Document 7Or4xVx4poGyEKnwd94LEnkEo

) 33 ft </) % g The View from NIOSH: Make It Safe On January 22, 1971, Dr. Maurice Johnson, environmental health direc tor for B. F. Goodrich, called on Marcus Key, director of the Xational Institute of Occupational Safety and Health. Johnson had a discovery to report. Three workers in Goodrich's Louisville polyvinyl chloride plant had died from angiosarcoma of the liver since 1971. Key summoned his top aides, who agreed that they had an emergency on their hands. Two days later a small army led by XIOSH Standards Development chief Vernon Rose, invaded the Louisville plant to conduct the first of many "walk through" inspections. Within a week, Rose's task force had a list of recommendations for re ducing worker exposure to vinyl chloride: --protective coveralls, shoes, and gloves for workers exposed to I*VO. -- airtight suits and respirators for reactor cleaners. --daily showers for exposed workers. --a 50 parts per million suggested ceiling on vinyl chloride monomer exposure. Xormally, writing a criteria doc ument--XIOSHcse for a recommend ed standard--is an eighteen-month process involving exhaustive study. In this instance, however, Rose relied on guesswork and precedent. Assum ing that vinyl chloride causes cancer through inhalation and skin contact, he modeled his standards on those used earlier by XIOSH for industrial carcinogens. Aiming for a mid-March deadline, XIOSH organized a hectic series of meetings and studies. By the end of February, its toxicology group had been unable to determine the carcino genicity of VCM below 50 ppm. The medical group had suggested a bat tery of liver tests for PVC workers, but industry and labor had split over the exposure ceiling. Industry urged 50 ppm, which it knew it could achieve; labor advocated "no detect able level." refusing to treat workers as guinea pigs. In this situation, Rose simply toughened and expanded on his ear lier recommendations. Most impor tant, he decided that the ceiling for vinyl chloride be set at "no detectable level"--the only exposure he knew to be safe. "It is doubtful," he conceded in a memo to Key, "that any plant can show workroom levels of nondetected." To meet it, respirators would have to be worn at all times. He wasn't sure this was practical, but he was certain it was safe. On March 11, Dr. Key submitted XIOSH's recommendation to Assist ant Labor Secretary .John Stender. When OSIIA proposed its permanent standard two months later, it incor porated most of the XIOSH text ver batim, including the "no detectable level" provision. The View from Firestone: Make It Practical To Todd C. Walker, the towering, outspoken president of Firestone Plastics, OSllA's proposed standard was as much a crisis as the Goodrich bombshell had been to XIOSH. He was determined to resist the stand ard with "the maximum information" at the OSH A hearings in Washington, D.C., this summer. Walker assembled four task forces --legal, engineering, financial, and medical--to develop a Firestone-rec ommended standard on a crash basis. Four alternatives were to be studied: the interim 50-ppm standard, "nondelectablc," and two intermediate levels chosen arbitrarily--10 ppm maximum with a time-weighted aver age (TWA I of 25 ppm, and a 15-ppm ceiling with a TWA of 10 ppm. For each level (he (picstions were: is it safe and is it feasible? Weeks later, the medical group was unable to say positively that any of the levels was unsafe. An epidemio logical study of Firestone's rubber and PVC workers showed no signifi cant differences, suggesting that 50 ppm was not relatively unsafe. The engineering group reported that the nondctcctnble level was un attainable. It also forwarded a cri tique of OSHA's proposed work prac tices. Protective clothing for all workers was unnecessary, it said, be cause PVC dust is not a carcinogen. VCM gas, which is, could be kept away from the skin only by air-tight suits, which would be "hot, cum bersome, expensive, and dangerous." OSllA's provision for air-supplied respirators for all exposed workers was also ill advised. These would be uncomfortable ("an instrument of torture"), fatiguing, probably haz ardous, and would interfere with work. One portable type weighs twenty-eight pounds and would have to be changed three times an hour. Nonportable respirators could be used, but workers would be attached to air hoses (themselves a workplace hazard) and confined to a radius of less than fifty feet. The financial group reported that capital investment would have to double to attempt reaching a nondetectable level. The legal staff conclud ed that OSHA's proposed standard was unfeasible anil therefore illegal. When it came to deciding what level he would recommend, Walker had a problem. His medical evidence showed the three levels above nondetectable to be equally safe. His en gineers said that the feasibility of the lowest of these (15-ppm ceiling with a 10-ppm TWA) was uncertain, and Walker ruled it out. Loft with a choice between the two higher levels, he opted for the 10-ppm ceiling with a 25-ppm TWA to show that Firestone was willing to do more than the mini mum. Thus, with a practicality rem iniscent of XIOSH's decision to rec ommend a level it knew was safe, Firestone ended up recommending a level it knew it could achieve. 52 ronTUNE Ocwbci 1074 R&S 105830 workers is balanced against the increased cost, to the plas tics industry and society as a whole. Unfortunately, this task has remained largely unacknowledged. OSUA probably will end up compromising on the de cree of exposure to the gas it. will allow; its decision is apt to be announced this month. Hut theayem y has been under terrific pressure to view the issue before it in ab solutist terms, as if its only legitimate concern were the preservation of absolute security for the vinyl plastics industry, or the achievement of perfect safety for vinyl chloride workers. For a while, it seemed a foregone conclusion that OSIIA itself would opt for perfect safety. On May 10, it formally proposed that the new standard for vinyl chlor ide be set at "no detectable level," i.e., that no plant would be allowed to operate so long as any of the gas could be found in the air or in contact with workers. The industry replied, in effect, that any such standard would bo techni cally impossible and economically disastrous, and that if OSIIA went through with it, the polyvinyl chloride in dustry would be put out of business. OSIIA's final decision will all'ect more than this single industry and its customers. The vinyl chloride issue may be viewed as the first major test case for a new movement in government regulation. The leaders of the movement are three of the newest federal regulatory agencies, all created since 1070: EPA, CPSC, and OSIIA. One general idea behind all of these agencies is that business can no longer promiscuously pass on to society all the indirect costs of running a modern economy. As Sheldon W. Sam uels, health director of the Industrial Union Department of the A.F.L.-C.I.O., put it, "The free ride on social costs is at an end. In the plastics industry you're seeing a manifestation of social costs." With jurisdiction over virtually every product and sub stance, these agencies, together with the FDA, are be ginning to use their sweeping powers to reduce the pub lic's risk of chronic disease, especially from industrial products. Some of the agencies are subjecting new sub stances to rigorous pretesting before they are allowed on to the market. And with the vinyl chloride case, they have tackled the first of a long list of basic substances on which our industrial economy is already built. It could put you to sleep During the first decades of its commercial existence, vinyl chloride seemed a most unlikely candidate for the role of heavy in a historic regulatory drama. Put into full-scale U.S. production in 1030, polyvinyl chloride was nailed as a ``miracle" material: cheap, stable, fire-resislmt, and able to assn me an extraordinary range of soft and d forms. Its major applications now include coated .varies (like those used in automobile seat covers), wire nsulation, floor tiling, pipe and conduit, phonograph ecords, and medical supplies, e.g., blood-storage hags. In the beginning the vinyl chloride gas seemed to be virtually harmless. The only apparent clangers were of explosion (at cimcentralions beginning around purls per million) and narcosis.. In fact, during 1910's the gas was tried out as a medical anesthetic, but doctors abandoned it when it was found to cause heart arrhythmia. With low prices providing little incentive for conservation, producers paid no particular attention to workplace exposure levels so long as they were safely below Ihe point of fire and explosion. And yet exposure levels in plants producing the gas itself were probably not very high even in the early years. Vinyl chloride is synthesized from chlorine and petrochemical feedstocks (usually ethylene) in a con tinuous closed process. The plants, which resemble oil refineries (and in some cases are attached to them), are open to the air. Historically, the heavy exposures have occurred in the plants where vinyl chloride is polymer ized into PVC, the whitish powdery resin from which actual plastics are made. It could make you "high" Polymerization is a batch process: vinyl chloride mon omer (VCM) and other substances are put into a pres surized vat, heat is applied, and hours later, when polymerization is completed, the vat is emptied, opened, and cleaned for the next batch. The process is full of leaks. In most of the early plants the gas could be smelled almost constantly (VCM has a faintly sweet odor that seems to be detectable at concentrations above 2,000 parts per million), and workers occasionally got "high" from the fumes. It is widely agreed that in this early period, lasting into the 1950's, exposures of several thousand ppm were common. During the 1950's, as the vinyl industry grew, a trickle of little-noted and often inconclusive medical reports be gan to raise doubts about the monomer's presumed harmlessness. In 1949 a Russian group found a hepatitis like condition in more than one-fourth of seventy-three PVC workers examined, and over the next ten years European researchers encountered other symptoms: skin lesions, a circulatory disorder, gastritis, and derma titis, to name a few. By the mid-19(iO'.s these had been confirmed and were described collectively as "vinyl chloride disease." Later in the 19(>0's, acroostcolysis, a disease involving a degeneration of the finger bones, was identified among workers who clean polymerization vats. As these findings accumulated, producers began to reduce exposure levels. In 19G1 the American Conference of Governmental Industrial Hygienists, a voluntary standards-setting organization, had put the maximum safe exposure at 500 ppm. During the 19G0's industry began working to get much lower than that, and by the early 1970's exposure levels were generally in the 100-to200-ppm range, with short-term "excursions" to levels many times higher. In this general downward movement, Dow Chemical continued pauc 200 FORTUNE October 197J 153 Books-& Ideas COttflHHCf! R&S 105831 policy action. like a stone dropped into a pool, sets ofV ripples of reaction. Since the economy responds with varying y|lairs. a second stone is often dropped the ri])]ncs from the first are still railing the economic waters. When this "stabilization" exercise is repeated often enough, the result is greater instability. There are also technical objections to using a full-employment budget to justi fy federal deficits, as the Nixon Admin istration did in 1072. Such a budget no longer measures the true impact of gov ernment spending and lending on the economy. Federal activities totaling tens of billions of dollars annually--among them the farm credit agencies, the Export-Import Dank, and the Federal Na tional Mortgage Association--have been spun off into independent corporations. A better yardstick Another defect is even more serious. "Full employment," a concept intended to measure economic slack, is still de fined solely in terms of joblessness. Last year,- unemployment averaged 4.9 per cent, and the federal budget showed a surplus on the full-employment basis, suggesting that there was still room for stimulus. Yet shortages of all kinds, notably in basic materials, plagued tlic nation. Full employment ought to be nu-asured in terms of our total capacity to produce, including labor, plant, and capital. If such a yard stick had been in use a few years ago, we might have bad more timely warning of today's raging inflation. Despite such problems. .Tim Tobin dearly believes that the new economics is still the road to millennium, provided that we adopt a number of fiscal and monetary reforms. Two have been put into effect since the book* was written. I!y setting the international value of the dollar free to float, the Nixon Adminis tration gave the Federal Reserve free dom to pursue a more flexible monetary policy. And Congress at last has created budget committees to set overall guide lines for spending. But Tobin also demands changes that have little chance of adoption. For in stance, he would give the President pow er to adjust appropriations to fit budget targets. And he wants Congress to sep arate tax reform from bills to raise or cut taxes, so that temporary surcharges or credits can be enacted speedily to stabilize the economy. If adopted, such proposals would only lend the government back to fine tuning with "macro." or broad gauge, economic policies. That is like using a shotgun where a rifle would be more appropriate. At comparatively small cost, we could open-end the duration of unemployment insurance, a step that would aid mature, trained workers. There should be, as Chairman Arthur Burns of the Fed has suggested, a much enlarged public em ployment program when the jobless rates go up. It would help mostly young peo ple and those without the skills to com pete in a modern economy. Putting 800,- 000 people on a government payroll at 85.000 a year would cost about $4 bil lion, but it might reduce unemployment by a fifth (i.e., from 6 to 3 percent!. In Tobin's program, public-service em ployment is only an adjunct of much more ambitious--and expensive--macro- economic policies. In today's changed economic environ ment, the new economics has become the old economics. The old solutions are not only inflationary, but of dubious help to the people who need it most. Broad- gauge policies for economic stability should be stable themselves. There is no need to change them to offset each wiggle on economists' charts. end Vinyl Chloride continued from page 153 was far and away the leader. In 19G1 it had conducted an animal experiment showing live)1 effects at levels as low as 100 ppm and had decided to get its own plants below 50 ppm. By the early 1070`s, Dow had achieved average ex posures in the neighborhood of 25 ppm in its copolymer plants (one of which produces resins for Saran Wrap). In 1070, Dr. Pierluigi Viola, an Italian physician study ing acrodsteolysis for Solvay, a major European PVC producer, reported an unexpected discovery. After twelve months' exposure at 00,000 ppm, many of his experi mental rats had developed cancers. Doubts about Viola's procedures led Montedison and other European producers to commission Dr. Cosare Maltoni to undertake a largescale animal experiment to sec1 if this carcinogenic effect could be replicated at lower exposure levels. Ey the end of 1073 Maltoni's well-executed study had shown that levels of VC'M as low as 250 ppm induced a variety of cancers in rats, including angiosarcomas of the liver. In June, 1974, he reported angiosarcomas at 50 ppm. American producers began to join the inquiry into vinyl cI^|fcjleand cancer in 107:'). Early that year the Manufac turer Chemists Association decided to commission two massive studies. One was an animal study somewhat like Maltoni's (it has since confirmed his findings). The other was an epidemiological analysis of the morbidity and mortality history of American vinyl workers. In December, Dr. John L. Creech, a Louisville, Kentucky, surgeon who is plant physician for B.F. Goodrich's mas sive PVC installation there, received a report that one of the workers had died of angiosarcoma of the liver. Re membering that another worker had died of the same cause two years earlier, he notified a superior. In midJanuary, 1974, while a systematic mortality study of Goodrich workers was being organized, Creech received a report of a third angiosarcoma death. On January 22, E.F. Goodrich announced the three deaths and their cause. To dale, a total of eight persons employed at the Louisville plant have been found to have contracted this disease. They blew the whistle themselves As of January, 1071, literally all the information link ing vinyl chloride to cancel' had boon developed by the industry on its own initiative. As Ralph L. Harding Jr., president of the Society of the Plasties Industry, ob served, "This is a unique situation. Industry financed the studies, and industry blew the whistle on itself." But this was quickly forgotten in the furor that arose during the weeks following E.F. Goodrich's continued page 202 200 FORTUNE October 1974 R&S 105832 announcement, Within days, regulators, public-health doctors, and union officials liad begun to dominate public discussion of the vinyl problem. Within weeks, the Louis ville Time* initiated a series of stories alleging that in dustry had engineered a Watergate-style cover-up of the angiosarcoma discovery, which it abandoned only when it saw that the information was about to leak anyway. This charge was symbolic of the manner in which the initiative passed out of the hands of industry. It was seized, rapidly, by a loose but not uncoordinated network of regulatory agencies, government research in stitutes, academic medical teams, labor unions, and other groups united by a common commitment to eradicate en vironmental causes of disease. This "regulatory-medical complex" is largely the creation of a decade's federal legis lation in the medical and environmental fields. Its unoffi cial leader is ])r. Irving J. SclikofT, prol'essorof community medicine at the Mount Sinai School of Medicine in New York City. The one-man power elite White haired, gracious, and prelernaturaiiy energetic, Selikoff is best known as the man who explored the haz ards of asbestos and who fought for many years to get them reduced. Cut a glance at his credentials shows him to hold so many other distinctions and positions that he constitutes a virtual power elite all by himself: a recipient, of the Albert Lasker Award of the American Public Health Association, he is also director of Mount Sinai's Environmental Sciences Laboratory, governor and past president of the New York Academy of Sciences, editor in chief of Enrironmnital Iicxcorch. president of the So ciety for Occupational and Environmental Health, and consultant to the A.F.L.-C.I.O. as well as to an almost end less list of medical organizations and government insti tutes. He seems personally as well as professionally close to nearly everyone who matters in government occupa tional medicine, and has excellent contacts in the press, which he uses skillfully. Though he insists that he is only a scientist, Selikoff is also a crusader and reformer, and the weapons he takes into battle, aside from his many personal talents, are research and publicity. Within a month of B.F. Goodrich's announcement, half of SclikoT's staff was working on a series of medical and epidemiological studies of workers at three older PVO plants. Researchers from the Harvard School of Public Health began an analysis of morbidity and mor tality in Goodrich's Louisville plant. The National Insti tute of Occupational Safely and Health, which docs re search and standards development for OSHA. began a major epidemiological study of workers at four older plants, and together with OSI1A sent out numerous learns to conduct, "walk-through" inspections of PVC produc tion facilities across the nation. In i\lay, Sclikulf con vened in New York City a large international working IfUNT October 1074 V 0 group on vinyl chloride, held under the auspices of the New York Academy of Sciences. As Dr. Joseph K. Wag oner of XIOSH described the position of the many re4 searchers who entered the field, " `Seek and ye shall find' is where we're sitting right now." What they found was a great deal of information that linked vinyl chloride ever more closely to a variety of diseases, and this information in turn generated news paper copy. To an attentive reader, the cumulative im pression conveyed was of a hidden crisis slowly uncov ered. With each passing week, the discovery of yet another angiosarcoma ease or the release of a new report seemed to show the crisis to be graver and more wide spread than it had been the week before. The tacit message was that industry had failed, and that govern ment would have to step in and do something fast. Federal regulators were quick to respond. By early February NIOSH and OSIIA were actively at work on the problem of workplace exposure. (See the report on page 152.) By the beginning of April OSHA had issued an emergency temporary standard of 50 ppm and in May it proposed "no detectable level" as a permanent standard. Eut during the summer, the plastics industry, which had maintained a low profile during the preceding months, reassumed the initiative under the leadership of S.P.I.'s Ralph Harding and Jerome II. Heckman. The burden of the industry position was that OSHA's pro posal was not required on medical grounds and was tech nically and economically unfeasible. In its place S.P.I. advocated a phased reduction to 10 ppm as an average and 25 ppm as a ceiling by 1976. The industry case was set forth in considerable detail and with much documentation during the OSHA hearings that began on June 25. Making policy in a desert It was clear at the hearings that, in the end, the vinyl chloride decision was going to be made in an informa tional desert relieved by only the most occasional oasis of knowledge. It was established that vinyl chloride causes cancer and other diseases. It was also established that, over the course of two decades, industry had re duced exposure levels in its plants by a factor of some thing like 50 without experiencing notable hardship or burdensome expense. But beyond that almost everything was uncertain. One large area of uncertainty concerns the shape of the so-called "dose response" curve foi- vinyl chloride between 0 and 50 ppm---the range within which, presum ably, OSIIA will set the permanent standard. To date, no animal experiments have been completed at exposure levels below 50 ppm, and since historic exposure levels in most existing plants have been above that level, it is ex tremely unlikely that epidemiological studies can reveal anything about human response below the level. The data for Dow Chemical's Midland, Michigan, copolymer plant, continued page 203 R&S 105833 whore exposures h:ivo boon monitored for upwards of a decade, are ditlicult to interpret. Dow's own studies sug gest no adverse health or mortality effects for workers at cxj^feircs below 200 ppm; however, Dr. Selikolf's group nq^Pcs a signifieant incidence of abnormal symptoms even anions Dow woi'kers. Where data are unsatisfactory, one must fall back on inference and theory---but these have proved even less satisfactory, and much more subject to dispute. At the theoretical level, there is disagreement over how cancer is caused. Advocates of the `'no detectable level" argued for the so-called "one-hit" theory of cancer causation, which holds that there can be no such thing as a risk-free exposure to a carcinogen. The theory implies that any identifiable exposure to vinyl chloride is certain to cause angiosarcoma, at however low a rate. But there is another theory of cancer causation, which emphasizes the role of the body's immune system in com bating cancer. According to this theory, cancers appear when the immune system breaks down. If what a carci nogen does is to weaken the immune system, and if the weakening process requires a certain level of dose, then it is possible that there is a risk-free level of exposure. At the present time, there is no definitive way to evalu ate the truth of these competing models. Thus when OSHA chooses a standard, it will do so in almost total ignorance of the different rates of cancer and other dis eases to be expected at different exposure levels. Th t of approaching zero The agency will be just as uncertain about the other major point in dispute--the level below which it is not economically feasible for industry to reduce exposure. "No detectable level" advocates point to the huge ex posure decreases that industry has already achieved, to the fact that many producers got below 50 ppm soon enough after the emergency standards were issued on April 5, and that not a few were far below that. To many regulators, it seemed obvious that industry could get to a near-zero level if it really wanted to. Industry representatives argued vehemently that a nondetectablc level simply could not be attained. "Even a system that doesn't leak, leaks," thundered Todd C. Walker, president of Firestone Plastics, at the OSHA hearings. The companies also argued that efforts to ap proach zero would be extremely expensive. Firestone, for nslance, detailed every capital expenditure that would be necessary if it tried to reach "nondelectable" exposure evels and concluded that the total cost would espial the .`iitire value of its existing planL. Even then, Firestone insisted, it would not ultimately achieve a "nondctectablo" `xposure and would be forced to go out of the plastics business. fbj^ie end of the summer, it appeared that even the )Sl^Hstaff felt the standard might be unjustified. An August, 1974, report by tbe agency's Division of Program Evaluation and Research observed: "First, it is not clear that it is technically feasible to comply with the proposed standard without a shutdown of the entire vinyl chloride industry. Second, it is not clear from existing experimental and other historical data that a `no detectable level' stand ard is justified. And third, it is quite clear that compliance with the proposed standard will require substantial cap ital investments and lead times." They'd call it a sellout If these findings should lead OSIIA to compromise-- to set an exposure standard of, say, 25 ppm--the agency should not expect to be praised for its moderation. It may even be assailed for violating its charier. The Occupa tional Safety and Health Act of 1970 states that OSIIA, in regulating toxic materials, "shall set the standard which most adequately assures, to the extent feasible, on the basis of the best available evidence, that no employee will suffer material impairment of health or functional capacity even if such employee has regular exposure . . . for the period of his working life." Members of the regulatory-medical complex would surely insist that a compromise was incompatible with these words--and would see it as an unprincipled sellout, sacrificing lives for dollars. Industry, meanwhile, is apt to view whatever level is allowed as an arbitrary interven tion, reflecting political emotionalism rather than reason. And whatever the level, it is hard to believe that the new vinyl chloride standard will do much to end the confusion and uncertainty that currently prevail in many different industries subject to regulatory power. The vinyl chloride hearings have made it clear that practically nobody in government, industry, or labor is willing to discuss these regulatory issues in trade-off terms. "We don't equate lives with dollars and cents--not at the Department of Labor," John Stender, Assistant Secretary of Labor in charge of OSHA, declares. Even spokesmen for industry seem unwilling to chal lenge Stencler's formulation head-on. "If we know we're exposing our workers to a known health hazard, we gel out of the business," says Dr. Ben Holder of Dow. In the course of the long argument about vinyl chloride stand ards, businessmen have shied away from assorting that some level of mortality might actually be "worth it." in stead, they have tried to smuggle some practical consid erations into the discussion by pointing to problems of "engineering and economic feasibility"--as if feasibility were an absolute. One reason for the general reluctance (o think in costbenefit terms is to be found in the language of the Occu pational .Safely and Health Act itself. Rut another rea son lies in the ethos of the regulatory-medical complex, which has something more on iLs mind than the rale at which people get sick or die. It is committed as well to a larger conception of the good society. In this society the idea of health is central. Ever more continual pane 204 FORTUNE Oclobct 10/-I 203 R&S 105834 remote causes of disease would be eliminated. The role of medicine in this society would be different; it would no longer merely cure, but would actively redesign the environment and ways of living to prevent disease. In evitably, it would be a society in which doctors, by virtue of their expertise, possessed considerable power. The role of markets would be sharply curtailed, inasmuch as they often lead people to make decisions contrary to their best medical interests. In this sense the regulatory-medical complex is a political movement. As such it perceives in issues such as the vinyl chloride standard a symbolic im portance that transcends the particular merits involved. They don't like business And, of course, it is an antibusiness movement in its underlying commitment. American regulatory agencies seem to reflect the times in which they were founded; the new regulation was established in an era of intense con flict and hostility to business, and there is little prospect of the movement's suddenly acquiring another personali ty. For all its unattractive implications for regulatory equity and consistency, this fact is not entirely without its redeeming aspects. By pressing industry hard, these agen cies will hasten economic modernization. It is clear that they have long since achieved immense success in raising health consciousness in industry and labor alike. As Dr. Ralph Langner, an industrial hygienist at Dow Chemical, says, "Vinyl chloride is to industrial hygiene what Rachel Carson was to the environmentalists." In any case, if Americans are now going to assume responsibility of deciding what is a "socially acceptable risk,'' and thus of implicitly putting a price on human life, surely it is desirable that the critical decisions not be left entirely to business--or to any one group or center of authority. A process of indeterminate struggle between business and antibusiness forces, yielding decisions more political than rational, seems preferable to a system in which a single cooperative establishment coolly announces the exact going rate at the close of every business day. Even so, it seems clear that the process of conscious ness-raising could usefully flow in the other direction as well. The regulatory-medical complex would not be any the worse if it had a clearer sense of the novelty of the concept of health it is promulgating and of the uneasiness of its relationship to the existing economic system. And it could take more fully to heart the potential conse quences of its regulatory interventions for ordinary liv ing standards. As G.J. Williams, vice president of Dow Chemical, remarked recently, "You could probably not find a single thing in the world that's essential, but they all go towards making life pleasurable. You can do with out almost anything, but not without everything." END The Bounded Main continued from page 131 cooperation. Ironically, there's a good . chance that the U.S. will be leading the trend to unilateral action. Interpretations of innocence Because of the diversity of its inter ests in the sea, the U.S. had been expect ed to play a keystone role in locking to gether a compromise among all the di vergent points of view represented at Caracas. In fact, however, the confer ence was one of the first manifestations of a remarkable reversion in the inter national posture of the U.S. From a pre occupation with the politics of peace, we have moved to a preoccupation with re sources and revenues. The clash between this new U.S. stance and the ideological preoccupations of the less-developed nations brought the sea-law negotiations to a standstill at Caracas. To be sure, American economic con cerns originally began the erosion of the freedom-of-the-seas principle. In 1945, President Truman unilaterally de clared the U.S. to be sole owner of the mineral resources on its underwater continental shelf, where oil and gas had recently been discovered. This move was quickly followed by a rash of unilateral claims by other nations, not merely to offshore resources but also to territorial waters wider than the traditional three miles. In most cases, the new limits t were set at twelve miles, but some coun tries, beginning with several in Latin America, claimed absolute sovereignty over areas extending as much as 200 miles to sea. At that point, the U.S. woke up to what it had set in motion, in particular the implications for shipping and avia tion. Traditional maritime law recog nizes the right of "innocent passage" through any nation's territorial waters but has always been vague as to what the term meant. With the advent of new kinds of traffic, including airplanes, mis sile submarines, nuclear-powered ships, and supertankers, various states have adopted their own interpretations of innocent passage--such as prohibiting aircraft overflights, requiring advance notification of warship passage, making submarines travel on the surface, or forbidding passage to tankers in order to avoid the danger of oil spills. Planners in sore straits When combined with the almost worldwide adoption of territorial limits greater than three miles, these con straints on innocent passage had serious implications for all maritime nations, but they especially worried the U.S. Navy and its Soviet counterpart. The heart of the problem was the "straits issue": with even twelve-mile limits, more than 100 important international straits fall entirely within national jurisdiction. Cold-war military planners were ap palled by the prospects of emergency ship and aircraft deployments being held up by a straits nation or of ballisticmissile submarines being obliged to 2C4 FOn'JNE October 1974