Elevate Difference

Living Downstream: An Ecologist’s Personal Investigation of Cancer and the Environment

In the original 1997 edition of Living Downstream, Sandra Steingraber was the first to compare data on toxic releases with data from U.S. cancer registries. In the last ten years since this edition was published, there has been rapid growth in the understanding of environmental links to human cancer and new published findings that corroborate the evidence Steingraber compiled in 1997. With a Ph.D. in biology and a Master's degree in creative writing, Steingraber has been the recipient of many awards, including Chatham College's Rachel Carson Leadership Award in 2001 and a Hero Award from the Breast Cancer Fund in 2006. Living Downstream is both a personal story of Steingraber's battle with cancer and her investigation into the potential sources of carcinogens released into the air, land, and water in and around her hometown of Normandale in West-Central Illinois, as well as in other areas of the United States.

Thirty years ago, when Steingraber was a twenty-year-old college student, she learned that she had bladder cancer and was surprised when her urologist asked her whether she had ever been exposed to textile dyes or worked in a tire factory or the aluminum industry. The author later learned that bladder cancer was considered a quintessential environmental cancer. In other words, there was more evidence linking it to toxic chemical exposure than to any other type of cancer. However, although bladder carcinogens had been identified, they continue to be used by industry even today. The obvious question, of course, is why have these chemicals not been banned. The reader quickly discovers that cancer causation is complex, as is proving the source responsible for this disease.

The author reminds her readers that of the 80,000 synthetic chemicals currently in use in the U.S., only about two percent have been tested for carcinogenicity and only five have been banned under the U.S. Toxics Substances Control Act since 1976. We also learn that the U.S. environmental regulatory system does not require exhaustive toxicological testing of chemicals before they are marketed. Legal limits are set on chemical releases, but, as we recently learned with bisphenol A (BPA), trace amounts can be more harmful to humans than higher doses. Moreover, we are often exposed to many contaminants simultaneously in the air we breathe, the water we drink, the food we ingest, and the land where we live and work.

Often compared with Rachel Carson, Steingraber makes some compelling arguments in favor of the precautionary principle, or the better-safe-than-sorry approach to chemicals. She also advocates the principle of reverse onus, which holds producers responsible for proving that their products will not harm the public, as is the case for pharmaceutical companies.

Sandra Steingraber has the expertise in science to give her the necessary authority to present an investigation of this scope and the impeccable writing to make it accessible to a wide audience. Although some environmental texts can be dry, Steingraber's writing and personal story make for a compelling read. Her drive and commitment to finding the missing pieces of the cancer jigsaw puzzle are humbling. I only wish that she had included a map of Tazewell County, Illinois, which we repeatedly visit throughout the book. A few diagrams of some the atoms she describes would have also been nice.

In short, if you have ever thought that the environment may have played a role in the death of a loved one and would like to know more, this is the book for you.

Written by: Heather Leighton, June 9th 2010

Thanks for your comment.

Not just the UK, but the entire EU requires, under the REACH legislation, that both producers and importers of chemicals disclose toxicity data for approval to enter or stay on the market.

I look forward to reading your article. Thanks for the link.

Apparently, the UK places the onus on toxicity testing with producers -- presumably because of the incentive for prevention build into their medical system, but I'm not an expert on the subject.

Here's a link to an article from the New Yorker (written by staff writer and Harvard Medical School chair Jerome Groopman)on environmental carcinogens, specifically covering issues connected with BPA, in case anyone wants further reading:


FR author Leighton alludes in this review to the difficulty of determining causation. One of Groopman's sources comments on the problem of combinatorics in determining causation from environmental factors -- that is, which ones, how many, in which combination, over what period of time, etc. etc.

Thanks for reviewing this book!