Living Downstream
An ecologist looks at cancer and the environment

The central premise of her book is that ever increasing exposure to toxic chemicals in air, food, water and soil are inextricably linked to rising rates of cancer. Excluding lung cancer, the incidence of cancer in the United States rose by 35 per cent between 1950 and 1991 and it is now the second leading cause of death overall, and the number one killer among Americans aged 35 to 64. Cancer, Steingraber asserts, "is an epidemic of the industrial era."

Living Downstream is the first book to bring together data on environmental contamination - recently made available through Federal right-to-know laws - together with newly released cancer registry data. With rigorous scientific examination, Steingraber takes the reader on a journey 'upstream' tracing the ecological roots of the disease.

Steingraber, pulls together the growing body of evidence connecting cancer with exposure to certain chemicals and radiation. Her analyses includes research on cancer in immigrants who soon display the cancer rates of their adopted countries, the unprecedented rise in childhood cancer, cancer in workers exposed to hazardous chemicals, cancer in fish and shellfish living in polluted waters, maps showing more cancer in industrialised areas than in rural regions and maps showing higher incidence of cancer in rural regions with heavy pesticide use and studies showing that certain chemicals can cause cell growth and division, and damage the immune and endocrine systems.

The focus of cancer research, argues Steingraber, can no longer be concentrated on genetic causes. Most cancer cells, she asserts, "are made, not born" since "collectively only 10 per cent of all malignancies are thought to involve inherited mutations." Ninety per cent of cancer therefore is created by carcinogens in the environment. "The environment" she points out "keeps falling off the cancer screen."

Steingraber calls for a "human rights approach," in the prevention of cancer. "Such an approach recognises that the current system of regulating the use, release and disposal of known and suspected carcinogens - rather than preventing their generation in the first place - is intolerable." What is required, she argues, is not just the exercise of the precautionary principle in public health matters but also the principle of the least toxic alternative, "which assumes that toxic substances will not be used as long as there is another way of accomplishing the task."

Reviewer: Maya Pastakia

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