by John W. Gofman, M.D., Ph.D., November 1989
We are now only a few months away from the 20th anniversary of Earth Day. As the environmental movement here and abroad is gaining strength (in the Soviet Union, too), it is appropriate to consider certain lessons -- of great importance to the entire movement -- which can be uniquely illuminated by the nuclear energy controversy.
1 * The Burden Of Proof
Industrialization and the introduction of popular consumer-items, like cars and radios, proceeded apace before it became evident that serious thought should be given to injection into the environment of legions of physical, chemical, and agricultural pollutants -- ranging from radiation, asbestos, lead, and mercury, to precursors of sulfuric and nitric acids, pesticides, dioxin, chloro-fluorocarbons, and more . . . much more.
As concern about pollution ("dumping") began to grow, the response with respect to each type of pollutant was: "Show us the harm, before you ask us to restrict anything." For instance, we spread lead from leaded gasoline everywhere before there was evidence of its damage to the central nervous system, the kidneys, etc. Recently, the Center for Disease Control acknowledged that long-term effects "are increasingly being observed . . . with lead levels much lower than previously believed harmful" (Associated Press, 8/19/88).
Still resisting the great environmental awareness in the public today is a very influential crowd of Special Interests. These Special Interests say that neither we nor the Third World should waste resources preventing environmental pollution by any agent whose harm is not yet proven. They insist that the burden of proof is on those who think such measures are necessary.
Special Interests, citing "scientific uncertainties," come close to denying that pollution hurts anything at all -- and the denials are particularly vehement with respect to hurting human health.
Along with the denials, the Special Interests predict that the result will be disaster for everyone, if the so-called extremists prevail: Lower standards of living, unemployment, an end to human progress, famines, perpetual poverty for the Third World. In short, they say "the sky will fall." (At the same time, they try to pin the "Chicken Little" label on environmentalists!)
2 * Aren't We Living Longer ?
The Chicken Little accusation against environmentalists is often accompanied by a non-sequitur: "Life expectancy is longer in the so-called polluted world than it was in the past." And it certainly should be longer. After decades of progress in sanitation and in controlling infectious diseases, and after decades of advances in medical knowledge, if life expectancy were still the same, it would mean that these advances in health were just barely able to balance new forces which were tending to shorten life expectancy.
The fact that life expectancy has grown in the presence of pollution means nothing. It might have grown a lot more in the absence of pollution. It is not possible for anyone to know what life expectancy would be today, if pollution were absent. Therefore, no one should suggest that pollution is harmless to human health by referring to average life expectancy. Moreover, it would be a mistake to regard good health and years alive as the same thing. Clearly they are not identical. We ask each other, "How's your health?", not "Are you still alive?"
I think it is fair to say that no one can measure the aggregate impact of pollution on human health -- and as for its possible effects on the central nervous system (including mental acuity and irrational behavior), the absence of information is just about total.
So, the central question is: What is the proper approach to pollution in the absence of solid health data on toxicity and possible safe doses, for each of 10,000 or more different pollutants and their interactions?
3 * A Suggested Major Principle
One approach can be stated as the no-dumping principle: No one has any right whatever to dump any industrial or personal waste-products into any part of the commons or into any kind of personal property. The principle does not require demonstration of potential harm from such dumping. (Personal property includes a person's own body, of course, as well as external possessions, and the "commons" includes whatever is publicly owned in common -- the air we breathe and the atmosphere beyond, the waters of the planet, including sub-surface aquifers, and public lands.)
Where might we be now, if the no-dumping principle had been in full force 100 years ago?
Industry's development would have occurred along totally different lines. Industrial processes would have been designed to produce as little waste as possible, and with respect to unwelcome by-products which were unavoidable, the expected operating status would have been full containment.
If the no-dumping principle had been in place for a century, an ethic would have developed by now in the public, where severe disdain would prevail toward those who have treated others with contempt by dumping on them. The shame of using other humans as experimental guinea-pigs would be well understood. Motorists would not be claiming the pseudo-right to choose fuel-inefficient, high-polluting automobiles. Automobiles would have been required to be clean from the beginning. Smokers would never have claimed the pseudo-right to make others tolerate their second-hand smoke. Behavior would be kinder in many ways.
But since we do not have the no-dumping principle in place, we continue to proceed like a society of guinea-pigs, waiting for deaths to show up in a demonstration of the harm caused by a particular agent. Failure to adopt the no-dumping principle "from the beginning" clearly makes it more difficult to adopt it now.
The basic human right -- from which the no-dumping principle is derived -- is that all peaceable people (this excludes criminals) are entitled to hold themselves and their property free from coercion, intrusion, and fraud, provided they secure the identical right for each other.
Opponents of the principle have already used a phony argument: "The idea would bring our economy to a dead halt, with demands that not even one molecule of a pollutant be allowed to get into the environment." They can manufacture "One Molecule" scenarios without limit -- all of them based on the false premise that proponents of the principle have no common sense, no economic sense, and no strategic sense. In reality, people concerned about principles don't go after "One Molecule" matters -- they would be thrilled just to resolve the big, obvious violations!
4 * What Really Happens Under The "Prove Harm" Rule
In the absence of the no-dumping principle, the "prove harm" rule dominates, worldwide. Therefore, it is highly important to consider the potential consequences for human health of continuing under that rule. (If we are unwilling to protect human health, then other species will fare even worse.) The nuclear energy issue illustrates in classic fashion what actually happens.
First, it is inevitable that every polluter will suggest that (1) his pollutant is harmless, below some "threshold" dose, and (2) a small amount of a substance which is harmful at high doses (e.g., aspirin, trace minerals) may be good for people at low doses . . . so each pollutant must be examined for possible beneficial effects on the public at large. ("Hormesis" has become the term for indicating possible benefits.) Every industry must hope that some "pioneer" polluter will make a plausible case for a threshold or for hormesis. And both ideas are attractive to the public too. We all want to believe that harm is absent, or doubtful, from each additional thing which is dumped on us.
Second, a very important axiom operates in favor of polluters, in the absence of the no-dumping principle: A small group of Special Interests, working for a benefit which is concentrated upon themselves, can almost always prevail over the vastly larger number of people who will pay the diffused costs. For instance, the general public puts up with paying for subsidies, tariffs, organized crime . . . and pollution . . . because each individual regards his direct cost of submission to be lower than his direct cost of resistance, on each of thousands of separate issues -- especially when it is likely that gifts and favors within the system are tipping the scales in favor of the highly motivated Special Interests.
Find out just what people will submit to, and you have found out the exact amount of injustice and wrong which will be imposed upon them.
-- Frederick Douglass, August 4, 1857
Third, since the "prove harm" rule puts the burden of proof on the victims and potential victims of pollution to demonstrate specific harm to themselves, they pay once as taxpayers for information which they distrust from government-funded research, they pay again for information which they distrust from polluter-funded research, and then they must pay a third time directly for information which they can trust. So the "prove harm" rule favors pollution on this basis too, among many others.
Fourth, no matter what the public can show scientifically -- even millions of deaths -- the denial-syndrome is powerful. When it comes to cancer from radiation, for instance, the model for some responses seems to be the Flat Earth Society -- which continues to deny that the Earth is a sphere, even after photos of it have been taken from the moon.
Fifth, under the "prove harm" rule, it turns out that proof of harm is not good enough anyway. Then the argument begins, over how much harm is too much. In the case of a million extra cancers from Chernobyl, for instance, it is true that they will occur gradually over 75 years or so, and they will not be detectable in the Vital Statistics. Under the "prove harm" ethic, any health-effect which fails to show up conclusively in the Vital Statistics can be debated as "inconsequential." In my world, it is impossible to regard giving cancer to a million people as a negligible crime. But that is where the "prove harm" rule leads.
Far-fetched? A brief review of events will make it self-evident how the radiation issue provides a giant warning with respect to handling additional pollutants.
5 * Lessons From 1969-1979
While nuclear power was still in its infancy, its promoters in and out of government said that, in the absence of hard evidence, they were going to act "prudently" and assume that ionizing radiation is harmful in proportion to dose, right down to the lowest possible dose. This is the "no-threshold and linear model of dose vs. response," and it was still the official position with respect to radiation in 1972, in the BEIR-1 Report. Indeed, thanks to citizen pressure in those years, the government drastically reduced "permissible levels" of dumping by the nuclear industry, and those reductions may have saved millions of people from radiation-induced cancer.
But all this happened before the nuclear industry realized how costly and difficult it would be to contain its radioactive by-products. Ever since the mid-1970s, a campaign has been conducted to convince the public that radioactive pollution is not worth worrying about.
For instance, every time a leak or spill or puff of radiation occurred into the environment, the so-called regulators and the industry claimed that the release was below the level where any injury to public health would occur. The fact that this claim was unsupported by any evidence and was therefore irresponsible -- and was also in direct conflict with the official no-threshold assumption -- is not the point. The point is that the claim was made again and again, nonetheless.
If at first you don't succeed, you are running about average.
-- M.H. Alderson
Soon we heard nuclear polluters saying at every occasion, "It's doubtful that anyone at all has been injured by the nuclear power industry. Show me one member of the public whose cancer was proved to be due to radiation." Since no cancer carries an identification tag telling us its cause, no particular case of cancer can ever be proved beyond doubt to be the radiation-caused cancer. Likewise, no particular case of lung-cancer can be proved beyond doubt to have been caused by cigarette smoking. Yet in both cases, definitive proof exists for cancer-induction, and it comes from the careful study of groups. The lesson: Introduction of confusion is inevitable under the "prove harm" approach, and the injury at issue need not be cancer -- it can be birth defects, central nervous system damage, destruction of lung-function . . .
6 * Lessons From 1979-1986
Then in 1979, the Three Mile Island accident occurred. Despite their public denials, nuclear promoters must have realized that major releases of radioactive poisons were a real possibility in future accidents. It seems self-evident to me that full reversal of the no-threshold, linear dose-response was urgently needed for the health of this industry.
Coincidentally, perhaps, two of the leading radiation committees published reports in 1980 in which they discarded the linear dose-response, and claimed that the cancer-risk per unit dose (per rad) is much less at low doses than at high doses. As for a threshold, the suggestion was explicitly revived by the BEIR-3 Report, which stated (p.193) that there was "uncertainty as to whether a total dose of, say, 1 rad would have any effect at all."
The crucial lesson from 1980 with respect to other pollutants is this: The 1980 reversal occurred in spite of strong human evidence accumulated since 1972 that the cancer-hazard was probably worse per rad at low doses than at high doses. And the record shows that the radiation committees were fully aware that the human data did not support their action in claiming the opposite.
My own analysis in 1981 of the same data provided some realistic estimates of cancer risk-per-rad, and they were about 20-30 times higher than estimates by the radiation committees. I have been asked by many science reporters, "How many experts in this field have you managed to convince, so far?" -- a question implying that a genuine search for truth is going on. That is a possibility.
At the other extreme, what is going on may be a "Kill-for-the-Company" ethic. Or it may be an acute case of Flat Earthism. Or it may be incurable optimism: "If we look hard enough, we can surely find a silver lining in those clouds." And it may be a mixture: "All of the above."
The important lesson is the same in any case: Those who plan to defeat pollution under the "prove harm" rule are going to find that proof makes no difference. Because the stronger the evidence grows supporting toxicity in humans, the more attention and support will be concentrated on the idea of some safe dose and some speculative low-dose benefits. Hope springs eternal.
For instance, by 1985, a campaign was underway to present "possible beneficial effects" from low-dose ionizing radiation as a reputable hypothesis. Not only did the Nuclear Regulatory Commission hint at possible unspecified benefits (NUREG/CR-4214, p.II-93), but the Electric Power Research Institute, Dept. of Energy (DOE), General Electric, EG&G-Idaho, and the northern California chapters of the Health Physics and the American Nuclear Society, sponsored a conference on radiation "hormesis" (benefits) that year. No benefits showed up . . . which was all the more reason for intensifying the search for that silver lining.
Rather obviously, the radiation community was bracing for its own "Hurricane Hugo." And it came soon enough in the form of the explosion of the Chernobyl nuclear power station (its "violent disassembly", DOE 1987, p.vii). The resulting fallout will give cancer to about a million people, if one uses my estimates of risk-per-rad and no threshold. In September 1986, I presented this estimate in a paper which also provided proof, beyond any reasonable doubt, that for cancer, there is no threshold. This paper circulated very widely here and abroad, inside the radiation community as well as outside.
7 * Lessons From 1986-1989
Using the same dose-estimates, but using the underestimates of risk-per-rad prepared in 1980, the radiation community produced much lower estimates than mine, of cancers from Chernobyl. But the accident was so enormous that even the underestimates produced figures like 14,000 to 75,000 extra cancer fatalities. The response? Referring to its own 1987 estimate of 28,000 cancer fatalities, the Dept. of Energy stated that the number is "negligible" compared with spontaneous cancer-deaths (DOE 1987, p.xiii).
Even my own estimate of a million extra cancers (half of them fatal) is a small number compared with the number which will occur anyway, but of what relevance is the comparison? If "perspective" is the issue, why not remind people that all mayhem and murder and wars are just trivial killers, compared with the natural death-rate (which is 100 percent) ?
The repeated statement, that 14,000 to 75,000 cancer-deaths constitute a very small increment in the natural cancer-mortality, is another great big warning from the radiation controversy to the environmental movement in general. If you prove harm, you will end up arguing endlessly over how much killing can be inflicted with impunity. Once premeditated random murder by polluters receives legal approval, and is also accepted as an ethical norm by the environmental movement, more than the physical health of humans is in peril.
By the time the 1987 DOE report on Chernobyl was abbreviated in the journal Science (Dec.16, 1988), the number of fatal cancers had been reduced from 28,000 to 17,400. Happy Holidays. Prominently displayed next to the number 17,400 was the number 513,000,000 -- the number of spontaneous cancer-fatalities expected to occur in the entire Northern Hemisphere during the same decades.
Now 17,400 victims from a single accident is not a pretty picture, and perhaps the authors consulted the Flat Earthers on how to cope with unwelcome results. In any case, at least seven times in only six pages, the report claims that low-dose exposures from the Chernobyl accident may cause no extra cancers at all. Have a nice day.
The president of the Health Physics Society has gone even farther in promoting the safe-dose idea, by suggesting that very low-doses should not even be considered in estimating risks from radiation. Meanwhile, the Nuclear Regulatory Commission behaves as if there were a safe dose, by proposing that some nuclear waste is "below regulatory concern" and can go directly into your local dump. And everything's coming up roses.
There are a thousand hacking at the branches of evil, to one who is striking at the root.
-- Henry David Thoreau (1817-1862)
All this is happening concurrently with new evidence from the atomic-bomb survivors which confirms that (A) the risk-per-rad is much higher than estimates used by the radiation community, and (B) the risk-per-rad is not lower when the total dose is low -- the risk is most probably higher. In 1987 and 1988, not one but two groups of analysts within the radiation community have confirmed such findings.
In the face of mounting evidence in one direction (Cancer : no threshold, and low-dose risks higher than ever), it is wondrous to behold how some people can maintain their faith that the waste they produce will be a boon to humanity. This faith is strongest when needed most: After Chernobyl and after revelations of radioactive messes around DOE facilities. The power of faith is a marvel, for suddenly speculation about possible benefits from nuclear pollution has started to show up everywhere, as needed.
If you don't believe this is happening, check the scientific journals such as Health Physics (May 1987), Science (August 11, 1989), and Lancet (August 26, 1989, p.518), or National Geographic (April 1989, p.411) and Wall Street Journal (letters, Sept. 26, 1989). The Dept. of Energy and the Electric Power Research Institute are major sponsors of research and conferences on possible benefits.
I have checked the kinds of studies which allegedly "suggest" that benefits at low doses may be discovered. No human benefit whatsoever at low doses has been validly demonstrated, and the key point is that even if such benefits on the immune system or other systems were ever found, they would be perfectly compatible with the conclusive evidence that there is no safe dose with respect to human cancer-induction. There is no inherent conflict. When we observe cancer induced by exceedingly low doses, we are seeing exactly the malignancies which the allegedly "stimulated" repair and immune systems have failed to prevent.
8 * The Original Question
Our original question was: What is the proper approach to pollution in the absence of solid health data on toxicity and possible safe doses for each of 10,000 pollutants?
Yet the events described here are occurring in a field where solid health data are present, both on the magnitude of cancer-risk and on the absence of any possible safe dose or dose-rate. Indeed, it is unlikely that there will ever be comparably definitive human evidence for any other pollutant on such questions. The reason is that ionizing radiation is unique in several ways.
Describing "The Tyranny of the Urgent" :
. . . the urgent cries-out for superficial tinkering
when fundamental change is required . . .
-- Charles Hummel and Bruce M. Evans
For instance, in this field, we do not need to depend on possibly irrelevant, and therefore eternally inconclusive, evidence from other species or cell-studies. Without conducting immoral human experimentation, human data exist for radiation because it is widely used in medicine. In addition, as a result of the atomic bombings in Japan, genuinely comparable groups of humans exist who were exposed to very different dose-levels. This situation is important for proving causality beyond a reasonable doubt, and yet it is unlikely to occur for other pollutants. Lastly, the unique physical properties of ionizing radiation make it possible to prove that there is no safe dose or dose-rate, even in the absence of human studies conducted at the lowest conceivable doses. We need to be realistic. Relative to ionizing radiation, "proof of harm" in humans from each of 10,000 other pollutants is going to be even harder to obtain, and far easier to challenge.
I do not deny that, under the "prove harm" rule, we have had some success in reducing the dumping of a certain number of pollutants, including the radioactive ones -- thanks to the dedicated efforts of citizens and some generous funders. But the lesson from the radiation issue is, nonetheless, that the "prove harm" rule puts human health in great peril.
Ideals serve a vital function: They are the only possible means by which one can make better choices . . . A goal must always be known before even the first bit of distance can be attained in its direction.
-- F.A. Harper (1905-1973)
In the absence of the no-dumping principle, each and every victory is subject to reversal. Research will be generously sponsored in the search for that silver lining, and no matter how inconclusive, a succession of new studies will then become the occasion for debate on relaxing restrictions on a particular pollutant. This is the natural consequence of the "prove harm" approach. F.A. Harper has warned about the trap of agreeing to deal with every claim which can be conjured up:" . . . consider the possible answers to 2 plus 2. The only non-mythical answer is 4. But there are infinite mythical answers . . . So if [a person's] aim were perfect and he could shoot a myth with every shot, he could spend his entire lifetime shooting myths released by only one myth factory, without ever demolishing all this factory could produce."If human society continues the "prove harm" approach to pollution, nothing can ever be settled. While "debate" is conducted on 10,000 separate pollutants, separately in different countries, the bulk of dumping will continue. And we can be certain that worldwide pollution of the air and oceans will increase, not decrease, for we must never forget that 80 percent of humanity has barely begun to industrialize.
If the affluent nations continue promoting the guinea-piggery ethic worldwide, instead of the no-dumping principle, we are clearly putting all of human health at risk. Even if the unknown (and unknowable) risks from each of 10,000 or more pollutants were very small, the aggregate injury to health -- from letting each of them build up in the biosphere -- could be unpredictable and huge.
It follows that the "prove harm" rule is a totally irresponsible way to approach the pollution issue. It seems to me that events in the radiation issue are an unmistakable warning that the only realistic approach to reducing and preventing pollution is the no-dumping principle.
In the absence of the no-dumping principle, it is essential that we and others keep providing independent research, but we must work vigorously at the same time for the no-dumping principle, on behalf of all the future generations who rely on us.
For Want Of A Nail . . . (Ben Franklin, 1706-1790)
For want of a nail, the shoe was lost . . .
For want of a shoe, the horse was lost . . .
For want of a horse, the rider was lost.
Let Us Not Make Our Descendants Say :
For want of a principle, human health was lost.
John W. Gofman is Professor Emeritus of Medical Physics at the University of California at Berkeley; Director (1963-69) of the Bio-Medical Division of the Livermore National Laboratory; author of Radiation and Human Health (1981) and co-author of X-Rays: Health Effects of Common Exams (1985).
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