I have been thinking about environmental toxins a lot lately. From the nuclear accident in Fukushima Japan to the 25th anniversary of the nuclear meltdown in Chernobyl to my own work as part of the Chicago Clean Power Coalition -- a group of 50 nonprofits working to clean up or shut down Chicago's deadly and dangerous coal-fired power plants -- I am becoming more and more aware that we are all constantly exposed to toxic chemicals and radiation. How much exposure endangers our health? The answer to that question depends on whom you ask.
I'm a wife and mother, so I ask that question in order to do what I can to protect my family. I am also a primary care physician and the director of the Chicago chapter of Physicians for Social Responsibility, a nonprofit dedicated to preventing what we cannot cure. If the levels of radiation emitted in the above-ground testing of nuclear weapons (now universally banned) could increase disease -- particularly cancer -- rates, shouldn't your physician know about this? If nuclear accidents in one country sent billowing clouds of radioactive waste half-way around the world and landed in the soil where a grazing cow was busy producing milk that your child would some day drink, shouldn't public health officials know about this risk? If many U.S. farmers applied the weed killer atrazine -- a proven endocrine disrupter -- to their land every spring, and the runoff ended up in drinking water all across our country and babies, children and adults drank water putting them at higher risk of subsequent infertility and prostate cancer, shouldn't the medical community be aware of this and take action to restrict the use of this widespread chemical?
Many well-known scientists, public health officials and physicians have been sounding alarms about the links between environmental toxins and human health for years now. From Rachel Carson, a biologist and author of "Silent Spring," to Dr. Helen Caldicott, a physician and founder of Physicians for Social Responsibility to Sandra Steingraber, PhD, a biologist and cancer survivor who wrote "Living Downstream" and starred in the documentary film of the same title, scientists and physicians have long been drawing the connections between environmental toxins and human health risk.
Some environmental health risks are well accepted. Doctors warn patients about eating overeating and universally encourage patients to stop smoking and to stop consuming too much alcohol. These risks generally represent personal choices, and interventions like diet, exercise, smoking cessation counseling and substance abuse programs are widespread and widely accepted by the medical community. But what about living near a coal-fired power plant, a toxic waste dump or a nuclear waste facility? Why is the medical voice not nearly as strong? As a practicing physician, I can list several factors from my own experience:
1. It is hard to assess individual risk
If you smoke one pack of cigarettes a day, your doctor can rattle off statistics about how your terrible habit is putting you at risk for lung cancer, heart disease, hypertension, emphysema and other serious ailments. Not to downplay the health risks attributable to second-hand smoke, the link between a very bad habit like smoking and health is linear, and a very easy one for doctors and other medical professionals to discuss with their patients who smoke.
The individual risk of exposure to environmental toxins is much harder to pinpoint. Some women may develop infertility by drinking water in which atrazine is found -- but which individual woman may really have a higher risk? No one knows. Chicagoans living near our coal-fired power plants experience higher asthma exacerbations and asthma deaths (as documented in a well-known Harvard School of Public Health study), but exactly which pediatric asthma patients in Chicago will have worse outcomes is not known. These sorts of population risks can rarely be brought down to the individual scale. Since most medical professionals council individuals about their own risks, it's much harder to warn patients about population health threats.
2. Countries under report their cancer rates.
Ukraine is notorious for covering up the facts of the Chernobyl accident. Not only did children go out to play in the fields surrounding the Chernobyl nuclear power plant as the afflicted plant was spewing radiation into the air, but many researchers express serious doubt that the accident resulted in only 4,000 extra cancer diagnoses, as the Ukrainian government claims. And what about the radiation cloud that spread across much of Northern Europe following the accident? What about the milk chocolate made with milk that had high radiation levels because it came from cows grazing on nearby irradiated grass? What were the cancer risks associated with this radioactive fallout? No country has accurately reported this data.
3. The exact rise in cancer rates is impossible to attribute to one environmental accident.
The incidence of certain cancers, particularly thyroid cancer and leukemia, may very well rise in the Japanese population most heavily exposed to radiation from the Fukushima accident. But it will be difficult for epidemiologists -- scientists who track diseases within populations -- to know exactly how many cancer cases to attribute to the nuclear accident. Cancer can take 15-20 years to appear following excess radiation exposure and other factors may boost or diminish cancer rates. Doctors caring for Hiroshima bombing victims are still seeing new cancers 65 years later.
Environmental toxins pose potentially grave threats to our health, and accidents only compound these threats both locally and for people all over the world who breathe air, eat food, and drink water. Speaking about nuclear power plant accidents, Dr. Jeff Patterson, immediate past president of Physicians for Social Responsibility said, "These accidents don't remain local. They go worldwide." Though the medical professional caring for you and your family may not address the health risk of environmental toxins, they can do serious harm. Just ask Rachel Carson, Helen Caldicott or Sandra Steingraber.
Though I work for Physicians for Social Responsibility, this blog post represents my personal views.