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Normandale, a small Illinois town of 480 people, is situated amid industry, chemical plants, a coal-burning power plant, a grain processing center, an ethanol distillery, a landfill that operated without state permits, and rusty barrels leaking unknown substances. A study by the Illinois Department of Public Health, which relied on actual and projected rates of cancer based on the cancer registry, indicated normal cancer rates. Questionnaires about experiences with cancer symptoms were sent to community members in lieu of face-to-face interviews. However, the questionnaire return rate was only 37.5%.
Cancer distribution within a space can offer just as many clues to causes as time. Cancer rates are often calculated by the number of diagnoses per 100,000 people. This method becomes tricky when working within a small town. More than half of all cancers occur in developing areas as opposed to wealthy ones. The International Agency for Research on Cancer revealed that populations in areas where smoking, consuming a western diet, industrialization, and obesity rates are higher have a greater risk of cancer. The Blacksmith Institute in New York, which provides data on illnesses in the most polluted cities, showed that increased coal production between 2000 and 2005 resulted in more polluted air and increased illness. Whether cancer was a direct result of this production is unknown; however, cancer in the area increased 33% between 1973 and 1997. Some journalists have reported on “cancer villages” along the Huiai River basin in China.
Migrant studies also play an important role in determining the origin of cancer. When individuals migrate to a new country, they leave behind their home country’s cancer rates and become part of the rates in their new area. Cancer patterns among migrants to Australia, Canada, the US, and Israel suggest that cancer rates relate to extended stays in the new environment. Studies of breast cancer in Chinese, Japanese, and European women in the US suggest that their cancer rates conform to the US. Women moving to areas with low incidences of breast cancer experience a decline in diagnoses.
Because the US lacks a nationwide cancer registry, determining geographic cancer incidence is challenging. Some of the National Cancer Institute’s maps show increased cancer mortality rates in highly industrialized areas of the US. Rates are increasing in previously low mortality areas. These maps tend to show deaths and not diagnosis. Some deaths may be due to poor medical quality in an area. Cancer atlases show that increased agricultural and industrial pollution correspond with increased cancer deaths. In England, cases of childhood leukemia and other cancers suggest that areas where high petroleum or chemical solvents are expended at high temperatures—such as oil refineries, airfields, paint makers, and foundries—exhibited higher rates of cancer. The study showed that the likelihood of cancer was higher for those who lived within a few miles of the toxins. People who moved away had less risk. This result strongly suggests that early prenatal exposure to environmental carcinogens creates the threat of cancer in children.
Occupation is another factor in the study of cancer origins. Workplace carcinogens are nearly identical to those in the public: “Indeed, the near half of the substances now classified as known human carcinogens by the International Agency for Research on Cancer were first identified in studies of workers” (65). Typically, domestic and migrant farmers have consistently higher cancer rates than the general population. However, the Agricultural Health Study (started in 1993) followed farmers in Iowa and North Carolina and found that their cancer rates were lower than in nonfarmers, perhaps because of the farmers’ active lifestyle and abstention from tobacco products. The study revealed, however, that specific cancers, such as prostate, seem more frequent in farmers than others. The study also showed patterns among certain pesticides and weed killers as resulting in higher rates of bone and pancreatic cancer. Farm children whose parents used atrazine were at higher risk for lymphoma and leukemia. Farm children had higher traces of the pesticide in their urine than nonfarm children, and farm women had longer menstrual cycles and later-age menopause. Breast cancer hasn’t been linked to pesticides, but women who lived closer to areas where pesticides were used have a higher risk of breast cancer. Other occupations with high rates of cancer include painters, welders, asbestos workers, plastics manufacturers, dye and fabric makers, miners, printers, radiation workers, firefighters, hairdressers, beauty salon workers, chemists, dentists, chemotherapy nurses, and those with jobs around electronics and solvents.
People living near industrial plants and toxic waste dumps are also at higher risk of cancer. Following World War II, areas that had leftover barrels of abandoned chemicals became superfund sites—areas funded by Congress for long-term cleanup. Studies found that communities near hazardous waste sites had a high rate of stomach and colon cancer. Breast cancer mortality rates were higher in women living closest to the site. In the US, men and women living in areas confirmed to have contaminated ground water from hazardous waste sites had higher cancer mortality rates than those not living in these areas. These counties had four times as many facilities cleaning these areas than the national average.
Case-control, cohort, and cancer cluster studies are all valuable types of inquiries into the relationship between environmental contaminants and cancer. However, each type of study has a specific purpose and outcome. Cluster studies, for example, often rely on small communities to determine rates of cancer and its causes. The problem with relying on population is that not enough people are included for a study to determine significant and accurate links. In addition, it can be unclear whether pollutants come directly from the local environment or drift in from other areas. Finding cancer due to exposure takes significant time. According to the Pew Environmental Health Commission, the biggest hindrance to cancer cluster inquiry is ignorance. Our nation lacks a basic understanding of toxic chemicals as well as a tracking system.
A case-control study of Long Island women in 1994 linked breast cancer to air pollution and proximity to chemical plants and resulted in the Long Island Breast Cancer Study Project. While it didn’t conclude that exposure to DDT directly caused breast cancer, it suggested that breast cancer risk is higher among women who use pesticides on their lawns and gardens than those who don’t.
In Massachusetts, the Upper Cape study revealed a possible connection between multiple cancers, including breast and lung, and the airborne chemical propellant used for firing artillery. Brain cancer notably increased in individuals living near pesticide-treated cranberry bogs, and leukemia and bladder cancer markedly rose in individuals drinking water from a distribution pipe that had a toxic interior vinyl paste. The Cape Cod Breast Cancer and the Environment Study investigated the Cape’s coastal marine sanctuary runoff and sewage.
Rachel Carson references World War II in Silent Spring mainly to remind readers of the introduction of wartime materials that contained new chemicals. War technology changed chemistry, and once chemicals were introduced to the civilian public, the approach to growing food, manufacturing homes, and disinfecting bathrooms also changed. Many of these chemicals weren’t tested for safety, and the war mindset of conquest and annihilation was brought into the home. Individuals born after the war are less informed about its impact on domestic life. Above her desk, Steingraber keeps a graph of synthetic materials produced since 1940. A second graph shows synthetic organic materials combined. Production of synthetic organic materials increased 100-fold in two human generations. Plastics are the synthetic materials that have grown the most.
The terms organic and synthetic are difficult to define. Organic suggests simple and close to nature—or, in science, any chemical containing carbon. Synthetic refers to material that is manufactured and doesn’t exist in nature. Most synthetic materials could be labeled organic since they have carbon atoms (plastic, nylon, DDT, and PCBs). These items derive from coal or petroleum, chemicals that contribute to the difficulty in defining organic and synthetic. Synthetic materials are based on the decomposition of plants (coal) or of animals (petroleum). Because these substances come from living entities, they’re organic. The human body contains systems to break down synthetic organic materials, so they easily interact with naturally occurring biochemicals in our bodies. However, this process allows pesticides and weed killers to interfere with and attack certain biological processes within our bodies. Inert synthetic organic materials aren’t biodegradable because their molecules are too large to decompose: “They are similar enough to naturally occurring chemicals to react with us but different enough not to go away easily” (94). Many fat-soluble synthetic organics accumulate in fatty tissue, including the breasts, liver, bone marrow, and brain.
DDT was first used in World War II to ward off the typhus epidemic in Naples and was also used to combat ticks, mosquitoes, and fleas. The surplus of DDT produced for war was turned over for general civilian use. Synthetic chemicals called organophosphates, introduced in the 1940s as an insecticide, attacked the nervous system and were tested as nerve gas on prisoners at Auschwitz during the war. The Allies introduced herbicides to destroy the enemy’s crops, and these chemicals, used as Agent Orange during the Vietnam War, were later used for weed and shrub control. While many of these chemicals are used in agriculture, private use on gardens and lawns allows them to find their way into food, water, and the air. Many studies have found correlations between home pesticide use and childhood cancers.
After the war, the US protected chemical products via high tariffs, making the chemical industry wealthy. Innovations in the use of kerosene, gasoline, artificial fertilizers, and explosives following World War I resulted in an economic boom during World War II to fill the demand for aircraft fuel, explosives, solvents, and metals. These products eventually became common in civilian life because of the threat of an economic downturn after the war. The war saw a transformation in demand from plant-based materials to those derived from oil. Many products are now made with formaldehyde, a substance linked to leukemia and several other cancers, whereas before the war, many products were made from soybean oil.
In 1976, the Toxic Substances Control Act (TSCA) revealed that many chemicals were either not tested or exempt from testing. The act doesn’t require testing and asks the EPA to balance economic benefits with safety. The TSCA requires toxicity data only when evidence of risk is demonstratable. The Federal Food, Drug, and Cosmetic Act (FFDCA) and the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) set legal limits for pesticide residues in food and animal feed. FIFRA requires companies that manufacture pesticides to test their products for toxicity and submit the results to the federal government. The Emergency Planning and Community Right-to-Know Act (EPCRA) and the Toxics Release Inventory (TRI) both rely on self-reporting and don’t report carcinogens in commercial products—and small businesses are exempt. Patterns show that the petroleum industry is responsible for a quarter of toxic releases, and toxic chemicals are sent to recycling facilities rather than landfills because of increased disposal costs.
The current environmental regulatory system isn’t beneficial and is “crippled by uncertainty” (116). Meanwhile, Europe is working to register all chemicals. Swift identification of cancer-causing substances should lead to decreased amounts of exposure to these chemicals. Canada’s provincial bans on cosmetic pesticides, the new European chemicals policy, and the global Stockholm Convention deserve the praise and support of cancer advocates. Green chemical design looks to nature for synthetic chemical creation, although without ways of foolproof testing, it’s difficult to know whether green chemistry is any safer. It’s also easier and cheaper to use the environment as a dumping ground for toxic waste.
Steingraber and a group of scientists examine three petri dish experiments with estrogen-sensitive breast-cancer cells. The experiment shows that endosulfan, an imported chemical found in pesticides, is estrogenic. Like the hormone it mimics, endosulfan—a testosterone-blocking chemical used in pesticides that finds its way into food sources—stimulates breast cancer cells to divide and multiply. The study also shows that multiple chemicals, even if individually weak, have a significant impact on human health when combined. Many European nations have banned endosulfan.
MCF-7, a line of cancer cells used by the Michigan Cancer Foundation, is the cell line available for study around the world. The cells were taken from a nun, Sister Catherine Frances, who died of cancer in 1970. Testing chemical and biological substances is expensive and complex, and whether petri dish experiments can closely mimic tests on lab animals is unknown. So far, the links are high. However, producing a significant and accurate test takes roughly 800 animals—usually rats and mice. Typically, scientists engage in two-year experiments to examine developing tumors. Just testing one chemical takes significant time, and about 80,000 chemicals are on the market, with hundreds added each year, so resources are insufficient to test all chemicals. The International Agency for Research on Cancer has conducted 900 tests since 1971, and 400 of them noted the existence of or potential for human carcinogens. In the US, the National Toxicology Program has conducted roughly 600 tests, and half showed carcinogens. Only chemicals identified as problematic are tested. Toxicologists estimate that less than 5% to 10% of all chemicals in commercial use might reasonably be considered human carcinogens.
In 2007, the National Research Council began using automated (robot) tests. These rapidly performing tests can evaluate thousands of chemicals at a time. However, interpretation of data on tens of thousands of chemicals isn’t possible. Although animals are no longer efficient in chemical testing, dog testing revealed significant information about the synthetic use of dyes in the textile industry. Additionally, when these dyes were added to rubber and antirusting agents, workers in the tire and machine industry became ill with bladder cancer. Exposure to flea and tick chemicals had similar results. Military dogs in Vietnam exposed to Agent Orange developed testicular cancer. Lab animals will continue to be used until petri dish experiments are developed.
Breast cells during early development are particularly susceptible to chemical carcinogens. Studies on rats demonstrate that an abundance of cells in the terminal end buds of a developing breast or a delay in bud maturation can increase the risk of breast cancer. Rats exposed to atrazine had different interior anatomy than rats that weren’t exposed. Nursing rats gained less weight, and mothers had undeveloped mammary glands. These results wouldn’t be possible with cell line experiments. However, the development of cancer in these rats does not happen the same way as in humans.
Bladder cancer in beluga whales in the North Atlantic share characteristics of an increase in bladder cancer among workers in a nearby aluminum smelter along the St. Lawrence River. Benzo[a]pyrene, a chemical resulting from the combustion of wood, gasoline, and tobacco, was found in tumors of four dead belugas that washed ashore, and one young whale exhibited abnormal breast development. St. Lawrence River belugas are dying at a much faster rate than those in the Arctic. Dissolved pollutants in the whale fat may be causing reproductive issues. Other nonlocal pesticide contaminants may appear because of drifting wind or in eels that migrate from Lake Ontario. Mirex, a foreign chemical, was once reportedly spilled into the water from a pesticide manufacturing plant.
In 1964, pathologist and physician Clyde Dawe discovered white suckers with liver cancer in a lake in Maryland. Dawe’s was the first discovery of wild fish with liver cancer. Further studies at Dawe’s request revealed that liver cancer in fish is linked to the environment. Many of these fish are bottom feeders and exist in polluted waterways. Additionally, aquarium studies in the laboratory show that the carcinogens known to cause cancer in humans and rodents also cause cancer in fish and mollusks—and are often metabolized in the same way.
Steingraber concludes the chapter with an idea for a pilgrimage. People with cancer should travel to various bodies of water known to be inhabited by animals with cancer. The pilgrimage would convene at Buffalo Rock, a place known to have been ravaged by a strip mine in the 1930s that polluted the soil with highly toxic shale and pyrite, killing all life forms there.
At the end of Chapter 6, Steingraber calls for a pilgrimage to all the areas of the country containing bodies of water that are home to animals known to have cancer. She recommends starting at Buffalo Rock, the site of a deadly toxic spill years ago. As she explains, in 1983, artist Michael Heizer began the movement to reclaim the area by sculpting the shapes of five river animals that call it home on 30-foot furrows. The animals—a water strider, a frog, a catfish, a snapping turtle, and a snake—are each hundreds of feet long. Visitors can climb the catfish’s whiskers, walk along the strider’s legs, and lie down on the snake’s head. On a clear September day, Steingraber imagines, “Cancer survivors would gather on the backs of these monumental animals and, in this place of damage and reclamation, bear witness” (142).
Steingraber suggests the intertwining of humans and other animals to fight for justice. The animals have sacrificed themselves for humans, as humans have sacrificed themselves in time of war. Wartime demand for machinery and weapons directly impacted environmental contamination of our air, food, and water. Steingraber’s analysis of the measures taken to test for potential carcinogens in the environment reveals an obvious human and nonhuman hierarchy in the war on cancer.
First tracing the historical development of toxins in the environment from the early to mid-20th century, Steingraber reveals clear connections between environmental contamination and warfare. This section of the book highlights her theme of war as a backdrop for environmental contamination. She argues that “war and manufacturing have frequently danced together here” (108) and notes the industrialization of her rural midwestern community following World War I and leading up to World War II. Supply and demand during time of war perpetuates the war image as right-to-know information has become privileged. We’ll never really know to what chemicals we’ve been exposed.
War increased the economic health of industries directly involved in making and using hazardous materials. World War II, for example, capitalized on the industrial growth following World War I by increasing the demand for kerosene, gasoline, artificial fertilizers, and explosives. The demand resulted in not only a healthy economy but a transformation from plant-based to oil-derived products. With an economic downturn looming in the wake of the war, many of these chemicals became commercialized and available to ordinary civilians. The increased production inevitably resulted in increased environmental contamination.
Before our exposure to chemicals in common pesticides and herbicides in our own homes, substances like DDT were used in World War II to combat disease-carrying insects. The surplus of DDT produced for war was then turned over for general civilian use. Moreover, synthetic chemicals (organophosphates), insecticides that attack the nervous system, were used as a nerve agent on prisoners at Auschwitz. Herbicides destroyed enemy crops, and Agent Orange—used during the Vietnam War—was found useful for weed control. Many studies have found correlations between home pesticide use and childhood cancers.
Steingraber spends significant time discussing the benefits and drawbacks of animal testing in the wake of wartime production of hazardous chemicals. The long and expensive tests on animals led to many significant breakthroughs in the awareness of cancer-causing toxins. However, these tests may not be as effective given the increase in the number of chemicals to which people are exposed each year. Steingraber presents an interesting hierarchy of needs in her discussion. This discussion addresses the place of “lower” and “higher” animals.
The metaphor of “lower” and “higher” animals suggests that demographics and locations receive varying attention when it comes to health issues. The studies in Normandale and Pekin, two rural Illinois areas, totaled eight pages, compared to studies in urban areas of Long Island and Cape Cod that produced 500 pages. Certain areas have the funding to conduct million-dollar studies. Steingraber presents a vivid dichotomy of the two groups in the following passage:
The citizens of Cape Cod and Long Island have struggled mightily to bring scientific attention to the link between cancers and environmental contamination in their communities. Still, the resources they command are starkly different from those among Normandale’s residents. My meetings with the breast cancer activists of Long Island have taken place on college campuses and convention hotels. I have spoken with the cancer activists of Cape Cod in a beachfront conference center. When I met with a community leader in my own hometown, we held our discussion in the back room of an auto repair shop and towing company (86).
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