PHILIP LANDRIGAN

MOYERS: You used a term I would like to explore. You talked about "environmental science." What is environmental science?

LANDRIGAN: Well, it is different things to different people. In the past, environmental science had pretty much been concerned with the external environment, with water and air, forests and the fisheries. What we have come to realize more recently, though, is that there are profound and ubiquitous interconnections between the environment and human health. So, today, the definition of the term has expanded to encompass the impact of the environment on the health of people.

MOYERS: Why is it so crucial now?

LANDRIGAN: Well, one big difference between now and 50 years ago has been the incredible pace of development of new synthetic chemicals, chemicals that never before existed. Today, there are some 80,000 different chemicals registered for use with the US Environmental Protection Agency. There are about 15,000 of those that are made in substantial quantities. Many of those are distributed widely in the environment, in air, in water, in the food that we eat, and we are all being exposed to them. So we are all -- while we benefit from the fruits of the chemical revolution, we are also at risk of whatever harmful effects those chemicals might produce in us.

MOYERS: Are we looking at the properties and consequences of all 80,000?

LANDRIGAN: Not adequately. In fact, we are not even looking with sufficient rigor at the 10,000 or 15,000 chemicals that are produced in greatest quantity. There have been recent studies conducted by the EPA, and a study a few years earlier by the National Academy of Sciences, which indicate that we have data on the potential toxicity of only about 43 percent of these chemicals. So what that means, to turn it around, is that more than half the chemicals that are out there in commerce have never been tested for their potential to cause injury to human health.

MOYERS: In this reporting we have been doing, I keep hearing the word "persistent chemicals." What is meant by that, and does it connect to what you are saying?

LANDRIGAN: Yes, it does. Persistent chemicals, of course, are chemicals that last a long time, years, even decades in the environment and also in people's bodies. Examples include polychlorinated biphenyls, PCBs; the pesticide, DDT; some of the heavy metals like lead. When lead gets into the human body, it goes to the bones, and it can stay there 25, 30, 35, 40 years. Those are persistent chemicals.

MOYERS: So the chemical revolution really began at the end of the second world war, in the 1940s. We are only 50 years into that revolution. There is a lot we don't know.

LANDRIGAN: There is an enormous amount we don't know. That's right. We have been much smarter at developing and using chemicals than in managing their potential toxic effects.

MOYERS: And this residue of these chemicals that we carry in our bodies, would you say it's indifferent or harmful to us?

LANDRIGAN: Many of these chemicals last for years or decades, and we are only now beginning to get some sense of the harmful effects that they can cause. There is so much that we simply don't know about these chemicals.

MOYERS: By training, you are a pediatrician concerned with the health of children. What particular concerns right now motivate you regarding the health of children?

LANDRIGAN: The big problem with children is that they are just inherently more vulnerable to environmental chemicals than adults. First of all, they are more heavily exposed pound for pound. They drink more water, they eat more food, they breathe more air, pound for pound. So they take into their bodies more of any chemicals that are in their environment, and, of course, they play on the floor and they put their hands in their mouths. Then, on top of that, they are very vulnerable biologically because they are growing and developing. Their organ systems are undergoing very rapid change, and those processes have changed.

And then, in addition to being more heavily exposed to these chemicals pound for pound, they are more vulnerable to them. They are biologically more vulnerable. They are sort of a double jeopardy, and they are at particular vulnerability because their organ systems are growing and developing. These developmental processes are very, very delicate, and they create windows of enormous vulnerability such that if a child is exposed to a toxic chemical at just the wrong moment of fetal development, of early development, the changes can be profound. Lead can cause lifelong loss of intelligence. Exposure to PCBs can also cause loss of intelligence as well as profound alterations of behavior, even at low levels of exposure. We now suspect that certain pesticides can kill cells in the brains of very young children at doses that would be more or less harmless for an adult.

MOYERS: Are there any trends in this area that worry you?

LANDRIGAN: There are several trends that concern me. Number one has been an increase in the incidence of certain forms of childhood cancer, especially brain cancer, which is the second most common form of cancer in childhood. According to the National Cancer Institute, there has been a 35-percent increase in incidence of childhood brain cancer since the early 1970's. Some of that is probably due to better diagnosis, better imaging, better access to CT scans and MRIs, but it appears that a good part of the increase is real. We really don't know what is causing it.

Also, there are disturbing trends in regard to reproductive problems. In men, in some parts of the country, sperm counts are going down. In young men, between the ages of 15 and 30 years, there has been a 68-percent increase in the occurrence of testicular cancer since the early 1970's. We don't know why, but it is quite real and very disturbing. And then, in baby boys, there has been a doubling in the occurrence of a congenital defect of the urethra which is called hypospadias, which creates a short urethra. So the opening of the urethra is on the underside of the baby boy's penis instead of out of the tip. Those data come from the Centers for Disease Control.

MOYERS: Are you saying that we don't know a lot of what we need to know?

LANDRIGAN: That's exactly right. There are profound gaps in our knowledge.

MOYERS: The question of why we don't know, what we don't know is at the heart of our investigation and our report. So I would like to take you back, if you would, to a little bit of history to piece together some evidence for us. Let's take the chemical, benzene. You have said that the regulatory history of benzene was both turbulent and tragic. Why tragic?

LANDRIGAN: It was tragic because we delayed more than a decade in properly regulating benzene, and in the course of that decade, many thousands of workers were exposed to benzene at unnecessarily high levels. And a consequence of that unnecessary exposure has been many unnecessary cases of leukemia and cases of lymphoma among those workers.

MOYERS: Why did we delay?

LANDRIGAN: We delayed because of a tragic series of events that went all the way to the Supreme Court. In 1977, the Occupational Safety and Health Administration received epidemiologic data that showed that benzene was a carcinogen, that it caused leukemia in workers who were exposed occupationally. On the basis of those findings, OSHA proposed that the occupational standard for benzene be reduced from 10 parts per million to one part per million, a 90 percent reduction in the standard.

The petrochemical industry protested that. They argued their case all the way to the Supreme Court. The essence of their argument was that OSHA had not demonstrated that a 90% reduction in the occupational standard would bring about a reduction in the occurrence of leukemia. The Supreme Court accepted the argument of the petrochemical industry. They put a stay on the standard, which is to say they threw out the standard, and, therefore, for the next 10 years, workers were allowed to be legally exposed to benzene at levels of 10 parts per million.

In those intervening years, researchers with the federal government, a team of which I was part, did very, very careful studies which demonstrated beyond any shadow of a doubt that a reduction in the occupational standard for benzene would bring about clear and immediate reduction in the risk of leukemia.

MOYERS: There was no doubt in your mind, no doubt in this research?

LANDRIGAN: No doubt whatsoever. What we found in those data was a very strong relationship between the quantitative level of a worker's exposure to benzene and the worker's risk of developing leukemia.

MOYERS: If the workers were exposed to more benzene, they were more likely to develop some toxic response?

LANDRIGAN: The more they were exposed, the more likely they were to develop leukemia. There was a clear relationship. And once those data were laid out in full, the Supreme Court accepted them and the one-part-per-million standard became law.

MOYERS: But at the time the petroleum industry resisted this research, were you sure then that exposure to benzene could be carcinogenic?

LANDRIGAN: Oh, yes. Even in 1977, when OSHA first made the attempt to reduce the benzene standard, we knew already at that time that workers who were exposed occupationally to benzene were five times more likely than other people from the same communities to develop leukemia, and we knew that workers who had been employed in those plants for more than 5 years were 21 times more likely to have leukemia than other people from the same communities.

MOYERS: When you said "we," who was we?

LANDRIGAN: We were the National Institute for Occupational Safety and Health and the Occupational Safety and Health Administration, the two responsible federal agencies.

MOYERS: This was about the time, was it not, that industry began using terms like "quantitative risk assessment?"

LANDRIGAN: The term "quantitative risk assessment" really burst into prominence around the time of the Supreme Court decision on benzene. Until then, until the late 1970s, it was considered quite proper to regulate a chemical to the lowest possible level of exposure if it had been shown qualitatively that the chemical had the potential to cause cancer, but all that changed with the Supreme Court benzene decision.

Quantitative risk assessment became the norm. And ever since that time, the regulatory agencies have had to go through years of additional study for any toxic chemical to demonstrate very carefully the relationship between exposure and disease, and they are allowed these days to promulgate a standard only when those very detailed studies have been absolutely completely completed.

MOYERS: You called the decision of the Supreme Court one of profound importance. Why so?

LANDRIGAN: The decision was profoundly important because it changed absolutely the way in which health agencies in this country are permitted to set public health standards. Prior to the Supreme Court benzene standard, public health agencies were allowed to act prudently on the basis of good qualitative evidence showing that a chemical could cause cancer in humans or in animals.

After the Supreme Court benzene decision, agencies had to go through a much longer, much more tedious, much more comprehensive process that often took many years to complete in which they were required to trace out in detail the relationship between a given level of exposure and a given level of risk of disease. That is the essence of quantitative risk analysis. It often constitutes lovely science, incredibly detailed, but it also frequently constitutes very poor public health because it delays for many years the enactment of good health protective regulations.

MOYERS: Is it fair to say that because of the Supreme Court decision, chemicals and the chemical industry became harder to regulate?

LANDRIGAN: I'd say it in a different way. I'd say that there has been a long-standing tradition in this country that in the law, chemicals had been considered innocent until proven guilty. The Supreme Court benzene decision made it much harder than previously to prove a chemical guilty.

MOYERS: But you knew that this chemical was guilty, and you had no doubt as a scientist, as a doctor, that this chemical was toxic. You knew.

LANDRIGAN: Yes, I did know. That's correct.

MOYERS: The Supreme Court said, "You are wrong."

LANDRIGAN: That's right.

MOYERS: What did you think when you heard about that decision?

LANDRIGAN: Well, we were angry. We were frustrated. We knew that we would have to work much harder in the future for a much longer period of time to establish beyond any shadow of a doubt that a chemical was guilty, and we were saddened. We were saddened because we realized that the consequence of this decision would be disease and death in American workers.

MOYERS: Did that prove to be the case?

MOYERS: What about the argument that we live in a society that cannot be made risk-free, that there is no way we can ever eliminate all of the exposures to harmful materials from the way of life that we have?

LANDRIGAN: There are certainly many risks in American society, some that we impose upon ourselves through our ill-considered actions and some that are imposed upon us without our will by other people. The job of somebody like myself who is a professional in medicine and public health is to try to educate people not to do stupid things to themselves and to try to educate our society not to do evil things to people.

We will never eliminate all risks. At the end of our lives, we are all going to die, but as doctors, we have an obligation to reduce those risks that we can reduce. And when somebody is unnecessarily exposed to benzene in the workplace and that unnecessary exposure causes leukemia, that is a situation that just makes me quite angry. As a doctor, it makes me enormously frustrated.

MOYERS: After the Supreme Court decision, you studied what happened, and you found that there were a number of deaths that might not have occurred if you had been able to establish these standards for benzene.

LANDRIGAN: We knew how many people were employed in industry exposed to benzene. We knew how many chemical workers there were, how many rubber workers, how many petroleum workers, how many workers in other industries that were exposed to benzene. And on the basis of knowing how many were exposed and knowing the levels at which they were exposed, we were able to calculate how many unnecessary deaths from leukemia resulted from exposures during that 10-year delay.

MOYERS: How many?

LANDRIGAN: And the number was 492 unnecessary deaths from leukemia.

MOYERS: Deaths that might have been prevented if the Supreme Court decision had gone the other way?

LANDRIGAN: Deaths that almost certainly would have been prevented if the standard had been reduced to 1 part per million back in the 1970's.

MOYERS: What are the lessons that you would have us draw from this case of delay?

LANDRIGAN: I think the most fundamental lesson is that we have to presume chemicals are guilty until they are proven innocent. It just does not make sense to continue to produce as many as 1,000 new chemicals in this country each year, release them into the environment, potentially expose people, and test only 43 percent for their toxicity. That is simply not wise stewardship of the chemical revolution.

MOYERS: We hear a lot about "cost benefit." The industry talks about cost benefit. Politicians talk about cost benefit. Newspaper editorials talk about cost benefit. Cost benefit sounds to a layman somewhat reasonable.

LANDRIGAN: It does sound reasonable. Cost benefit does sound reasonable until you begin to do the complete arithmetic, and then it is a lot less reasonable.

MOYERS: How so?

LANDRIGAN: It is very easy for the chemical industry to calculate what it is going to cost to reduce an exposure because to reduce exposure they are usually going to have to change a process or install some ventilation or put on a filter. Those are costs that are easy to calculate. By contrast, the costs of disease are much harder to determine because the disease which is caused by a chemical like benzene may not occur until 5 or 10 or 20 years after the exposure has taken place.

The worker who was exposed may have moved on to another job by that time. He may be retired. The costs are often borne by the family out of their pocket, not by the company. So the company doesn't have good records on the true medical costs. And then how do you account the cost of pain and suffering? How do you account the cost of a wife losing her husband at the age of 46 to leukemia that was caused by benzene? So cost benefit is one of these things that sounds very, very plausible when you first hear about it, and it becomes increasingly elusive as you get down into it.

MOYERS: Are you suggesting that we should regulate as soon as there is evidence of toxicity?

LANDRIGAN: No. I am saying we should go back further than that. I am saying that we should enforce the Toxic Substances Control Act which was passed by the Congress in 1976. The Toxic Substances Control Act says that chemicals should be properly tested for toxicity before they come onto the market.

It says additionally that chemicals that are already on the market ought to be tested for their toxicity in a retroactive fashion. That law has mostly not been enforced. Many, many chemicals come on the market with only a cursory review by the Environmental Protection Agency because the EPA doesn't have the staff. The chemicals get out there. They get used, and it is only belatedly -- too late -- that we find out that the chemicals are toxic.

MOYERS: You raised the Toxic Substances Control Act. What was its purpose?

LANDRIGAN: The purpose of the Toxic Substances Control Act was to test chemicals to be sure that they would not cause toxic injury to people.

MOYERS: How did it get passed?

LANDRIGAN: It got passed with great difficulty over a great deal of protest by the chemical industry in 1976.

MOYERS: Was the initiative from the public health community?

LANDRIGAN: The initiative was from the public health community. The public health community were responding to disasters that had occurred in which chemicals had gotten out of chemical factories and caused disease in surrounding communities, and at the time of those disasters, nobody knew what chemicals were in the factories. That spurred a public outcry which culminated in the passage of TSCA.

MOYERS: It took a disaster or a series of disasters to get people to act.

LANDRIGAN: Most public health legislation has followed disasters. The Mine Safety and Health Act was passed in 1968 following the Farmington mine disaster in West Virginia, and the OSHA act was passed 2 years later on the wave of the same sentiment. TSCA was passed as a consequence of public health disaster.

MOYERS: You have said it hasn't been well enforced. What do you mean?

LANDRIGAN: There are several problems with the enforcement of TSCA. First of all, from the beginning, the office at EPA which is charged with enforcing the act has been under- funded and understaffed. Secondly, the folks from the chemical industry exerted a powerful influence in drafting the regulations that actually dictate how the act is enforced.

MOYERS: It's clear that we waited too long to act on benzene, just as we waited too long to act on PCBs and DDT and lead poisoning. Why did we wait so long?

LANDRIGAN: You know, it's sort of an American thing. We are just in love with progress and in love with new things, and as a society, we have been far too quick to adopt new technologies and adopt new chemicals, use them widely, put them out in the environment, all of it in sort of the optimistic belief that we could solve the problems as they arose. Well, we are clever. We do solve problems. But it is really not a good thing for our country if we solve problems 20 or 30 years too late and hundreds of people have unnecessarily suffered from cancer or hundreds of babies have unnecessarily suffered loss of intelligence as a consequence of our lack of forethought.

MOYERS: What have you learned, Dr. Landrigan, about what happens when a chemical, like benzene, becomes part of the political process?

LANDRIGAN: It is almost inevitable that when a chemical becomes part of the political process that its regulation is going to be delayed. A chemical that has no commercial value is easy to regulate.

MOYERS: And what happens when it is obvious to industry that there is a threat to them?

LANDRIGAN: There is a sequence of events, and I have seen it with lead. I have seen it with benzene. I have seen it with asbestos. We are seeing it now with certain pesticides. The industry will first deny that there is a problem, then they will argue that the problem is small. Then they will argue that the effect is seen only in animals, but what is seen in animals has no relation to people. And then, finally, when the evidence becomes overwhelming that there are harmful effects on people, they will voluntarily pull the chemical off the market before they are required to do so.

MOYERS: And then, sometimes, there is a lawsuit, such as we have seen in the case of vinyl chloride, and then the discovery process, the floodgates open, and you find out so much that you wish we had known before, but it has taken a long time.

LANDRIGAN: And there are some tragic cases of that. It turns out, for example, that the asbestos companies were well aware of the potential of asbestos to cause human cancer for decades before the public health community made the same discovery, and throughout those years, the companies continued to market the product and allow people to be exposed. Even today, the manufacturers of asbestos are vigorously promoting their products in the Third world. The asbestos market in the USA has crashed. The asbestos market in Western Europe has crashed. But the companies have turned their marketing machinery to the Third world, and they are selling millions of tons of asbestos in South America, in Africa, in Southeast Asia.

MOYERS: What does that say to you about the industry?

LANDRIGAN: It says to me that there are people in the industry who are just indifferent to human life.

MOYERS: The tobacco industry is also doing the same thing, selling abroad to make up for the market that is diminishing here at home.

LANDRIGAN: Yeah. Unfortunately, there are some real parallels between the tobacco story and the story of asbestos and the story of lead and the story of PCBs and the story of certain pesticides.

MOYERS: How do you explain that this could happen?

LANDRIGAN: The industry was very smart. They were very strategic, and they planned way ahead. And I think much of the secret of their success is that they have fundamentally changed the regulatory paradigm. Twenty years ago, the regulators were able to act before they had all the data. They were able to act prudently and preemptively. They could take a chemical off the market or severely restrict the use or control its exposure on the basis of compelling, but perhaps incomplete, evidence and by being able to act that way, by having that power, the regulators of 20 years ago saved many lives. Those regulators of 20 years ago were acting like doctors who make a diagnosis before they have done a complete CT scan of every square inch of the human body.

Today they are required to go through this incredibly tedious analysis before they can establish almost any kind of public health regulation. The only exception might be an extreme crisis.

MOYERS: Paralysis by analysis.

LANDRIGAN: Paralysis by analysis. One of the other things that the industry did, which clearly reflected deliberate advanced planning was that they brought a lot of scientists into their camp. They fund scientists at universities and medical schools across the country, and it has gotten to the point now where most medical journals, including the journal that I edit, require a statement by the author of each paper as to the source of their support. Before I accept a paper for publication, I want to know who paid for the science.

MOYERS: Were you the editor of the Journal back in 1991?

LANDRIGAN: Yes, I was.

MOYERS: Back in 1991, the American Journal of Industrial Medicine, published a study by Dr. Otto Wong which linked vinyl chloride not just to liver cancer, but to brain cancer.

LANDRIGAN: That's right.

MOYERS: You were the editor then.

LANDRIGAN: Yes, I was.

MOYERS: Tell me what happened.

LANDRIGAN: Well, the paper came in. It went through peer review. We sent it out to a couple of scientific reviewers who examined it. They said it was suitable for publication, and then after a bit of editing, we published it.

MOYERS: What did it show?

LANDRIGAN: It showed that workers who were exposed occupationally to vinyl chloride had excess death rates from liver cancer and brain cancer.

MOYERS: Conclusively in your judgment?

LANDRIGAN: Conclusively in my judgment.

MOYERS: But wasn't this study funded by the industry?

LANDRIGAN: Yes, it was.

MOYERS: And he came to a conclusion that was detrimental to the industry?

LANDRIGAN: That's right.

MOYERS: Did you know at the time that it had been industry-funded?

LANDRIGAN: No. Our policy on requiring disclosure of funding came along a few years after that.

MOYERS: But you were persuaded that this was a sound study?

LANDRIGAN: Yes, I was.

MOYERS: And it showed a relationship between workers who were exposed to vinyl chloride and cancer in those workers?

LANDRIGAN: Yes, it did.

MOYERS: What happened then?

LANDRIGAN: What happened was that a few months later, Dr. Wong wrote to me as editor of the Journal and asked that his findings be retracted.

MOYERS: Retracted?

LANDRIGAN: Retracted.

MOYERS: Do you know that there was an intense campaign, in the chemical industry to get him to retract his study?

LANDRIGAN: I've heard that since. I did not know it at the time.

MOYERS: Did he ever tell you that?

LANDRIGAN: No, he didn't.

MOYERS: Had you ever seen a retraction like that before in the journal?

LANDRIGAN: No, I had not.

MOYERS: When did you find out that it was an industry-funded study?

LANDRIGAN: We probably suspected from the beginning that it was industry-funded because Dr. Wong is a scientist, too, who tends to consult for industry. That was no secret, but we certainly were not aware of this dispute that you are describing until--until I learned of it five or six years later.

MOYERS: It would have been impressive that an industry-funded study found evidence that confirmed the worst about the chemical.

LANDRIGAN: Very unusual. Over the years, there have been some studies supported by the industry that have found problems and have reported them, but I must say that most of the studies that find problems are not supported by industry. Most of the studies over the years that have been supported by the industry tend to find no problems.

MOYERS: So Dr. Wong retracted the study, the finding?

LANDRIGAN: Yes, he did.

MOYERS: Then reprints of that retraction have been distributed far and wide within the chemical industry, and, in fact, they are still cited. His retraction is still cited by companies when they defend themselves against cases involving brain cancer.

LANDRIGAN: Yes, it is.

MOYERS: What does that say to you?

LANDRIGAN: It's hard for me to give a simple answer to that one because I don't know all of the fighting that went on in the back room. But what I can say is that the initial paper that we reviewed and published looked to me like sound science. The methods were credible. The findings were believable. Various alternative explanations for the findings were considered, and at the end of the day, Dr. Wong concluded that occupational exposure to vinyl chloride was the cause of the cancer in the workers. I can only speculate what made him withdraw the findings

A retraction is a very serious event in the scientific literature. Honest scientists do from time to time withdraw papers because they have found some error in their methodology, maybe they found some error in their methodology. But there was no evidence that that was the case with Dr. Wong. The methodology was very standard. The findings were very believable, and the retraction was really quite unexpected.

MOYERS: Have you come to any insight into industry-sponsored science?

LANDRIGAN: About 15 years ago, a colleague and I did an analysis of studies in the medical literature that looked at the impact of lead on the brains of children. The question that all of these studies were trying to answer was whether low-level exposure to lead could cause loss of IQ, change of behavior in children. We had about 40 studies to examine.

What we found was that of 20 studies supported by the industry, every one of those 20 studies claimed that there was no relationship between low-level lead exposure and loss of IQ. Of the 20 or so studies that had come from university groups, all but one found that there was a connection between exposure to lead and loss of intelligence in children. Then, when we looked a bit deeper, we found that the one academic study that failed to find a connection was, in fact, a study that had been sponsored by the industry. So we wrote that up. We published it as a letter to the editor in Lancet, which is a medical journal published in England.

MOYERS: What did you learn from that?

LANDRIGAN: The conclusion is that the piper pays the tune.

MOYERS: And gets the melody the piper wants?

LANDRIGAN: Yeah.

MOYERS: Do you think the public understands that science can be manipulated?

LANDRIGAN: No. I don't think that the general public understands that at all. I think the public has an image of scientists as a disembodied people in white coats, such as the coat I am wearing today, who are doing honest work in laboratories. Most folks don't understand that science is a profoundly human activity, that scientists have feelings and temptations and strengths and failures like everybody else. And they don't understand that science can be bought and paid for.

MOYERS: That you can get the results you want if you determine in advance what results you want?

LANDRIGAN: Unfortunately, yes.

MOYERS: Don't you think that journalists like the one sitting in front of you, when we interview scientists, should we inform the public of the scientist's affiliation, as you are now doing in your magazine?

LANDRIGAN: I think it's good honest journalistic practice to always get both sides of a story. Journalists do it all the time, and that's good. But I think when journalists do that and when they interview scientists, it is really incumbent upon them to identify the sources of support for the scientist whom they are interviewing.

MOYERS: What would we know? What could we know if there were more independent science? Would we know sooner rather than later what some of these dangers are? Would we save lives?

LANDRIGAN: I think if there were more independent science, we would undoubtedly save lives, and we would also prevent disease that is not necessarily fatal. For example, for 50 years in this country, we were putting thousands of tons of lead out the tailpipe of automobiles, because we were using tetraethyl lead as an anti-knock agent in gasoline.

In the mid-1970's when the use of tetraethyl lead was at its peak, we were putting 200,000 tons of lead particles into the air in this country every year. Finally, in 1976, we began the lead phase- down. In the 20 years since the lead phase-down began, we have reduced the average blood-lead level in American children by 93 percent. As a result of that, we have raised the average IQ of American children by 3 or 4 points. That is an enormous increase in the national intelligence that has occurred over this time.

MOYERS: And you are sure that the lead was causing this adverse impact on children's intelligence?

LANDRIGAN: Absolutely sure. The independent science that was done in the '50s and the '60s and the '70s and the '80s showed beyond any shadow of a doubt that lead was reducing children's intelligence. But if we had known that 30 years sooner, we could have prevented the whole tragedy.

MOYERS: So getting the science right is obviously very important. What else should we do?

LANDRIGAN: I think the first requirement is to get the science right. We have to separate science from industry funding. The more industry funds science, the more science is going to be bent. And there is a profound ethical dimension. Scientists have to understand that the highest goal is truth. Physicians have to understand that the first principle, the bedrock of the Hippocratic Oath, is to do no harm.

MOYERS: And that is an ethical and moral matter.

LANDRIGAN: It is absolutely ethical, and it's totally moral.

MOYERS: How many man-made chemicals does it take to scramble the body's chemical messages?

LANDRIGAN: One chemical, one single chemical at the wrong moment, especially at the wrong moment in early development, can have lifelong consequences. PCBs are a good example. If the child is exposed in the mother's womb to PCBs, the result can be loss of intelligence, change of behavior, and those effects, so far as we know, are not reparable. They persist for a lifetime. Science is only beginning to study the combined effects of two or three or four or five chemicals, and yet, in reality, we are all being exposed to multiple chemicals every day. We know almost nothing about the synergisms and the interactions that result from multiple exposures.

MOYERS: And some of these chemicals can be like the man who came to dinner that can come and stay a long time.

LANDRIGAN: Some of these chemicals like PCBs last in the body for decades. DDT lasts for decades. Lead lasts for 25 or 30 years.

MOYERS: And you say there are 80,000 known chemicals, and there are 15,000 that are considered potentially--

LANDRIGAN: There are 80,000 different manmade chemicals that have been registered with the EPA for possible use in commerce. Of those 80,000, there are about 15,000 that are actually produced each year in major quantities, and of those 15,000, only about 43 percent have ever been properly tested to see whether or not they can cause injury to humans. We are flying absolutely blind. A phrase that I have heard used by my colleague, Dr. Herbert Needleman, is that what we are doing in our society is we are conducting a vast toxicologic experiment, and without their will, we are using our children and our grandchildren as the experimental animals. Today -- somewhere in the neighborhood of 1,000 new chemicals are being presented to EPA every year for consideration for possible manufacturer. If you do the arithmetic, that is 20 new chemicals a week. EPA doesn't have the staff to even begin to cope with that volume of chemical manufacturers.

MOYERS: What are people to do? Are we just to throw up our hands and say it's helpless, we are overwhelmed?

LANDRIGAN: I think this is a situation that calls out for a legislative solution. And it is a situation where people alone can do nothing, but people acting in concert and going to the Congress can bring about the necessary legislative change. In this country, we need profound revision of the Toxic Substances Control Act and the regulations that flow from it. Until we fix this vital piece of legislation, this travesty is going to continue.

MOYERS: But given the enormous rivers of money that flow into the political process, both parties, all candidates, all politicians, do you think we can get that kind of political and legislative action?

LANDRIGAN: I don't think that we have a hope of getting this kind of legislative action until we profoundly reform campaign funding. Right now, campaign funding pollutes the regulation of chemicals.

MOYERS: You have been at this a long time. Is there a pattern in this process of regulatory delay?

LANDRIGAN: The industries hate to be told what to do, and they have found that by insisting upon very detailed quantitative risk assessment, they can delay regulation for years, sometimes even for decades.

Industry science has gone through an evolution. Back in the '70s and '80s, the industry was calling for quantitative risk assessment, and they used quantitative risk assessment as a tool for slowing regulation. In the '90s, they came up with a new wrinkle, and this new wrinkle which is very much in the literature today is a call for understanding the molecular mechanism by which a chemical causes damage in the human body. And the latest mantra from the industry is that it's really not proper to regulate a chemical until you understand not only the quantitative risk assessment, but the actual molecular and the cellular level by which the chemical causes damage.

This new approach gives the industry a lot of room to maneuver, because one mechanism may apply in rats and another mechanism may apply in mice, and industry scientists can fight for years over which is the better model for predicting disease in humans. So the situation you describe of paralysis through endless analysis has become even a longer process than it used to be.

MOYERS: What do you say when industry says, "Look, we are talking about maybe one death in 100,000 or 200,000 people in a society like this. It is impossible to minimize all risk, and it is impossible to save everybody who might be exposed to the consequences of modern life"?

LANDRIGAN: I will accept the notion that it is not possible to reduce risk to zero, but I am always mindful of the axiom of my predecessor at Mount Sinai Hospital. Professor Irving Selikoff was my predecessor and did a great deal of work relating asbestos to cancer. What he used to say is that statistics are people with the tears wiped off, and what he meant by that is that if there were even a single unnecessary death caused by exposure to asbestos or exposure to benzene, that was one death too many, one death too many for the worker himself, for the worker's family, for the worker's children.

MOYERS: And we're talking here about situations in which the industry knew one thing and didn't tell the public.

LANDRIGAN: Yes. In reality, we are usually not talking about one death in a million. We are talking about several hundred unnecessary deaths in a population of only a few thousand. Those are important numbers by anybody's standard.

MOYERS: And there are lives that could have been saved except for industry's refusal early on to share what they knew with doctors, the public health community, and with the workers themselves.

LANDRIGAN: There is no question in my mind that we could have saved many hundreds of lives if we had known earlier on that chemicals like vinyl chloride and benzene had the potential to cause human cancer.

MOYERS: So getting the science right is not the only issue here. We are talking about something that goes beyond the data.

LANDRIGAN: That's right. The science is necessary, but it is not sufficient.

MOYERS: What is sufficient?

LANDRIGAN: What is needed is science and an unpolluted political structure that is empowered to set regulations that protect the public health.

MOYERS: The American people have been told that we have in place a system that protects their health and the health of their children from exposure to dangerous chemicals. In your experience, are they right to feel safe?

LANDRIGAN: In the United States, we have public health protections that do not exist in many other countries. There is no question about that. But at the same time, if we are being completely honest here, we have to understand that we have allowed the public health infrastructure in this country to erode badly. For example, we lack procedures for proper testing of every new chemical that is to come on the market.

Our systems for tracking disease in the American population are very weak. There are many diseases, for example, birth defects, asthma, certain occupational diseases, for which we collect no data at all across the broad sweep of the American public. And the result is that people who are practicing public health are often flying blind. They simply don't have the information that they need to take intelligent preventive action.

MOYERS: It has taken us 50 years to get to this dilemma. How long do you think it will take for us to get out of it?

LANDRIGAN: Well, the good news here is that these problems were caused by human action, and, therefore, we ought to be smart enough to be able to think ourselves out of the box into which we put ourselves. I think the issue is one of political will. If we can mobilize ourselves to do the right thing, if we can reduce the terribly harmful influence of soft money on American politics, then I think we have a hope of getting out of this terrible situation.

MOYERS: What does it mean that these big corporations, the chemical industry has such a lock on Congress?

LANDRIGAN: I think that it's a real threat to democracy.