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Environmentally Speaking
Health and the Environment
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When the cost of health care in America has risen to $ 140 incidence is especially high in communities where there is a billion a year, witn most of this going for after-the-fact heavy concentration of chemical industries. When Dr. David
attempts at treatment and cure, it is obvious that we need tBoaltimore of MIT received the Nobel Prize in 1975 for his
reo: der our national and individual priorities. How much
wor,k linking viruses and cancer, he said: "The role of vi
more health-effective and cost-effective it would be if more ruses in cancer is small. The best hope today for cures is
emphasis were placed on prevention--on keeping harmful research into environmental causes of cancer."
materials out of the air, water, and soil--and out of our
Each day, each of us breathes 16,000 quarts of air. They
people.
often contain a debilitating mixture of sulfur oxides,
In the United States, national concern for the environ
carbon monoxide, photochemical oxidants, nitrogen
mental aspects of public health is of fairly recent origin.
dioxide, particulates, and other airborne pollutants.
Not until after World War II did we really become aware of.
We have accumulating evidence that mercury, lead, and
the health dangers, both immediate and long term, of many cadmium in the environment can attack the central nervous
of the substances we produce, use, and often release into
system. We know that fluorocarbons weaken the protective
our environment.
shield of the ozone layer, greatly increasing the risk of skin
The ratio of environmentally-induced disease to all dis cancer. Last year, we acted to ban fluorocarbons in inter
eases is large and growing larger. As Dr. Ernst Wynder has state commerce as of April 15,1979.
pointed out: "In a society where infectious diseases have
There is clear evidence that carbon tetrachloride and
ben largely overcome through sanitary measures, immuni chlorinated phenols can damage the liver; ethylene glycol
zation, and anti-biotics, the major causes for today's toll are and cadmium sulfate can produce kidney disease; asbestos
largely unhealthy lifestyles, unhealthy working environ
and beryllium can cause lung disorders; vinyl chloride and
ments and disease-producing products."
arsenic can cause cancer.
The more experience we gain, and the more data we ac
Asbestos and chloroform have been found in our drink
cumulate on the health effects of pollutants, the deeper our ing water. In fact, we are now aware that chloroform and
concerns become. Scientists have developed compelling
other trihalomethanes occur in drinking.water as a result of
evidence that children can contract ghronic and acute dis the way we have been chlorinating that water to make it safe
abilities as a result ot air pollution. One study concluded
for drinking. So our problems are compounded by the irony
that as many as 20 percent of the children in a city such as that, in treating water to protect public health, we can actu
New York can develop severe and chronic respiratory dis ally create reactions that could prove harmful.
eases, During the 1973-74 oil embargo, the most significant Another chemical trouble spot was the discovery of the
factor in a dramatic drop in death rates in the San Francisco widespread contamination of the Nation's waters by poly
area--a 13.4 percent decrease compared with the same
chlorinated biphenyls (PCB's). Yet another was the revela
ptnod over the previous four years--appears to be reduced tion that the pesticide, Kepone, had caused nerve damage
exposure to pollutants from auto exhausts.
among workers.
The World Health Organization estimates that from 60 to
90 percent of all cancer is the result of "environmental
factors" in the broadest sense of the term..The rate of cancer
deaths is greater than at any time since World War II; the
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Incidents like these helped to convince Congress to pass the Toxic Substances Control Act. This law marks a recogni tion that we live in a chemical age, and that that age may be a mixed blessing. Those chemicals will be our single great est environmental challenge in the next couple of decades. They seem to be everywhere, if often only in small quantities.
The kinds of problems I have just mentioned do not lend themselves to quick-fix solutions. They demand thoughtful, rational, careful analysis and decision-making. And this kind of analysis and decision-making cannot be carried out in a vacuum. Nor can,the problems simply be handed over to government officials, however ethical and competent, with instructions to "solve them--tell us what to do." The problems are deeply rooted in our highly technological industrialized society, and they must be addressed in terms that are not just acceptable to, but in fact arrived at by, that society.
For most toxic chemicals, for instance, the decisions are not going to be that clear-cut. We're going to have to make tough judgments about the appropriate degree of control, weighing the risk posed by a given chemical against its economic importance.
With the Toxic Substances Control Act, ERA is now required to regulate not just the residues of dangerous chemicals, but their manufacture, use. and distribution. This is a new order and a big one. I believe I am safe in predicting that within a decade this program will dominate all others in EPA. It will shift our emphasis to prevention, to keeping harmful substances out of our air, water and soil, rather than concentrating on cleaning them up after the damage has been done.
We have not abandoned our concern with the natural environment.
Understanding human impact on the environment pro vides us with critical clues regarding our own present and
future well-being (and environmental harm often serves as an "early warning" about potential threats to public health). In addition, there is a close correlation between measures that protect public health and those that protect the environ ment. But we clearly have an increased concern with public health issues. This concern is well illustrated by our strong new focus on toxic chemicals.
There is growing concern on the part of the public about what the chemical age has done to its world. Along with this., however, there's also a growing skepticism about how real some of the dangers are.
I don't believe that this skepticism means there is a wide spread sentiment for giving up on efforts to deal with new public health threats. In fact. I'm very conscious of a very strong opposite pressure; that is, to get the toxic contami nants out of our air and water so that people won't face being involuntarily exposed to them.
However, the response does mean that both public and private officials concerned with health matters have an important responsibility.
For governmental agencies like EPA, it means we have to be candid, laying what we do know about toxic chemicals before the public, but making clear where our knowledge is limited.
For industry, it means not attempting to play on the pub lic's doubts. Legitimate concerns about the chemical revolu tion desprve better than a Madison Avenue counter-attack by the private sector.
And for the health community, it means making a far greater commitment than has been shown in the past to examining the health effects of toxic chemicals, and to educating the public about such effects. Leaving this duty to government alone is a luxury that this country can no longer afford.
JULY/AUGUST 1978
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