Living Downstream by Sandra Steingraber, Virago, 拢18.99/$24.95, ISBN 1860494692 (June in US)
IN MY youth, the big killer was car crashes. The 1950s were a bad time for road deaths in Britain, and I saw the evidence at first hand-the main road to the Channel ports ran right past my village. That road, in fact, claimed my best friend.
But at least we knew what to blame. More recently, I have noticed that several parents of children at our local school have died from cancer. Are these cancers linked? Is there a common cause? Is there a cluster, or have I imagined it? With cancer, it is hard know what to blame.
Advertisement
I picked up Sandra Steingraber鈥檚 book, subtitled 鈥淎n Ecologist Looks at Cancer and the Environment鈥�, with some trepidation, because I feared a simple-minded harangue about how chemicals are killing us. But the book is much better than that. For one thing, it is beautifully written: spare, precise and passionate. For another, it admits to the uncertainties, while holding relentlessly to the truth that, one way or another, our environment is responsible in large part for the modern scourge of cancer.
The book is called Living Downstream-downstream, that is, of carcinogens. As she says in her preface, you need to 鈥渨alk up river鈥� to see why bodies keep floating down. It is about cancer registries and toxic release inventories, but also about the failures of science and how a society excuses the presence of synthetic poisons in its midst.
It begins in the cornfields of Steingraber鈥檚 home state of Illinois. Here, during 鈥渢he heyday of organochlorine pesticide use鈥�, kids played behind the atrazine spray trucks and Steingraber contracted bladder cancer at the age of 20. The investigation that unfolds into why she develops 鈥渢he big C鈥� is scary, but never mawkish. And it combines the personal and the forensic splendidly, constantly returning to both scientific journals and a friend who was dying of a rare spinal cancer as she wrote. Steingraber explores the spread of carcinogenic chemicals through the environment and food chain of the postwar US, whose citizens were 鈥渢he first generation to eat synthetic pesticides in our pur茅ed vegetables鈥�. Along the way, she points out how most damage is done in the earliest days, and how many of the nastiest now-banned chemicals are still oozing through our bodily fluids.
She is understandably interested to know why aromatic amines, identified as a cause of bladder cancer a century ago, are still in widespread use. She demolishes the myth that we die of cancers today only because we live long enough to contract them. And she exposes how the discoveries of genes that predispose for cancer are used to distract attention from the environmental agents themselves. 鈥淐ancer rates are not rising because we are suddenly sprouting new cancer genes.鈥�
Steingraber is just as sharp on statistical subterfuge. If the death risk from exposure to one carcinogen is one in a million, then that should be of little comfort if many millions are exposed. You don鈥檛 get one-millionth of a cancer: you either get it or you don鈥檛. The old saw that 鈥渢he poison is the dose鈥� simply doesn鈥檛 work here.
Individuals are clearly in a poor position to influence their fate. And yet, perversely, much of the literature on cancer stresses the power of the individual to make 鈥渓ifestyle choices鈥� to minimise their risk. More logically, a collective risk should be met by a collective response to banish carcinogens from the environment.
In the absence of unexposed control populations, and with myriad potentially toxic variables and long latency periods, science inevitably has problems getting to grips with the environmental causes of cancer, says Steingraber. So we have to look for clues and reach judgments 鈥渢hrough inference鈥�.
Steingraber is a biologist, a poet and a member of the US government鈥檚 National Action Plan on Breast Cancer. All three roles are abundantly evident in this book. After reading it, I tried to imagine what it would have been like as a child to know people were dying outside our village while the existence of the road was just a rumour. For this, perhaps, is where we are with cancer.