Book Review: Living Downstream: An Ecologist Looks at Cancer and the Environment by Sandra Steingraber

Living Downstream:
An Ecologist Looks at Cancer and the Environment

by Sandra Steingraber
Addison-Wesley, 1997
Reading, ME
357 pages, $24 hardcover

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In the US, the cancer epidemic has been progressing steadily. In 1950, 25 percent of adults in the US could expect to get cancer during their lifetimes; today about 40 percent of us (38.3 percent of women, 48.2 percent of men) can expect to get cancer.

Among Americans age 35 to 64, cancer is the number one killer. Because of this fact alone, one might expect that the nation would welcome a book by a qualified scientist who examines all the lines of evidence linking cancer to chemical contamination of the environment and offers solutions.

But one would be disappointed in that expectation. Sandra Steingraber's new book, Living Downstream: An Ecologist Looks at Cancer and the Environment, has been greeted with nearly total silence.

At age 38, the author is an accomplished researcher, writer, and teacher with a PhD in biology from the University of Michigan. She obviously spent years preparing the manuscript, visiting special libraries, interviewing cancer researchers, and applying her scientific training to the diverse evidence linking cancer to environmental contamination.

Furthermore, the book is beautifully written. Steingraber (who has previously published a volume of poetry, Post-Diagnosis) has the gift of combining poignant, lyrical prose with scientific exactitude and clarity. She is among the rarest of scientists – those who can write so well that their readers are transported effortlessly through the complexities of an arcane topic like cancer cell biology.

Simultaneously, she is careful to note the limitations of scientific knowledge. She never oversteps the bounds of what is really known, what is suspected but unproven, and what is merely informed speculation.

The book is, first, a detective story. Steingraber investigates Tazewell County, Illinois, where she grew up, looking for clues to the rare bladder cancer that she herself contracted at age 20. It is also a thorough scientific treatise on the relationship of cancer-causing chemicals to human and animal health.

Steingraber cites the following evidence as indications that certain chemicals (and radiation) can cause cancer:

• Immigrants soon exhibit the cancer rates of their adopted countries, rather than the cancer rates of the place where they were born.
• Maps show more cancers in urban than rural areas.
• Maps show more cancers in rural counties with heavy pesticide use than in those with low pesticide use.
• Individual studies reveal cancer clusters near chemical factories and near particularly polluted rivers, valleys, and dumps.
• Rates of childhood cancers are rising. The lifestyles of children have not changed much in 50 years; they do not smoke, drink alcohol, or hold stressful jobs. Yet childhood cancers are steadily rising.
• Fish and shellfish living in polluted water have increased cancer rates. In North America there are now liver tumor epizootics (the wildlife equivalent of epidemics) in 16 species of fish in at least 25 different fresh- and salt-water locations, each of which is chemically polluted. In contrast, liver cancer among members of the same species who inhabit nonpolluted waters is virtually nonexistent.
• Studies show that chemicals can damage the immune system and the endocrine system, promoting cancers.

Yet, despite the abundance of evidence, science has never proven beyond all doubt that the use of chemicals by the human economy is responsible for a substantial fraction of the cancer epidemic. As Steingraber puts it, “Like the assembling of a prehistoric animal's skeleton, this careful piecing together of evidence can never furnish final or absolute answers. There will always be a few missing parts.”

However, the limitations of science do not render us helpless. Steingraber notes that as she was writing the last pieces of the book in late 1996, the news broke that scientists had finally found the agent in cigarette smoke that causes lung cancer. Yet, she points out, she herself grew up protected from cigarette smoke by her parents and teachers, and by public policies that kept cigarette smoke out of restaurants, hospitals, and many other public spaces – actions taken and public policies created by people “who had the courage to act on partial evidence.”

This is a key concept. It underlies the principle of precautionary action. Yet many scientists and policy makers exhibit a hushed complicity, afraid to speak out about what they themselves believe to be true: that cancer is caused by exposure to carcinogens and that enormous suffering could be avoided if we would reduce our exposures to cancer-causing chemicals in air, water, and food.

Steingraber says we will have to adopt a new way of thinking about chemicals. “This requires a human rights approach,” she says. “Such an approach recognizes that the current system of regulating the use, release, and disposal of known and suspected carcinogens – rather than preventing their generation in the first place – is intolerable.” Such a practice shows “reckless disregard for human life.”

And: “When carcinogens are deliberately or accidentally introduced into the environment, some number of vulnerable persons are consigned to death. The impossibility of tabulating an exact body count does not alter this fact.”

By any measure, Living Downstream is an extraordinary work –extraordinarily easy (even pleasurable) to read, extraordinarily thoughtful and even-handed in its treatment of a politically- charged topic, and extraordinarily informative, thought-provoking, and useful.

Reviewed by Peter Montague, editor of the excellent Rachel's Environment & Health Weekly, which is published by the Environmental Research Foundation. To subscribe to this free publication, call 1-888-2RACHEL, or send e-mail to [email protected] with the single word HELP in the message.

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