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Wednesday, Dec. 12, 2007 04:24 pm

Consider the possibility

Dr. Sandra Steingraber imagines an Illinois that stops poisoning its people with cancer-causing chemicals.

Untitled Document

Did you find your jeans, Sandy?”
Feet are scurrying about upstairs. A faint “Yes” floats down the stairwell. Kay Steingraber tells me to have a seat; on the kitchen table I note the remnants of a breakfast interrupted by my early arrival. Through the kitchen window, I spot Steingraber’s grandson, raking leaves. Kay’s daughter, the scurrying Sandy, is Dr. Sandra Steingraber, one of the country’s foremost experts on the environmental links to cancer and reproductive health.
Dr. Steingraber has invited me to accompany her from Pekin, where she’s staying with her mother, to Rockford, the site of her next speaking engagement. Elijah, her 6-year-old, joined her on this trip; 9-year-old daughter Faith is at home, in Ithaca, N.Y., with her father.
How odd it is to see this woman — whose book Living Downstream has been optioned for a documentary, who has appeared on network-news programs, who has briefed United Nations delegates on the dioxin contamination of breast milk, and who has testified before the European Parliament on the impact of toxic chemicals on children — in such a domestic setting. And, at the same time, it’s not odd at all. Unlike so many other scientists, Steingraber strives, as an author and lecturer, to personalize the impersonal statistics linking health and environmental contamination. “In the field of environmental health,” she says, “there is a human life behind every data point. There is a story to be told.”
Often the story is her own. Yet, she also seems heroic in her fight against “toxic trespass,” in her promotion of the “precautionary principle,” and in the unending assistance she provides to those who can gain strength from her knowledge — especially in her native state.
Steingraber is strongly committed to central Illinois, on which her 1997 book Living Downstream centers.
The night before, Steingraber spoke on behalf of Peoria Families Against Toxic Waste, which is waging a battle against the expansion of a local hazardous-waste landfill by the Peoria Disposal Co. It is one of only 16 landfills in 13 states that accept such waste — some of which arrives from 12 other states — and it happens to be located over an aquifer that provides much of the area’s drinking water. This was the second visit in two years by Steingraber, whose job it has become to bolster, with additional information and media attention, this grassroots organization and its allies, which include the Heart of Illinois Sierra Club and the medical staff of all three Peoria hospitals.
Speaking from the pulpit of Peoria’s Unitarian Universalist Church, the willowy Steingraber seemed too slight of build, too soft of voice, to lend weight to the argument against expansion. But beyond this delicacy lies a formidable knowledge that has garnered her positions on President Bill Clinton’s National Action Plan on Breast Cancer and, more recently, the California Breast Cancer Research Program. She is at heart a scientist, and at age 48 she has under her belt a Ph.D. in biology from the University of Michigan, a fellowship from Harvard, and a fetal toxicology study that she conducted at Cornell University. Steingraber tells her Peoria audience that legislation meant to keep us safe, the Toxic Substances Control Act, was groundbreaking and globally important when it went into effect in 1976. The law, however, also grandfathered in all chemicals that were in commerce before 1979 — all 62,000 of them — and it cannot keep up with new scientific discoveries. The law, she says, is based on the paradigm that “the dose makes the poison.”
“The notion that there is a safe threshold level for toxic chemicals — the level at which harm is negligible — has really carried through many periods of history and undergirds our entire regulatory system, even now,” she says, “so that when a chemical is discovered to be inherently toxic through careful laboratory bench study — because it is a neurological poison, carcinogen, a mutagen, maybe it’s linked to infertility, it disrupts the immune system — the way we respond to that discovery is not to immediately search for a nontoxic substitute, but instead we go to work in the lab to try to determine what the maximum exposure will be before the harm is less than negligible.”
Our bodies, she says, are being exposed to mixtures of chemicals, but testing is conducted on chemicals on an individual basis. “We know from biomonitoring studies that between 400 and 500 toxic chemicals exist in human tissues. When we take a look at umbilical-cord blood,” she says, “we find 287 different chemicals.” Steingraber lists particular chemicals that are reaching our children even before birth — pesticides, stain removers, wood preservatives, heavy metals, industrial lubricants, combustion byproducts, flame retardants — all of which have been found in cord blood. Steingraber tells the Peoria crowd, which at intervals murmurs and shifts in muted astonishment, that “safe” thresholds do not take into consideration the genetic variability that we now know exists. Certain segments of our population are more vulnerable to toxins than the rest of us because of the genetic hand they have been dealt. The threshold limits set by scientists also fail to take into account the special vulnerability of infants, children, adolescents, and pregnant women. In other words, she says, timing also makes the dose. A system based on risk assessment cannot be responsive to new findings such as these, Steingraber says. You cannot go back and dig up old waste when science makes a new discovery, as was the case, she points out, when new data showed a link between cadmium and prostate cancer, “and at lower levels than we ever thought possible.” Because of these shortcomings, she says, the 27 nations of the European Union have scrapped the risk-assessment process in favor of the precautionary principle, which uses inherent toxicity as a trigger for action. Therefore, the potential for a chemical to cause harm is sufficient for it to be removed from circulation.
The European Union has not only banned heavy metals from its landfills — heavy metals account for much of the waste in the Peoria Disposal Co. landfill — it is also banning them from electronics, effectively stopping the contamination at its source. PFATW and the medical community believe, on the basis of an increased incidence of cancer reported by St. Francis Medical Center and the increased blood lead levels in Peoria’s children as reported by the head of the Peoria Medical Society, that the toxic-waste landfill is tied to medical problems. If there are suspicions and indications that this may be true, the precautionary principle would tell you that you cannot wait for absolute proof when human health is at stake. But, as Steingraber writes in Living Downstream: “Our current methods of regulation, by contrast, appear governed by what some frustrated policymakers have called the dead body approach: wait until damage is proven before action is taken. It is a system tantamount to running an uncontrolled experiment using human subjects.”
Toward the end of the evening, Steingraber reads a personal e-mail from her mentor Dr. Joseph Guth, a biochemist, attorney, and senior policy analyst for the Center for Environmental Health: “Where does all the waste that our economy and the global economy continues to generate going to go? To the land of the politically powerless, which includes the Third World and the First World and those who are disenfranchised and those who are asleep. If the good people of Peoria want to stay asleep, everyone else’s waste is coming right at them.”
As she reads Guth’s message, her voice is gentle, like a mother soothing a child who is injured or who is facing a doctor’s appointment or a hospital stay: Yes, it hurts, but together we can fix it, and we’ll be OK. Despite her disconcerting message, Steingraber gets a standing ovation.
As we drive Interstate 39 toward Rockford, I ask Steingraber about the source of her bravery. How could she, 20 years ago, travel to war-torn areas of Africa to study the environmental effects of war on the Blue Nile River? How can she continue to confront issues that make most of us feel helpless?
It was not destiny, she tells me. At times, she says, she has stumbled through life’s decisions as the rest of us do, and, like the rest of us, she has been affected by events beyond her control — her mother’s breast cancer, her own battle with bladder cancer while only in her twenties. I notice that she speaks of her mistakes and misgivings as easily as she speaks of the science she has intensively studied, and she in turn listens intently.
I already know from Steingraber’s lectures, from the way she responds to people, that she does not hold herself above anyone. Perhaps it is this — her respect for the scientific and nonscientific worlds alike, her willingness to expose her own tribulations — as much as her incredible background, that allows her audience to believe that they, too, can do their part, with their own abilities and talents, to pave the way for a less toxic future. During the three-hour drive our conversation jumps often between urgent issues and everyday happenings. As we approach Rockford, it takes another giant leap from remembrances of our youth (Steingraber remembers with regret slowing her pace as she walked to school so as not to arrive with the boy with “cooties”) to the enormity and longevity of cleanups at Superfund sites, one of which is being dealt with in Rockford. Before environmental laws were established in the 1970s, many industries disposed of their waste in the most convenient way possible, which often meant dumping them on the ground or into the closest body of water. The most highly contaminated and dangerous sites eventually came to be covered by the Comprehensive Environmental Response, Compensation, and Liability Act, more commonly known as Superfund, in 1980. This act allowed for immediate response to threats to human health and massive remediation efforts. Such was the case at the Rockford site. Contamination of soil and an underlying aquifer resulting from the disposal of hazardous waste at the Southeast Rockford Groundwater Contamination site — including chlorinated solvents, waste oils and fuels, paint sludge, and hospital wastes — was thought to have occurred mainly in the late 1950s and early ’60s, although it was not discovered until the late ’80s, prompted by a citizen complaint. In 1991, the EPA moved 283 residents from wells to a municipal water supply. An additional 264 homes had received municipal water service by late 1992.
In Living Downstream Steingraber writes briefly about the Rockford site, and she now mentions its connection to an advance in the understanding of human epidemiology. It was a study conducted here, she says, that revealed that when one is dealing with a chemical that evaporates easily, the greatest exposure, surprisingly, comes from breathing the air, not drinking the water. This study, which was initiated in 1989 by the Illinois Department of Public Health, made the contamination in Rockford “famous in toxicology circles.”
Four source areas of contamination have been identified at the Southeast Rockford Groundwater Contamination site, and cleanup work began in 2005 with a limited removal of contaminated soil at one of the four sources. According to the Illinois EPA, additional work at this area is expected to commence in 2008, and it is hoped that the agency can start to address a second source area as well. It has been nearly 20 years since the discovery of this site. Millions of dollars have already been spent, and millions more will be needed. The perils of playing legislative catch-up, of believing that the future holds answers to problems involving waste, are excruciatingly apparent at Superfund sites.

Steingraber has an amazing ability to reduce scientific findings of great intricacy to elegant terms and stories. In Peoria she took us through human development from conception to old age, highlighting our vulnerabilities to chemicals at each phase of life. At Rockford College, Steingraber again escorts her audience on a complex journey, telling the story of an “environmental detective” following lines of evidence to logical conclusions. She leads the audience through the vast and tangled data potentially linking “the No. 1 pesticide used in the United States,” atrazine, to non-Hodgkin’s lymphoma. The first clue: the cancer-registry data, which show that the incidence of non-Hodgkin’s lymphoma has tripled over the last half-century. Furthermore, Steingraber says, there are no changes in genetics or bad habits to explain the increase. The maps that graphically indicate zones of incidence show clusters in regions with high use of herbicides. The next line of evidence, she says, comes when you ask whether certain professions have shown an increase in the incidence of non-Hodgkin’s lymphoma more rapid than that in the general population. You will learn that the disease is more common in farmers, Vietnam veterans exposed to Agent Orange, and golf-course superintendents. And what does the animal data show? It shows that dogs, too, get non-Hodgkin’s lymphoma.
Steingraber, at a recent event sponsored by the Land Connection
Then Steingraber asks what the scientific community knows about the actual genetic fingerprint of pesticides in patients with non-Hodgkin’s lymphoma. She tells us that research shows a rare mutation in which “a chunk of DNA actually breaks off, flips upside down, and then reattaches itself.” When a search for this mutation was made in the general population, she reports, it was found “in high frequency among those who are farmers or those who are pesticide applicators.” The evidence — with the cancer-registry data, the maps, the occupational literature, the animal data all pointing to the same suspect — is incriminating; nevertheless, it’s still considered partial evidence. “And the question is, when does the weight of the evidence become sufficient that we decide as a society that we’re paying too high a price for this kind of weed control? When will we decide to do something different?” she asks. We have, in fact, had the will and the courage once before, she tells us — in 1964. This is when the U.S. surgeon general warned us, “on the basis of animal studies and a few correlative studies,” that smoking caused lung cancer. The definitive proof that smoking causes lung cancer — the exact gene and the exact mutation — was not discovered until 1996. “But we didn’t need to know that mechanism before we warned people about smoking and lung cancer,” she says. “I’ve been protected from what we now recognize as a known carcinogen, secondhand tobacco smoke, my whole life because my parents had the courage to act on good but partial evidence — and I think we can likewise find the courage to exercise good judgment in the face of good but partial evidence and to embrace the precautionary principle, which dictates that people should not remain in harm’s way while the wheels of scientific proof-making slowly grind on. It’s the kind of courage that requires imagination.”
Imagine, she says, an Illinois with falling cancer rates and an economy that is no longer dependent on the production and use of cancer-causing chemicals. “Two hundred years ago abolitionists were called unrealistic when they dared to envision a U.S. economy not dependent on slave labor — and I think if we can divorce our economy from slave labor we can certainly divorce it from chemical carcinogens. We can become chemical abolitionists,” she declares.
After her lecture in Rockford, Steingraber talks to every person who has lined up to speak to her. When we return to our hotel, she asks me whether I would like to take a look at the materials that inform her lectures. I cannot pass up the chance to look through her personal file. She sends me back to my room with a bulging folder.
I scan, as closely as my tired eyes will allow, science reports, policy reports, a Government Accountability Office report called “Options Exist to Improve EPA’s Ability to Assess Health Risks and Manage Its Chemical Review Program,” and personal e-mail correspondence from experts, some of whose names I recognize. Sandra Steingraber does not, apparently, pull information from thin air. Her folder includes a 2006 article from The Lancet, one of the oldest peer-reviewed medical journals in the world, titled “Developmental Neurotoxicity of Industrial Chemicals.” The report contends, “A few industrial chemicals are recognized causes of neurodevelopmental disorders and subclinical brain dysfunction.” It continues: “Of the thousands of chemicals used in commerce, fewer than half have been subjected to even token laboratory testing for toxicity. Nearly 3,000 of these substances are produced in quantities of almost 500,000 kg [kilograms] every year, but for nearly half these high-volume chemicals no basic toxicity data are publicly available, and 80 percent have no information about developmental or paediatric toxicity. . . . In the U.S.A., a legal mandate to require testing was established in the Toxic Substances Control Act, but is largely unenforced.”
Her folder also includes a copy of Mark Schapiro’s “Toxic Inaction,” published in the October 2007 edition of Harper’s, which examines how Europeans “recently decided to do something about all the untested chemicals that are ending up in their blood” through the recently enacted Registration, Evaluation, and Authorisation of Chemicals legislation. Schapiro quotes a European Union official who states: “The assumption among Americans is, ‘If it’s on the market, it’s okay.’ That fantasy is gone in Europe.”
When writing about the universal use of DDT in the seminal book Silent Spring, Rachel Carson, to whom Steingraber is often compared, noted that “in most minds the product takes on the harmless aspect of the familiar.” But given what I have learned on this road trip, I wonder as we drive home whether it is, rather, the harmless aspect of the unfamiliar. If we have never heard about it, then how bad can it be? Many people in Peoria were unaware of the toxic nature of the nearby landfill. In fact, in a strange twist, a recent editorial by the Peoria Journal Star seems to present this fact as a reason not to oppose the landfill expansion: “Many folks who were not even aware of the landfill’s existence are vehemently opposed to it now, including an uncommon coalition of local doctors who cite its potential health risks.” In addition, the Web site of Peoria Families Against Toxic Waste advises, under a section called “What Can You Do?” that people e-mail, phone, and talk to friends and neighbors because “many people in Peoria County are still not aware this hazardous waste landfill exists.”
In Rockford, Steingraber asked people what they know about the Superfund site in their community. No one she asked has heard of it, despite the fact it has been nearly 20 years since the contamination was discovered; despite the fact that, according to the U.S. EPA’s Superfund Web site, “all four areas continue to pose a potential threat of further contaminant release.”
We decide to take the back roads home, and Steingraber comments on the loveliness of the landscape. This sentiment, which tends to elude most native Illinoisans, reminds me of the opening chapter in Living Downstream. In it she speaks to imagined first-time visitors to Illinois farm country: “But Illinois is not flat at all, I would insist, as I unfold geological survey maps that make visible the surprisingly contoured lay of the land. Parallel arcs of scalloped moraines slant across the state, each ridge representing the retreating edge of a glacier as it melted back into Lake Michigan and surrendered the tons of granulated rock and sand it had churned into itself.”
For Sandra Steingraber, nothing is too familiar or unfamiliar about her much-loved Illinois as she peels back the layers to reveal both its allure and peril.

Springfield writer Jeanne Townsend Handy’s story on bicycling, “Pedal power,” was published in the Aug. 30 edition of Illinois Times.
Bound for Springfield in July

Dr. Sandra Steingraber will be in Springfield in July 2008 to speak at the ribbon-cutting ceremony celebrating the opening of the Southern Illinois University School of Medicine’s SimmonsCooper Cancer Institute. Steingraber had been an “insightful, thought-provoking” keynote speaker at the February 2001 installment of the medical school’s annual cancer symposium, “when the Cancer Institute was just a gleam in the eye of faculty at SIU,” says Ann Hamilton, director of continuing medical education. “It seemed that she would be the perfect speaker to bring us full circle.”
Steingraber says she hopes to work with the SimmonsCooper Cancer Institute to develop a rapid-response team that would proactively conduct environmental investigations in ZIP code areas in Illinois with higher-than-normal rates of cancer. Illinois is the ideal state, she says, for this kind of active investigation, given its “gold standard” cancer registry, its numerous toxic sites, and its pesticide contamination in rural areas. “One can investigate, in Illinois, the role of both industrial and agricultural chemicals on cancer rates,” she says. Steingraber also plans to call for active investigation into clusters of children’s cancers in Illinois, “as there is troubling evidence from the lab bench and from human data linking pesticide exposure to pediatric brain and blood cancers.”
She adds that the evidence is so compelling that many Canadian cities and provinces have outlawed the cosmetic use of pesticides. “It’s time for Illinois to stop taking a ‘See no evil, hear no evil’ approach to environmental health,” she says. — Jeanne Townsend Handy


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