species Act, and Consumer Reports magazine, among others. "Our society must take a 'Consumer Reports approach' to decisions that will affect the environment," she declares.
And why not.
O'Brien addresses that question, too, and some might consider her responses to "Barriers to Alternatives Assessment" a bit blithe. She states Barrier 3 this way: "Sometimes the only reasonable alternatives are more 'difficult' to use or more expensive to establish." O'Brien puts "difficult" in quotes because she doesn't believe in that word. Her answer to this objection is that society must establish a different bottom line, requiring corporations to account for the full costs, environmental and otherwise, of their activities.
Okay. Next project?
She does acknowledge that bucking the status quo isn't easy, but her book could have been subtitled: "Where There's a Will, There's a Way." She offers plenty of handles on the way to make better environmental decisions and delivers a good boost to the will, as well.
In Harm's Way: Toxic Threats to Child Development
In Harm's Way: Toxic Threats to Child Development is more grim, but it has pictures.
Its most shocking message is, in fact, carried on its cover: two sets of drawings by Mexican Yaqui Indian children, one group heavily exposed to pesticides, the other group relatively unexposed. The drawings of the unexposed group are smiling stick figures, clearly recognizable as human beings. The other drawings are indecipherable scrawls.
Bits of this graphic punctuate page after page describing toxic chemicals and substances, on the one hand, and developmental disorders on the other, in this thorough review of what is known about how the former may influence the latter. Ted Schettler and his team of co-authors have brought together in one place information that has been fragmented to date, carried by separate
scientific disciplines and communities of interest. They present it in a form that is easily accessible to the lay reader, including parents, teachers, and physicians.
Anyone who reads this book will not be able to look in the same way at the jumpy little 7-year-old who keeps throwing himself out of the chair while you try to get him to focus on his favorite Dr. Seuss. I tutor kids at a community center. They all have "problems" which are easy to put down to poverty, stress, abuse. We try to keep them from getting too far behind so they
don't lose out altogether in school. Now and then a student will come to us with a label: low IQ or, increasingly, that catch-all, ADHD (attention deficit hyperactivity disorder). But mostly they are just labeled problem kids.
And now I wonder. How many of those behavior disorders, those learning problems (he can't do math; she can't read) are triggered or exacerbated by environmental poisons?
Classroom teachers report an epidemic of learning and behavior disorders. It is tempting to rationalize that they are just getting better at recognizing them. But Schettler et al. document the frightening statistics: 17 percent of children under the age of 18 suffer from such disorders; the number taking Ritalin for ADHD has doubled every 4-7 years since 1971; autism
prevalence doubled between 1966 and 1997.
One chart, "Toxicants and their Health Effects," on page 94, contains the essence of the book's information. Physicians should memorize it. But the explanations throughout the book are well worth reading.
Particularly important is the authors' argument that we must develop a common language to talk about these disorders so their causes can be more easily traced. For diagnosis and treatment purposes, discreet symptoms or traits - such as hyperactivity, compulsive behavior, attention deficit - have been clustered into "disorders" such as Autism, ADHD, Oppositional Defiant
Disorder, and so forth.
But those labels are far from precise and often embrace overlapping symptoms. Moreover, many symptoms or combinations of symptoms have never been clustered into a disorder and therefore have been little studied. The authors believe it is important keep the focus on individual symptoms. They advocate both studying specific symptoms more thoroughly and maintaining a
conversation across scientific boundaries about the relation of specific environmental substances to specific symptoms.
Another enlightening section is the discussion of multiple causes of disabilities. "Genes or the Environment: An Outdated Dichotomy" describes precisely how some genetic propensities are triggered by environmental exposures and suggests that such interactions may be the rule rather than the exception. Other sections describe the astonishing vulnerability of the developing fetus to certain chemicals at precise stages. Much remains to be learned.
What is clear from this study is that the human nervous system, especially in our young, is not prepared to withstand the chemical assaults to which it has been subjected. We are paying, and have been for some time. Our children are paying, and we are finally noticing.
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