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Health effects and environmental pollutants
54
Book Reviews
George Claus and Karen Bolander. Ecological Sanity. 592pp. David McKay Company Inc., New York, 1977. $16.95. Ecological Sanity is a well written and easy to read presentation o f factualy based scientific arguments on m a n y of the recent and sometimes emotional ecological issues. In its 590 plus pages, Drs. Claus and Bolander aptly cover a multiplicity o f environmental issues for the interested public, industry, legislators as well as the involved scientist. There is a 21 page bibliography containing a wealth o f primary references which obviously can be of significant assistance to any one, more than casually concerned with the subject. The book is not a "pro-environment digest" but by using scientific knowledge it criticizes and finds faults or flaws with some o f the established policies. Some of these subjects include phosphate vs Nitrilotriacetic Acid (NTA) detergents, nitrogen fertilizers and a significant portion o f the book is on the D D T question. One small drawback is the research and background data for this book was completed by 1972 and therefore it is not quite up to date. The publishers in a brief note assumed the responsibility but they do not explain the reason for the inordinate delay of four years.
Washington D. C.
William J. Lacy
G.L. Waldbott. Health Effects and Environmental Pollutants, 336pp. C.V. Mosby, $12.50, 1978. The history of science has not passed a kind verdict on attempts at scientific encyclopedias. For the most part, efforts such as d'Alembert's organization of the philosophe's Encyclopedia, C o m t e ' s synthesis of Positive Science, and Engel's Dialectics of Nature stand as m o n u m e n t s to the impossibility o f their tasks. They reflect their writers' preoccupations more than they represent truly comprehensive pictures of the science of their times. Thus, C o m t e ' s fascination with phrenology and Lamarckian evolution renders a highly distorted view of French physiology; and Engel's c o m m i t m e n t to dialectical reasoning concentrates primarily on those sciences evidencing contradictions in their development. Because it is considerably more modest in scope than these enterprises, George L. Waldbott's encyclopedic book, Health Effects of Environmental Pollutants, succeeds on several counts. First of all, he acknowledges the tentative nature of scientific understanding in the area. Waldbott also indicates the problems of moving from toxicological to pathological and epidemological information. Finally, he addresses his book not only to students o f environmental health and physicians, but to safety personnel in industry and to government agencies. This second edition offers new sections on fluorocarbons, vinylchloride, polychlorinatedbiphenyls (PCB) and some fire retardants. It also features sections on noise pollution, dioxins, aflatoxins and microwave radiation. Although the publication date is June, 1978, some of the references are as recent as March, 1978. The book opens with a brief review of historical incidents of significant environmental pollution, such as the Meuse River Valley disaster near Li6ge, Belgium in 1930, where thousands o f people became violently ill, and the Donora, Pennsylvania inversion, where trapped industrial pollutants rendered at least half the town ill and estimates of those killed varied. Waldbott notes that such catastrophic events are deceptive. There m a y be a tendency for people to believe that when such incidents subside, problems of environmental pollution are insignificant. While most medical training is oriented to such acute, episodic events, training also needs to consider " t h e slow erosion of a person's health by the ever-present pollution in cities, particularly a m o n g those living near industrial establishments or exposed to automobile exhaust and m a n y other c o n t a m i n a n t s . " (p. ll) Because relatively little data are available on the long term effects o f low levels o f exposure to pollutants, Waldbott necessarily relies on discussions o f acute intoxication and occupational exposure. After reviewing some o f the major sources of pollutants and their basic biochemical properties, Waldbott presents an analytical scheme for considering them in terms of their potential health effects.
Acknowledging that m a n y pollutants have multiple effects, he devises a system based on their chief effects. Pollutants are classified according to whether their chief effects are: respiratory (pulmonary, granulomatous agents, asphyxiants, fever producers, or " d u s t s " ) ; systemic (affecting more than one organ system, e.g., entering through the food chain to the gastrointestinal tract to the blood); and host specific (allergens, mutagens, carcinogens). While this latter category includes both respiratory and systemic pollutants, Waldbott maintains that their route and organ of attack is largely determined by host-specificity. This is a point which might be challenged, particularly in light of recent work on oOvagenic, spermagenic, and teratogenic effects; but his analytical system does work in organizing a wealth o f data, the validity of this last assumption notwithstanding. The remainder of the book follows this scheme for discussing more than a thousand toxicological, clinical and epidemiological studies of the health effects of pollutants. He offers a special section on "economic p o i s o n s " , or those substances which, while hazardous to h u m a n s , are also of economic value. In this category Waldbott includes more than 30000 different pesticides, whose annual cost is projected to be $6.3 billion in 1986. There is no mention in this context, or any other, of anesthetic gases whose adverse effects are only now being taken into account in operating room design and personnel practices. Waldbott notes that spraying and dusting are the most dangerous modes of application for pesticides. Ordinarily, between 5 and 70% o f sprays and 40 and 800/0 o f dust applied from the air drift far afield from the target. In his discussion of the contamination of Michigan with PBBs, of the general pollution in the U.S. by the 4000 tons of PCBs that enter the waterways annually, of the explosion and pollution with dioxin in Seveso, Italy, Waldbott reports rather little adverse h u m a n health effects. He states, " s o far, however, no serious permanent health damage of Seveso has been reported." The town was uninhabitable, and for a period of time, several pregnant women had abortions. These two facts themselves could be construed as adverse health effects. But this is a minor lapse in the context of a very useful compendium which should be an excellent teaching tool or self-instructional manual. In his last chapter on prophylaxis and treatment, Waldbott offers an important view of the possibilities o f disease prevention through environmental control. He notes that " o f diseases for which prevention can accomplish more than treatment, those due to air pollution head the list." He makes his case unassailably, noting that people whose lives are threatened by polluted environments have little recourse once they reach this state. He cautions students of environmental health not to be swayed by reports that few adverse effects on h u m a n s have been reported for m a n y pollutants. While this m a y be true, in a strictly scientific sense, because data have not been developed, this does not mean that no h u m a n health damage has occurred, merely that it has not been fully explored. With this valuable book, Waldbott joins the ranks of medical critics who point to the increasing health and economic costs o f environmental pollution. For those who are sceptical of this opinion, his work gives great pause. For others, it is a strong confirmation o f what we have long suspected: Granted that we cannot precisely assess the proportion o f contemporary illness that is due to environmental factors: but that does not m e a n that those factors are insignificant, merely that they require more deliberate study.
Environmental Law Institute Washington, D.C., U.S.A.
Devra Lee Davis
Ignacy Sachs. Environment and Development - - A New Rationale f or Domestic Policy Formulation and International Cooperation Strategies. Ministry of Supply and Services, Ottawa, Canada. 1978. This report was prepared for the Policy Branch of Canadian International Development Agency and the Advanced Concepts Center o f the Department of the Environment o f Canada. It was prepared in 1977 and became available in 1978.
Book Reviews
George Claus and Karen Bolander. Ecological Sanity. 592pp. David McKay Company Inc., New York, 1977. $16.95. Ecological Sanity is a well written and easy to read presentation o f factualy based scientific arguments on m a n y of the recent and sometimes emotional ecological issues. In its 590 plus pages, Drs. Claus and Bolander aptly cover a multiplicity o f environmental issues for the interested public, industry, legislators as well as the involved scientist. There is a 21 page bibliography containing a wealth o f primary references which obviously can be of significant assistance to any one, more than casually concerned with the subject. The book is not a "pro-environment digest" but by using scientific knowledge it criticizes and finds faults or flaws with some o f the established policies. Some of these subjects include phosphate vs Nitrilotriacetic Acid (NTA) detergents, nitrogen fertilizers and a significant portion o f the book is on the D D T question. One small drawback is the research and background data for this book was completed by 1972 and therefore it is not quite up to date. The publishers in a brief note assumed the responsibility but they do not explain the reason for the inordinate delay of four years.
Washington D. C.
William J. Lacy
G.L. Waldbott. Health Effects and Environmental Pollutants, 336pp. C.V. Mosby, $12.50, 1978. The history of science has not passed a kind verdict on attempts at scientific encyclopedias. For the most part, efforts such as d'Alembert's organization of the philosophe's Encyclopedia, C o m t e ' s synthesis of Positive Science, and Engel's Dialectics of Nature stand as m o n u m e n t s to the impossibility o f their tasks. They reflect their writers' preoccupations more than they represent truly comprehensive pictures of the science of their times. Thus, C o m t e ' s fascination with phrenology and Lamarckian evolution renders a highly distorted view of French physiology; and Engel's c o m m i t m e n t to dialectical reasoning concentrates primarily on those sciences evidencing contradictions in their development. Because it is considerably more modest in scope than these enterprises, George L. Waldbott's encyclopedic book, Health Effects of Environmental Pollutants, succeeds on several counts. First of all, he acknowledges the tentative nature of scientific understanding in the area. Waldbott also indicates the problems of moving from toxicological to pathological and epidemological information. Finally, he addresses his book not only to students o f environmental health and physicians, but to safety personnel in industry and to government agencies. This second edition offers new sections on fluorocarbons, vinylchloride, polychlorinatedbiphenyls (PCB) and some fire retardants. It also features sections on noise pollution, dioxins, aflatoxins and microwave radiation. Although the publication date is June, 1978, some of the references are as recent as March, 1978. The book opens with a brief review of historical incidents of significant environmental pollution, such as the Meuse River Valley disaster near Li6ge, Belgium in 1930, where thousands o f people became violently ill, and the Donora, Pennsylvania inversion, where trapped industrial pollutants rendered at least half the town ill and estimates of those killed varied. Waldbott notes that such catastrophic events are deceptive. There m a y be a tendency for people to believe that when such incidents subside, problems of environmental pollution are insignificant. While most medical training is oriented to such acute, episodic events, training also needs to consider " t h e slow erosion of a person's health by the ever-present pollution in cities, particularly a m o n g those living near industrial establishments or exposed to automobile exhaust and m a n y other c o n t a m i n a n t s . " (p. ll) Because relatively little data are available on the long term effects o f low levels o f exposure to pollutants, Waldbott necessarily relies on discussions o f acute intoxication and occupational exposure. After reviewing some o f the major sources of pollutants and their basic biochemical properties, Waldbott presents an analytical scheme for considering them in terms of their potential health effects.
Acknowledging that m a n y pollutants have multiple effects, he devises a system based on their chief effects. Pollutants are classified according to whether their chief effects are: respiratory (pulmonary, granulomatous agents, asphyxiants, fever producers, or " d u s t s " ) ; systemic (affecting more than one organ system, e.g., entering through the food chain to the gastrointestinal tract to the blood); and host specific (allergens, mutagens, carcinogens). While this latter category includes both respiratory and systemic pollutants, Waldbott maintains that their route and organ of attack is largely determined by host-specificity. This is a point which might be challenged, particularly in light of recent work on oOvagenic, spermagenic, and teratogenic effects; but his analytical system does work in organizing a wealth o f data, the validity of this last assumption notwithstanding. The remainder of the book follows this scheme for discussing more than a thousand toxicological, clinical and epidemiological studies of the health effects of pollutants. He offers a special section on "economic p o i s o n s " , or those substances which, while hazardous to h u m a n s , are also of economic value. In this category Waldbott includes more than 30000 different pesticides, whose annual cost is projected to be $6.3 billion in 1986. There is no mention in this context, or any other, of anesthetic gases whose adverse effects are only now being taken into account in operating room design and personnel practices. Waldbott notes that spraying and dusting are the most dangerous modes of application for pesticides. Ordinarily, between 5 and 70% o f sprays and 40 and 800/0 o f dust applied from the air drift far afield from the target. In his discussion of the contamination of Michigan with PBBs, of the general pollution in the U.S. by the 4000 tons of PCBs that enter the waterways annually, of the explosion and pollution with dioxin in Seveso, Italy, Waldbott reports rather little adverse h u m a n health effects. He states, " s o far, however, no serious permanent health damage of Seveso has been reported." The town was uninhabitable, and for a period of time, several pregnant women had abortions. These two facts themselves could be construed as adverse health effects. But this is a minor lapse in the context of a very useful compendium which should be an excellent teaching tool or self-instructional manual. In his last chapter on prophylaxis and treatment, Waldbott offers an important view of the possibilities o f disease prevention through environmental control. He notes that " o f diseases for which prevention can accomplish more than treatment, those due to air pollution head the list." He makes his case unassailably, noting that people whose lives are threatened by polluted environments have little recourse once they reach this state. He cautions students of environmental health not to be swayed by reports that few adverse effects on h u m a n s have been reported for m a n y pollutants. While this m a y be true, in a strictly scientific sense, because data have not been developed, this does not mean that no h u m a n health damage has occurred, merely that it has not been fully explored. With this valuable book, Waldbott joins the ranks of medical critics who point to the increasing health and economic costs o f environmental pollution. For those who are sceptical of this opinion, his work gives great pause. For others, it is a strong confirmation o f what we have long suspected: Granted that we cannot precisely assess the proportion o f contemporary illness that is due to environmental factors: but that does not m e a n that those factors are insignificant, merely that they require more deliberate study.
Environmental Law Institute Washington, D.C., U.S.A.
Devra Lee Davis
Ignacy Sachs. Environment and Development - - A New Rationale f or Domestic Policy Formulation and International Cooperation Strategies. Ministry of Supply and Services, Ottawa, Canada. 1978. This report was prepared for the Policy Branch of Canadian International Development Agency and the Advanced Concepts Center o f the Department of the Environment o f Canada. It was prepared in 1977 and became available in 1978.