Synthetic Chemicals and Bill Moyers

American chemical companies certainly did not do everything that they should have done to protect their workers from injuries caused by certain industrial chemicals. That much is clear from the 90-minute Bill Moyers' documentary, Trade Secrets, which aired on PBS earlier this week. But the implications for public policy are not necessarily those that Moyers recommends.

The Moyers program was largely based on a million pages of old industry documents made available as part of the discovery process in a lawsuit filed by the wife of Dan Ross, a Conoco worker who died of brain cancer in 1990. The suit alleged that Ross' brain cancer was caused by his occupational exposure to vinyl chloride monomer (VCM) and was settled out of court.

Moyers shows that chemical industry executives knew of the dangers posed by VCM (which should be kept distinct from polyvinyl chloride, PVC, which is safely used to make all sorts of products today) and failed to inform their workers in a timely fashion. For example, in the 1960s, the industry learned that exposure to VCM could erode the bones in the hands of workers who cleaned the tanks in which it was mixed. During the half-hour roundtable that followed the documentary, a hapless lawyer representing the chemical industry denied that the industry had tried to hide this fact by pointing out that the industry doctor who had discovered the problem published his findings in the Journal of the American Medical Association (JAMA). Moyers astutely asked, Did that doctor tell the workers at the plant about his findings? The lawyer sputtered that the workers' own doctors could have read about it in JAMA and warned them. That's simply not good enough.

In another case, Dr. Caesare Maltoni, a European researcher, found in 1973 that VCM caused liver cancer in mice at exposures over 250 parts per million. Public health historian Gerald Markowitz (who apparently worked for Dan Ross' attorney) claimed in the documentary that industry executives signed "a secrecy agreement between the Europeans and the Americans so that each of their researches will be secret from everybody outside the industry." The chemical industry's response is that the secrecy agreement had to be signed so that the industry could have preliminary access to Dr. Maltoni's data rather than wait for it to be published in the peer-reviewed scientific literature. Considering that Dr. Maltoni's work was financed by European manufacturers of VCM, it not unreasonable to think that they could have just ordered Maltoni to release his data. In any case, the industry's rather lame response to the Moyers program can be found here.

To further illustrate industry malfeasance, Moyers also considered cases involving benzene, which increases the risk of leukemia in exposed workers, and a pesticide called DBCP which causes sterility in exposed workers. These cases were also clearly avoidable tragedies.

That said, the chemical industry is not alone in twisting the facts to suit their case. Moyers himself performs rhetorical jujitsu by bringing up those environmentalist icons, Times Beach, Missouri, and Love Canal in Niagara Falls, New York. Times Beach was forcibly evacuated over a dioxin scare and Love Canal was evacuated when a Hooker Chemical waste dump was breached by building a highway near it and pipelines through it. However, far from proving Moyers' case for lurking toxic dangers, researchers have found no evidence of increased birth defects or cancer among the former residents of those areas.

As the use of Dan Ross shows, Moyers is also not above using the old "victim as epidemiologist" ploy. This involves finding a sympathetic victim who believes himself injured by an evil corporation and then contrasting his plight with the robotic defenders of industry, who inevitably hide behind reams of cold unfeeling data. Guess who wins the hearts and minds of the public? But the plain fact is that we will never know for sure what caused Dan Ross' cancer.

Moyers makes a breathtaking leap from a few specific cases of high occupational exposures to VCM, benzene, and DBCP to the broad generalization that thousands of modern synthetic chemicals may be causing health problems for millions of Americans.

At the end of the documentary, Moyers ominously concludes: "Half a century into the chemical revolution, there's a lot we don't know about the tens of thousands of chemicals all around us. What we do know is that breast cancer has risen steadily over the last four decades, 40,000 women will die of it in this year alone. We do know brain cancer among children is up by 26 percent. We know testicular cancer among older teenage boys has almost doubled, that infertility among young adults is up, and so are learning disabilities in children. We don't know why. But, by the industry's own admission, very little data exists to prove chemicals safe. So we are flying blind, except the laboratory mice in this vast chemical experiment are the children. They have no idea what's happening to them, and neither do we."

Notice how very selective Moyers is being in the data that he cites. Has breast cancer really "risen steadily over the last four decades?" It is true that breast cancer incidence rates did climb about 1 percent per year from 1940 to 1982, and appeared to jump to 4 percent per year from 1982 to 1987. That jump in the 1980s is largely the result of increased mammography screening which found cancer at earlier stages, not a real rate of increase. The National Cancer Institute recently concluded that "[b]reast cancer incidence rates have shown little change in the 1990s."

What's responsible for the earlier rise? Known risk factors include delaying childbearing, changes in breastfeeding patterns, and increased consumption of dietary fats. Over the years, scores of studies trying to prove that DDT causes breast cancer have turned up nothing conclusive.

With regard to brain cancer in children, the overall incidence rose from 1973 through 1995 (from 2.3 to 3.1 per 100,000), with the greatest increase occurring from l983 through l986. In 1998, an article in the Journal of the National Cancer Institute suggested that the rise may not represent a true increase in the number of cases, but may be due to better diagnosis using magnetic resonance imaging, a powerful new technology that allows doctors to scan brains more precisely and which became more widely available only in the 1980s. More important, in 1999, the National Cancer Institute concluded that "[o]ver the past 20 years, there has been relatively little change in the incidence of children diagnosed with all forms of cancer; from 13 cases per 100,000 children in 1974 to 13.2 per 100,000 children in 1995." So there's no epidemic of cancer among children.

With regard to testicular cancer rates among teenagers, why did Moyers focus on this specific cancer? Testicular cancer rates among older teenagers apparently peaked at 3.4 per 100,000 in the 1992-1995 cohort and have dropped to 3.0 per 100,000 in the 1993-1997 cohort. To give some sense of proportion, consider that only 900 teenagers, male and female, developed any gonadal (testicular or ovarian) cancers according to a report from the U.S. Centers for Disease Control in 1998. While each of these cases is tragically sad, the overall numbers are too small to draw any possible conclusions about anything.

Infertility among young adults is up. But again, confounding factors include increased higher rates of venereal disease and abortion, which are known risk factors for infertility. The diagnosis of learning disabilities is also up, but as the director of the Washington, D.C.-based Statistical Assessment Service, David Murray, points out, that increase is likely the result of expanding the definition of what constitutes learning disabilities since the 1970s rather than a real increase.

The cases of VCM, benzene, and DBCP underscore the fact that all of the people harmed by these chemicals received very high exposures while on the job. The public is exposed to much lower levels.

The plain fact is that overall cancer incidence rates and, more to the point, cancer mortality rates in the United States have been falling for about a decade. (See "What Cancer Epidemic?")

As the chemical revolution has unfolded, average American life expectancy has also been increasing. This is not to say that exposure to synthetic chemicals, especially workplace exposures, don't sometimes harm people. But they are not a major cause of death in the United States. The American Institute for Cancer Research estimates that "[e]xposure to all manufactured chemicals in air, water, soil and food is believed to cause less than 1% of all cancers."

In the documentary, Dr. Philip Landrigan, a long-time activist with Physicians for Social Responsibility, tells Moyers, "I think the most fundamental lesson is that we have to presume chemicals are guilty until they're proven innocent." However, if cancer rates are the evidence, then it is not unreasonable to conclude that the modern chemical revolution has produced largely innocent substances.

Indeed, on the other side the ledger, one also ought to consider the number of lives that have been saved by the products made from synthetic chemicals. This includes people who would have died from tainted food if there had been no plastic wrap to keep foods fresh and safe from bacteria; those who were saved by automobile air bags; those saved by disposable sterile plastic syringes, blood bags, and medical tubing; and those not injured because solvents, soaps, and foods were stored in unbreakable plastic bottles and containers.

Corporate executives should not be allowed to get away with withholding relevant information about safety and health from their workers–and they should definitely suffer severe legal consequences if they try to do so. Bill Moyers certainly fingered some bad actors in the chemical industry from many years ago, but in the end, he simply cannot show that the health of Americans is at significant risk because of synthetic chemicals.