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Excerpt: 'How Everyday Products Make People Sick'

NPR | By Paul Blanc

Published December 14, 2007 at 1:19 PM EST

Chapter 1: The Forgotten Histories of "Modern" Hazards

Mercury Poisoning

A few years ago, I was asked to provide a medical consultation for a fourmonth-old boy who was admitted to the hospital because of possible appendicitis. He was of an unusually young age for such a problem, but the precipitant of the problem was more unusual still. A few weeks before, the parents of the boy had noticed symptoms of colic in the infant and treated

him with the remedy that had been used in their home village in rural Mexico for generations: they gave him some quicksilver to drink.

One might wonder how this village had gone on for very many generations with this kind of folk wisdom, but, in fact, quicksilver (another name for pure elemental mercury) isn't taken up through the stomach or intestines very quickly. By other routes mercury is indeed quite hazardous; for example, if inhaled, it rapidly enters the body through the lungs, and in forms such as salts and their by-products it is well absorbed through the gut. But in most cases, when quicksilver is taken by mouth it passes right through the system. It may not cure colic, but it doesn't do too much harm, either.

Mercury, however, is a curious substance. Because of its properties, it may not pass. It is a fluid, but it is also very heavy, much more so than water. For this reason, liquid mercury tends to settle to the lowest spot it can. The appendix, hanging as a little tail off the intestines, is just such a low spot. In the case of this child, the appendix filled up like a thermometer.

By X-ray, the dense mercury in his abdomen lit up like a metallic worm. He was suffering from a mercury-impacted appendix that, in the end, required surgical removal.

Toxic substances have become so much an everyday fact of modern life as to verge on being perceived as a cliché of risk rather than as a true and substantive threat. We may find it incredible that anyone could use quicksilver as a folk remedy. Then again, many of my peers, members of a generation who were children or adolescents in the 1950s and 1960s, can report at least one experience of playing with mercury in the schoolyard or, better yet, mixing up tiny puddles of it in their own basements. Times do change. To an important extent, so too do the toxins to which we are exposed. These changes involve more than simply evolving perceptions of what constitutes an unacceptable risk. To keep up with an expanding inventory of hazards requires tracking unusual if not arcane information sources. On my preferred reading list is a twelve-page newsletter published every week by the federal Centers for Disease Control in Atlanta. Its upbeat name is the Morbidity and Mortality Weekly Report. The cognoscenti refer to it simply as the MMWR.

In the pages of the MMWR, for example, one can learn of such cases as that of a child in a Michigan suburb who was struck with a bizarre illness. His hands turned pink and began to scale, he began to drool, and his mood became irascible and difficult to manage. An unusual infection was considered as one possible explanation, but this was excluded by laboratory testing. No hereditary condition fit his bizarre constellation of abnormalities.

But the child's syndrome does have a name. The illness is called pink's disease. It was, at one time, a well-known entity.

This syndrome, including both the odd skin changes and ominous nervous system findings, is exactly how mercury poisoning is manifest in a child afflicted with chronic poisoning. This child's parents had not given him mercury to drink as a home remedy, nor had he been experimenting with quicksilver in the family room. An exhaustive battery of questions revealed little. When asked of any recent changes at home, the parents could report only that the interior of the house had recently been repainted. There was nothing extraordinary in that: a standard commercial indoor latex paint had been applied. Yet when the child was tested, he had extremely high mercury levels. The rest of the family was tested as well. They, too, were poisoned, albeit less severely.

What, then, was the source of their toxic exposure? The answer lay in the seemingly innocuous house paint. As it turns out, it contained excessive amounts of an approved chemical additive intended to prevent mildew. That additive is called phenyl mercuric acetate, a form of mercury not previously associated with human illness. Nonetheless, enough mercury had vaporized from the paint to cause harm. Trapped within the indoor environment, it turned the suburban house into an ideal exposure chamber, leading to mercury poisoning in the entire family.

The links between the first child, with mercury in his appendix, and the second, suffering the effects of mercury inhalation, are stronger than they might appear at first. The link is not simply that the same toxin was involved in each case. The more important tie is that a single, ancient hazard is still present in our everyday environment, not only in an old and traditional form but also in an entirely new combination. This is a scenario repeated all too often in the last decade, the last fifty years, and stretching back over a span of centuries.

Revisionist Environmental History

The pages that follow will detail the stories of many of these recycled and reinvented hazards. These stories call into question what we may take as a given: that because our modern ecological concept of the "environment" is relatively new, the toxic threats that drive our understanding of this construct are also of recent origin. The superficial timeline of environmental history, it is true, supports this mistaken view. When I first began my training in public health, focusing on occupational safety and health, the United States was preparing for its bicentennial. The Occupational Safety and Health Administration and the Environmental Protection Agency were both less than ten years old. Earth Day was an idea in its infancy. The pockmarked geography of our poisonous landscape had not yet erected the familiar signposts of Love Canal or Chernobyl, catastrophes that were to follow in the later 1970s and 1980s. The environmental map, as we know it today, was then largely terra incognito.

We've come a long way since then. Ironically it's just far enough to see the emergence of what can best be labeled a revisionist history of both the movement for environmental protection and even the environment itself. Central to this revisionism is an inclination to debunk and discard almost any concern that may be raised over the risks of toxic substances. Whether a hazard is identified on the basis of laboratory studies, is linked to an out-break of human illness, or is detected as a more subtle ecological threat on a global scale, the revisionist response invariably minimizes the risk.

Revisionist environmental theory justifies attacks on key pieces of environmental legislation. For example, in 2000 the American Enterprise Institute — Brookings Joint Center on Regulatory Studies revisited the question of lead's adverse effects on childhood intelligence. The report issued did not dispute that the metal was toxic but found that the economic benefit to parents was only eleven hundred to nineteen hundred dollars per IQ point gained through lead abatement. The spare-the-lead-and-spoil-the child conclusion the report reached reads, "This analysis suggests lead standards will redistribute resources from parents to their children, because the benefits to parents are less than the costs of the standards. The Environmental Protection Agency and the Department of Housing and Urban Development should reconsider their lead standards."

New versions of environmental history instruct us that our fetish over toxins is likely to be seen by future generations for the absurdity that it surely must be. The environment can take care of itself, we are falsely reassured, just as it has always done. Woody Allen humorously mined this vein in his film Sleeper a number of years ago, portraying a character waking up in the not-too-distant future only to discover a world in which cigarettes and high cholesterol diets have been found to be health promoting. Allen's film was healthy satire, but the revisionists would have us take it as a documentary. They promote as established fact the dangerous misconception that environmental concerns are purely modern creatures born of our narcissistic age.

Perhaps this distorted view merely reflects a general shortsightedness we all share to one extent or another. William Faulkner observed that the old do not perceive the past to stretch back linearly. Rather, they look back through a very narrow corridor of sequentially ordered recent history, which then opens out onto a wider expanse of time, as if a large meadow where more distant and less distant events, like cattle, graze comfortably together. The timeline of environmentalism can be similarly perceived, even by those closest to the movement itself. About as far away as anyone can make out in this landscape stands the distant figure of Rachel Carson, heroically holding aloft a copy of Silent Spring. In the cosmology of environmentalism, one cannot even extrapolate beyond this point: we arbitrarily fix the date of the ecological big bang as the year 1962.

Thus, for all intents and purposes, Silent Spring becomes a holy text, a Veda of the environmental movement's own creation myth. DDT serves as totemic a role in this mythology as Jackie's pillbox hat serves for the myth of a Kennedy Camelot (from precisely the same time period). Back beyond 1960, in environmental time, there is only an expanse of apocryphal prehistory in which vague rumor or impressionistic allusion links scattered images or anecdotes of contamination with possible real historical events. A connection is sometimes made between the expression "mad as a hatter" and mercury poisoning, which occurs in the hat trade from use of the toxin to make felt from rabbit fur and can result in mental derangement. The theory that widespread lead poisoning may have contributed to the decline of the Roman Empire is recycled with a certain frequency. Otherwise, all seems unformed and void, even to most environmentalists themselves.

In fact, the true environmental record is far from a blank slate. There is a rich and well-documented history of injury and illness, much of it concentrated in the workplace or in neighborhoods contaminated from spillage just beyond the factory door. This history has a clear and important message to transmit. It shows us how time and again innovative processes have been introduced into large factories or small workshops, novel products have entered the marketplace, and new contaminants have been released into the environment. Each time these have occurred, episodes of disease, disability, and death have ensued. This is not a new story beginning in 1960 or even in 1690. It is an old, sad tale that gets told over and over but seems somehow to be forgotten after each new recitation. The revisionist recounting of the anti-environmental time line intentionally undermines it, characterizing the issues involved as little more than a modern fad that will soon pass and be forgotten. The environmentalist sense of the movement's history, cut off from much of its own past, often has the same net effect.

We must reclaim our lost history so that, going forward, we can accurately judge the steps we must take to address the public health and safety threats before us today. These threats predictably arise as the unintended by-products of the ways in which we make and use consumer goods and produce and transport basic commodities and industrial materials alike.

This does not mean that health and safety risks are unavoidable. Rather, past experience teaches that the amelioration of these problems will require strategies geared to their complex social, economic, and technological interrelationships.

This chapter reexamines some of the deceptively simple but incorrect assumptions that we have about what is, in fact, "new" in our environment, whether at work, at home, or in the wider ecosystem. We can easily start with a list of our hypermodern concerns that seem to be of recent origin: pollution in the water and air; asbestos fibers in our workplaces and schools; carpal tunnel syndrome from our keyboards; sick building syndrome from our sealed-in International Style offices; and the vague toxicity of "burnout" from the day-to-day stress of modern life.