Toxic shock: the environment-cancer connection.

Frank Wiewel lives the Joni Mitchell song: He's looked at clouds from both sides now. At home in the heartland of Ohto, Iowa, where corn is king, he once saw clouds simply as harbingers of rain. Not anymore. Now he sees them as floating concentrations of toxic waste. As president of People Against Cancer, a grassroots group dedicated to cancer prevention and promotion of alternative therapies, Wiewel was shocked to learn from an article in The Des Moines Register that the soil of America's bread basket is so saturated with chemicals that "our clouds are laced with pesticides like atrizine that have actually evaporated out of the ground along with the water, and rain down on us from out of the sky."

And when Wiewel sees clouds, he thinks numbers. "Eight million Americans have cancer right now, with 1.2 million diagnosed just last year," he says. Your odds of contracting cancer are currently one in three and climbing, and cancer now kills one in four in this country. The federally funded National Cancer Institute (NCI) reports that 526,000 Americans died from cancer in 1993.

Weiwel's organization is just one foot soldier in the 24-year War on Cancer, but his own decade of cancer research has led to a stark conviction: "We have permeated our food, our air, our water, and our living environment with poisons and we have little--if any--evidence of their safety."

No matter how well you've lived over the years, whether you're vegetarian or beef-eater, city-dweller or Eskimo, you live on a polluted planet. Measurable quantities of chloroform, fre-on and carbon tetrachloride flow from your lungs when you breathe, and your fatty tissue and blood carry trace amounts of the infamous DDT and its breakdown partner DDE. Every man's semen swims with 35 different kinds of PCBs, plus ethers and phenols, and every woman's breast milk boasts a Frankensteinian brew of the pesticides chlordane, dieldrin, lindane and mirex, mixed with some 65 isomers of PCBs and dioxins.

Greenpeace reports that, through activities as diverse as incinerating trash, spraying crops, chlorinating drinking water and bleaching paper, your body is burdened with some 177 different kinds of organochlorines, reactive compounds with carbon-chlorine bonds that include pesticides, dioxins, PCBs, solvents, acids and more. The Environmental Protection Agency's (EPA) reassessment of the dangers of dioxin, the chemical that shuttered Times Beach, Missouri in 1982 and earlier rained over Vietnam in the defoliant called Agent Orange, calculates that the average American carries some 40 to 60 parts per trillion of dioxin compounds in our tissues, a level of exposure that, while minute, is "very near the levels expected to cause adverse health effects."

Toss into your tissues the heavy metals lead (in food and air), mercury (mostly in fish), cadmium (in food and cigarette smoke), chromium (a by-product of steel production) and arsenic (from pesticides and burning coal). Throw a pinch of radioactive strontium 90 (from nuclear testing) in your bones and iodine 131 (concentrated in milk since Chernobyl) in your thyroid. Shake vigorously ... and the cancer war has just begun. For while industry has introduced anywhere from 50,000 to 70,000 synthetic chemicals into the environment, the National Research Council has substantive toxicity data available on a meager two percent of the chemicals used in commerce. While some 1,500 new chemicals--plastics, solvents, cleaning agents and reformulated fuels--enter the marketplace annually, underfunded government watchdogs check the toxicity of only about a dozen, or maybe 20. That's it.

We know that 750 million pounds of some 20,000 different pesticidal potions are poured over the American landscape annually, and regulations legally allow for 40 pesticides in carrots, 67 in strawberries and 82 in grapes. A 1992 Food and Drug Agency (FDA) study concluded that the average American shopping trip is laden with some 60 to 80 pesticides, herbicides, rodenticides and fungicides--several of them considered carcinogenic--though, of course, all at "acceptable levels."

John O'Connor, who ran the now-defunct National Toxics Campaign, calls "uncontrolled toxic chemicals and waste perhaps our nation's number one hidden health problem." Jay Feldman, director of the Washington, D.C.-based National Coalition Against the Misuse of Pesticides (NCAMP), has "declared war against environmental contaminants and the legislators who allow the pollution of our bodies to continue." And many environmentalists are demanding that chemicals be considered guilty until proven innocent, not vice versa. In response, a nervous Chemical Manufacturers Association has flooded TV, newspapers and magazines--even environmental ones--with ads touting their stewardship of natural resources and concern for environmental responsibility.

Caught in the crossfire are you and your cells. Is cancer killing us softly with environmental toxics? Or are we, as insists "father of the green revolution" Norman Borlaug, the 1970 Nobel Peace Prize winner and chemical fertilizer proponent, in the "grip of a virulent strain of chemical-phobia" induced by the "pseudo-scientific promoters of toxic terror"?

Report from the Front Line

In a White House ceremony that echoed both John F. Kennedy's space race and Lyndon Johnson's "War on Poverty," Richard Nixon gave Americans a Christmas present in 1971 by signing the National Cancer Act to unleash the "War on Cancer," a crash program to cure cancer by the Bicentennial five years later. The National Cancer Institute, which has now missed the deadline by 19 years and counting, has funneled $25 billion into this war--and requested from Congress another $3.6 billion for fiscal year 1995, a whopping 80 percent increase over 1994. What has been the bang for our tax buck?

Dr. Samuel Epstein, a professor of occupational and environmental medicine at the University of Illinois School of Public Health, says, "Cancer rates are escalating to epidemic proportions." The "Big C" grows bigger: It's the number two killer, trailing only heart disease. Epstein's numbers show that since 1950 overall cancer incidence has increased by 44 percent, breast cancer and male colon cancer by 60 percent, and prostate and kidney cancers by 100 percent. Testicular cancer has tripled since 1938, and melanoma, prostate cancer, non-Hodgkin's lymphoma, multiple myeloma and cancers of the brain and liver are all climbing.

Dr. John C. Bailar III of McGill University has told the President's Cancer Panel (a "joint chiefs" of the Cancer War), that cancer death rates have climbed seven percent between 1975 and 1990--even with breakthroughs in chemotherapy and new imaging techniques that allow us to spot cancerous growths sooner (though a sizeable portion of the increase is attributable to lung, cancer mortality from cigarette smokers). He concluded his testimony glumly: "Our decades of war against cancer have been a qualified failure."

The numbers for African-Americans are especially grim: Although the incidence of cancer in blacks is only eight percent higher than in whites, African-Americans die from cancer 35 percent more frequently than do whites. And for children, though survival rates have climbed, the NCI reports that so have childhood cancer rates from acute lymphocytic leukemia and cancers of the brain and nervous system. More than 6,000 children younger than 14 will be diagnosed with cancer this year--and the disease is a leading cause of death in kids, second only to accidents (see sidebar).

Epstein estimates that Americans spend "about $110 billion annually on cancer treatment, nearly two percent of our GNP." And 10 percent of our total health care bill. The American Hospital Association predicts that, by the year 2000, cancer will replace heart disease as the nation's leading killer.

Cancer's War of Words

Popular discussion of cancer lurches from one headline to the next. Last week, it was trans-fatty acids in margarine; this week, the heterocyclic amines produced when we grill chicken and beef on backyard barbecues. At cocktail parties nationwide, we shrug off the latest bad news with a blithe, "Oh, everything causes cancer," and everyone smirks knowingly.

But in cancer circles, there's a stunning dismissal of the impact of chemicals on rising cancer rates. Dr. Clark Heath, the American Cancer Society's chief epidemiologist, speaks for his profession when he characterizes your risk from low-dose chemical exposures as "minuscule. That's not denying," he says, "that trace chemicals do carry a risk, but the popular, lay perception of the risk is greatly exaggerated."

Any epidemiologist will tell you that the horsemen of cancer's apocalypse are smoking and diet, which cause perhaps two-thirds of all cancers. The rest can be blamed on a host of factors: excessive sunbathing promoting skin cancer; occupational exposure, especially among asbestos workers; genetic proclivity to cancer; excessive drinking; and infectious diseases like AIDS.

Environmental toxins are the Rodney Dangerfield of cancer research--they get no respect, and that makes Epstein fume. "The National Cancer Institute is totally silent on the role of toxic chemicals in cancer causation, and the American Cancer Society also trivializes the risks from chemicals."

That's because of the way science conducts its cancer work. The research cathedral rests squarely on twin towers: toxicology tests and epidemiological studies. In a process worked out through decades of convention, a substance undergoes rigorous testing on a variety of animal species to search for carcinogens and toxic levels of exposure.

Next come epidemiological studies. Since science doesn't test carcinogens on unsuspecting human guinea pigs, epidemiologists study large groups of people who have been exposed to measureable concentrations of substances for known periods of time (often workers who've received occupational doses of a substance) and their results confirm, contradict, or lead to the oft-written "more research is needed at this time."

Epidemiological studies present Olympian hurdles, most notably the pulling of single threads from the rich tapestry of lives. The search for cancer pockets around Superfund sites and petrochemical factories, for example, has often been inconclusive. A factory neighborhood with a blue-collar or minority population presents a variety of possible cancer-causing factors, like high smoking rates, preference for high-fat, low-fiber diets, and high incidence of drinking. "We saw an association between lung cancers and truck drivers," explains Aaron Blair, chief of NCI's Occupational Studies Section, "and assumed it was from breathing diesel fume exhaust. But sometimes you see an association betweeen A and B because C is lurking in the background. Later, we discovered that most truck drivers smoke; that was the lung cancer risk."

And animal tests carry legendary problems since they are always performed at high doses. "What regulatory agencies are concerned about," says F. Jay Murray, who performed ground-breaking studies on dioxin 20 years ago, "is very low risk, the theoretical one in a million. But if we try to figure what dose causes one cancer in a million individuals, you'd need more than a million rats in a test, and no one can do that. So we test on 50 or 100 rats, use much higher doses, then assume we can draw a straight line down what happens at low doses," a what science calls a dose-response curve. "But it's just not that simple."

Consider three widely repeated criticisms:

One, Elizabeth Whelan, president of the industry-funded American Council on Science and Health, decries the mouse test as "essential to those who seek to terrify us about food additives, pesticides and other trace-element chemicals. The time has come for us to recognize that mouse terrorism poses a serious problem in terms of both maintaining our high standard of living and our good health."

Two, from Berkeley microbiologist Bruce Ames: "High doses kill cells, causing neighboring cells to divide to help healing. But chronic cell division is a strong risk factor for cancer. The high dose itself causes cancer, and most chemicals pose no risk--zero risk--at low doses. At high dose, fully one half of the natural chemicals we test are carcinogens."

Three, from toxicologist M. Alice Ottoboni, writing in the now-defunct Garbage magazine: "Every chemical has some set of exposure conditions under which it is toxic, and conversely, every chemical has some set of exposure conditions in which it is not toxic." She then cites a maxim of toxicology: "The dose makes the poison."

These criticisms infuriate Samuel Epstein. "There is overwhelming agreement by most qualified scientists that if a chemical causes cancer in well-diagnosed animal tests, there is a strong likelihood that it will also cause cancer in exposed humans. Usually, the animal studies are ahead of the human studies." Is there a safe threshold level for a substance? "Nonsense," he insists, "The overwhelming evidence from every single expert is we have no way to set a threshold. One part per billion (ppb) represents quadrillions of trillions of molecules." Since just one molecule of a carcinogenic substance may unlock a cell's DNA and promote the growth of a tumor, the notion of a threshold (i.e. "harmless" level--like the 40 ppb of dioxin residing in your tissues--quickly unravels.

Forging New Links

What are not compatible are cancer researchers. What was once a war on cancer has degenerated into a war among researchers, vying for headlines, funding, and access to popular opinion. The trial of chemical carcinogens by a jury of doctors, media, industry and environmental groups remains hung until a smoking gun is discovered.

Mary Wolff might have found one.

In a widely discussed, widely embraced and widely derided study, Mary Wolff of the Mount Sinai School of Medicine concluded that women with high blood serum levels of DDE, a metabolic breakdown product of DDT, showed a quadrupled rate of breast cancer. She fears that DDT's molecular structure mimics the hormone estrogen, and elevated estrogen levels may lead to breast cancer. "The data suggest," she explains, "that estrogens exert a cancer-promoting effect and that a diet rich in animal products and fat may increase a woman's risk of breast cancer. Our data suggest that organochlorine residues, and in particular DDE, are strongly associated with breast cancer risk. These observations are important in light of the fact that DDE is a widespread contaminant of animal food products, and that human absorption is related to the ingestion of animal fat."

Though fatty diet has long been known as a leading factor in cancer's climb, science is less certain why. Are fats carcinogenic? Or does a fatty diet rob people of the cancer-killing chemicals of fruits and vegetables? Wolff's study suggests a third, more sinister, possibility: Fat-soluble organochlorines, like DDT, PCBs and dioxin that are transferred from fatty foods to body fat, are a hidden risk factor.

But when a California study failed to replicate Wolff's results, industry press releases--which many newspapers dutifully printed--chirped, "No link between cancer, DDT seen." Not quite true, for the study did discern a weakly positive correlation between breast cancer and DDE levels in African-American and white women. Oddly, a third group, Asian-Americans, showed the reverse: high DDE, low breast cancer. Lump all three together, no correlation. Experts like the American Cancer Society's Clark Heath all too quickly hailed this study as definitive "proof" that Wolff was wrong.

Truth is, Wolff's already got a second opinion. Last year, the New York State Department of Health found that almost 15 percent of the women studied on Long Island who were victims of breast cancer after menopause had lived within one kilometer of a chemical, rubber or plastics plant. Their conclusion: Proximity to such places elevated breast cancer risk by 62 percent. State health commissioner Mark Chassin noted that "if this association proves real, it will be the first time that an environmental risk factor that is avoidable has been identified."

A second smoking gun points at farmers, normally a healthy group with a lower overall cancer risk, perhaps because farmers tend to smoke less and exercise more. But the NCI has uncovered a fatal trend in farmers: Cancers of the lip, skin, prostrate and brain, as well as multiple myeloma and non-Hodgkin's lymphoma, are higher than normal. "The very tumors that are excessive in farmers are now increasing and appear to be drifting into the general population," says NCI's Blair, "and we ought to be worried about this."

Devra Lee Davis, a senior advisor within the Department of Health and Human Services, co-authored a study which concluded, "In all age groups, cancer incidence is increasing in the United States." Contrasting current adults with those of a century ago, she found that a white male in his 40s has twice the risk of developing cancer that his grandfather did; a white female has a 50 percent greater probability of all cancers than women of that era, as well as a doubled risk from breast cancer specifically. She thinks that "changes in carcinogenic hazards, in addition to smoking, are likely to have occurred," and recommends environmental toxics as a likely place to start the search. Joe Thornton, who directs Greenpeace USA's anti-toxics campaign, says the "Davis study provides very strongly argued scientific support for what many people have intuitively understood all along--we have a cancer epidemic on our hands, and evidence links it to chemicals and pollution in the ecosystem."

The End of Sex

Theo Colborn of the World Wildlife Fund brings a chilling message to the ongoing guerrilla war against cancer. "We were fighting the wrong war all along," she insists. Colborn is one of a group of scientists worldwide who has received massive attention for reporting startling news from the field. From alligators born with very small penises to rainbow trout hatched with organs of both sexes, from bald eagles with twisted beaks to Great Lakes fish with thyroids so large they explode, Colborn is convinced that a series of organochlorine chemicals function as "environmental hormones," estrogen-mimicking substances capable of subtly altering the endocrine and reproductive systems of exposed animals, altering sex itself.

Worse, workers in this terrifying arena have begun linking these effects to humans. In our embryos, sex organs begin to differentiate between the seventh and 14th weeks--and changes in the hormonal environment at just the right time can alter development. In males of several countries, including the U.S., the incidence of low sperm count, malformed sperm, boys born with malformed penises or undescended testes, and testicular cancer itself have risen dramatically.

"Now we're talking about loss of reproductive capability, of transgenerational effects," Colborn worries. "The chemical gets into the mother during embryonic development, and the embryo receives second-hand exposure. All it takes is just a low dose--in fact, one dose delivered at the right time--and you got changes in the embryo that are irreversible."

And it's not just males who are of concern. Researchers are studying the rapid rise in endometriosis for a possible connection, and Colborn considers even more subtle effects like learning disabilities and shorter attention spans in children. One Wayne State University study looked at Great Lakes women who ate two or three lake fish per month, and found their babies tended to be lighter and smaller, with reduced skull circumference, and, by age four, showed short-term memory problems.

Consider your body's burden of perhaps 40 parts per trillion of dioxin, an infinitesimal drop in your body's chemistry. The horror of endocrine disruptors is that the very hormones your body naturally produces--and which these chemicals mimic--are designed to function at just those small levels.

Dr. Kenneth Olden, director of the National Institute of Environmental Health Sciences, a sister agency of the NCI, calls the new estrogenic research "strong" and "compelling," and admits that "pesticides and agricultural chemicals play a major role in birth defects and infertility, premature births, osteoporosis, possibly even Alzheimer's and Parkinsons's diseases. We need to investigate these."

The powerful potential of industrial pollutants to act like biological Bobbits has everyone's attention, especially the male-dominated institutions of research and the press. Apparently, that's what it took: a swift kick in the groin.

An Arc of Consequence

For the National Cancer Institute, activists demand wholesale changes. "They put virtually no effort whatsoever into reducing avoidable exposures to carcinogenic chemicals in air, water and food," Epstein avers. Perhaps even the NCI, with its well established bias for funding diagnosis and treatment--not prevention--is evolving as well. NIEHS's Olden notes that his agency is co-sponsoring a major study "with the NCI and EPA, a large epidemiological project in Iowa and North Carolina, on the health effects of agricultural chemicals on farm workers, pesticide applicators, and their families." His policy recommendation is elegant, but impossible: "We need to identify agents that cause cancer or any health problem, and get them out of the environment."

Sure, but we've produced 70,000 different chemicals, and understand only a fraction of them. Even dioxin, the most studied chemical in history, and an accidental byproduct of several industrial processes, produces no consensus on either its health effects or removal options. And that's why Greenpeace is demanding removal of all chlorinated hydrocarbons--since we can't afford to study them painstakingly one by one, they argue, we should remove the entire family of 11,000 substances from the environment.

Which brings us back to Frank Weiwel, staring at a pesticide-strewn cloud floating over Iowa's landscape. "We still don't know what acceptable limits are, and we've never studied them in combination," which is how they end up in your tissue, phenol next to ether, DDE floating alongside dieldrin. "If we wait for the proof, we're all dead."

MIKE WEILBACHER is an environmental educator, writer and former host of an environmental show on Philadelphia radio.