DR. RICHARD LEMEN

MOYERS: Describe, generally, what you found when you looked at those documents that give us the inside story of how the chemical industry reacted when it discovered that workers in vinyl chloride plants were suffering from some strange disease.

DR. LEMEN: I think my first reaction was, "Why did it take so long for them to take action when they knew of a disease called acroosteolysis occurring in the mid-1960s. And it wasn't until almost the 1970s before any publication of that material were out into the public. Looking at the whole issue, it just appeared to me the slowness in which action was taken and the cautiousness to avoid any type of panic that might cause harm to the productivity of the industry. So I was taken by the slowness that, to describe it very generally, the slowness in which action was taken.

MOYERS: Did what you saw in those vast mounds of material surprise you?

DR. LEMEN: What surprised me, I suspected that there might be information like that because I had worked with vinyl chloride, since the early 1970s. And so it was my feeling that there was information that was being held back, but that information was certainly justified when I saw it in the literature that I reviewed some 25 or 30 years later.

MOYERS: You looked at it and you saw a pattern?

DR. LEMEN: Yes.

MOYERS: What was the pattern?

DR. LEMEN: The pattern was, again, slowness, trying to misrepresent what was there, trying to put the best light on a situation, to keep the information from affecting any of the production or any of the activities of the industry, to present it so it put them in the best possible light.

MOYERS: The industry.

DR. LEMEN: Yes.

MOYERS: One of the workers in Louisville had been complaining since the mid-1950s, and yet the company never told him that he wasn't the only one.

DR. LEMEN: That's not surprising to me. I find that a lot of times the companies will not confide in their workforce and that they will not talk to other workers about the problems that they're having.

MOYERS: We have a letter that was written to the medical director of the Monsanto Chemical Company on February 2, 1965 --from a Professor in Preventive Medicine at the University of Cincinnati, who informs the medical director of Monsanto, "It is difficult not to conclude, on the face of the evidence, poor as it is, that this is an occupational disease." He's referring to the disease that struck the Louisville worker. What does that memo say to you?

DR. LEMEN: It says to me that the medical community that was researching certainly was recognizing a new entity, a new disease, and that they were alerting the industry. What happened after that took some five-to-six years before the industry even recognized that this was potentially an occupational disease.

MOYERS: It would take another two years after this memo was written -- for B.F. Goodrich to secretly inform other manufacturers of the problem and then, only then, did they get a meeting together. It took two years from the date of this memo, February 1965, before the industry got together for a meeting.

DR. LEMEN: Again, it was the slowness of action on the industry's part that was the most striking issue in reviewing these documents.

MOYERS: This is a memo written at the end of the meeting called by the industry to discuss what this research was showing. And one of the first conclusions in confidential memorandum of record is, "There is no question but that skin lesions, absorption of bone of the terminal joints of the hands and circulatory changes can occur in workers associated with the polymerization of polyvinyl chloride." What does that say to you?

DR. LEMEN: It says to me that they knew that there was a problem and that they should have been taking immediate preventive measures to prevent workers from further exposure.

MOYERS: They were admitting among themselves that there was a problem?

DR. LEMEN: That's correct.

MOYERS: But they didn't do anything publicly about it?

DR. LEMEN: No, and they should have. The basic tenet of public health is to prevent, once you have found something, immediately stop exposure. That's what happened with many epidemics. When you stop exposure, you stop the disease.

MOYERS: So they should have told the workers right then.

DR. LEMEN: They absolutely should have told the workers. Even if it was only a suspicion, they should have told the workers what they knew and what they could do to prevent their exposure to what they thought was causing the disease.

MOYERS: Shouldn't they have removed the workers from those jobs where they were working in the so-called "kettles"?

DR. LEMEN: Absolutely. MOYERS: You think they should have said, "Cease and desist. No more working in this--"

DR. LEMEN: Oh, absolutely. Absolutely. They should have ceased that and put in very stringent controls to make sure that the workers were not being exposed until they found out what the exact cause was and how to prevent it in those workers.

MOYERS: Instead, at the conclusion of this June 1966 meeting, attended by representatives of several of the large chemical companies, what they decided to do was "to meet again in a year or so" -- that's a direct quote, "in a year or so and compare notes." They were taking their time.

DR. LEMEN: That’s one of the things that struck me, was the time that they took to take action. They should have taken action from the very start of the information that they had. Even though it might cause some concern, workers are not informed, and workers will work best if they know what they're exposed to. And they should have told the workers, and working with the workers -- and with the company representatives -- I think they could have solved this problem. I think they could have solved it a lot sooner and prevented a lot of disease that continued because of their slowness in their actions that they took.

MOYERS: But it's clear from these documents, document after document, that their primary concern was avoiding problems with labor and avoiding publicity?

DR. LEMEN: Absolutely. And they were scared, they were afraid. They thought that if they mentioned something that the workers would go up in arms. Well, workers know that they need to have a job, but they also want to be provided a safe job. And if they're informed, they can work with the industry in maintaining a safe job. So the industry, in my opinion, was negligent in not bringing the workers in as a part of the team to work on a solution for preventing this disease.

MOYERS: Here's another document, October 24, 1966, from a meeting from the Manufacturing Chemists Association, MCA, the industry trade group, an Occupational Health Committee meeting in Cleveland, Ohio, October 6, 1966. And they discovered another problem. One of the theories presented by one of the consultants, by some of the consultants to B.F. Goodrich was that the condition being described, the strange disease that these workers were experiencing, "may be a systemic disease, as opposed to a purely localized disease," that is, in the fingers. They are worried about possible long-term effect on body tissue, especially if it proves to be systemic."

What's that saying? Interpret that for a layman.

DR. LEMEN: What that's saying is that this disease may be much beyond just the fingertips that they were concerned about, but may affect the body in a variety of different ways, much beyond the acute effects that they're seeing with this disease; that it could have effects on other organs in the body or other parts of the body. They just didn't know at that point in time. However, there was enough indication to make them aware that this could well be a disease that goes beyond this damage to the tips of the fingers and that the implications could be much broader than what they had originally thought.

MOYERS: What are the implications of something like this for the workers? People like Bernie Skaggs?

DR. LEMEN: What is his future going to hold? Is he going to be treated for the disease that he has, but 10-to-15 years later, another disease related to this is going to show up? It's going to put him in a situation where he doesn't know what's going to happen to him. And it's going to increase the worry on him, his family and what his reaction is going to be.

MOYERS: Even as the disease developed in him, he wasn't told.

DR. LEMEN: That's right, and that was wrong. He should have been told, and he should have been told everything that the industry knew at that time. He should have been told, right now, this is a localized disease, but it may be systemic. Therefore, we should work with your physician to make sure that you're under a surveillance program to assure that any changes can be detected at the earliest possible moment.

One of the basic tenets of occupational health is to make sure that the physician knows what the person's occupation is. A lot of physicians don't ask a worker, "What do you do?" And that's what should be done. Physicians need to ask the worker, "What do you do?" But on the other hand, the company physicians need to alert the local physicians in the community, "Here is what we know, and we want to share that information with you."

So it was imperative, in my opinion, for the company to alert the local physicians, so that they were aware of what the company knew.

MOYERS: Instead, Bernie Skaggs and these other workers were allowed to go on working in these hazardous circumstances that the company, the industry, knew were dangerous, that something was going on that wasn't right.

DR. LEMEN: That's right, and that's wrong.

MOYERS: And the companies kept talking to one another. Here's another quote from the memo: "BFG..." that's B.F. Goodrich "...is sharing its knowledge with all PVC manufactures." PVC is polyvinyl chloride. "They hope all will use discretion in making the problem public because they particularly want to avoid exposes like "Silent Spring."

DR. LEMEN: I think that this is a fundamental problem that we've had in public health for a long time, and that is who is more important? Is it the chemical being produced, or is it the human being producing the chemical? Unfortunately, the chemical industry in the past has put more emphasis on their product than they have upon the people that are putting the product together.

MOYERS: Finally, in February 1969, 10 years after Mr. Skaggs first reported the disease in his hands, scientists who had been commissioned by the companies to study the problem urged the following: Let me quote this. "The severity of exposure of reactor cleaner to vinyl chloride -- chlorine and also of personnel on the charging floor should be kept at a minimum, desirably below 50 ppm..." That's parts per million?

DR. LEMEN: That's correct.

MOYERS: "...rather than merely below the current threshold limit value of 500 parts per million." Now, as a layman, I don't know what that means. What does that mean?

DR. LEMEN: Well, that means that the threshold limit value that was the recommendation made for protecting workers by a group called the American Conference of Governmental Industrial Hygienists had recommended 500 parts per million. There were memoranda in the data that I looked at that showed that they wanted to bring it down to at least 50 parts per million and that the industry was saying, "Well, this will be very hard for us to meet this. So we can't really bring it down to 50 parts per million." And as a result, the American Conference of Governmental Industrial Hygienists never lowered their standard, at that point in time, down to 50 parts per million.

But what that's saying is they needed to bring it down at least 10 times lower and probably even lower than that, and they didn't do it.

MOYERS: The scientists were saying lower the content of vinyl chloride in this product?

DR. LEMEN: In the process.

MOYERS: In the process. But the industry didn't do that.

DR. LEMEN: No.

MOYERS: Listen to this: "A motion to accept the report as submitted was then defeated by a vote of seven to three."

DR. LEMEN: I remember seeing that in the data. That's very interesting. They didn't want to accept what the scientists said. They wanted an opportunity to rewrite that document so it put them in the most favorable light, which is the wrong thing to do.

MOYERS: What's stunning to me is that at this meeting were, representing the companies, many people with "MDs" behind their names, MD, MD, MD, MD, MD, MD, MD. And they were among those voting against the researchers who had said, we've got a problem here.

DR. LEMEN: That is an amazing finding, and I think that that reflects who the medical doctor's patient really was. Was their patient the workers in the plant or were they representing their patient, their employer?

MOYERS: Had the industry been more open with the workers, would they have discovered the nature of this hand disease sooner?

DR. LEMEN: I think so.

MOYERS: What difference might that have made?

DR. LEMEN: I think it would have made a world of difference, because they could have put preventive techniques into place. They could have put enclosed systems, so that the workers would not have to go in and clean the systems out by hand. They would have put other preventive systems of personal protective equipment in place so that the workers would not be exposed to the chemicals within the reactors.

It would have made, in my opinion, a world of difference because you would have stopped that exposure very early on, and therefore limiting the ability of workers to develop disease.

MOYERS: Is it fair to conclude that this collusion of silence on the part of the industry cost many workers their health and some workers their lives?

DR. LEMEN: Very definitely.

MOYERS: Unnecessarily?

DR. LEMEN: Very unnecessarily.

MOYERS: Let me move ahead to 1974. 1974 is the year when the B.F. Goodrich situation broke open in Louisville, Kentucky, when it was announced that four workers at a vinyl chloride plant there had died of a very rare liver disease. Do you remember the reaction inside the public health community?

DR. LEMEN: The reaction inside the public health community was one of, "Wow, that's a really unusual number of cancers of a very rare tumor of the liver occurring in a group of workers that all had a similar work history. There must be some connection to the workplace, and we really need to investigate this." So I think it was a really strong reaction that such a rare event could occur in a small plant, a relatively small plant, among a relatively small group of workers, and they all had the same disease. It was not until what I would call the smoking guns, or the diseases, occurred that we were really aware that there was a problem in this industry, even though there were animal tests that were done in Europe, and they were showing carcinogenic effects. If we would have known this early on, w might have been able to prevent some of this disease that was occurring.

MOYERS: But beyond the animal studies, the researchers had evidence that what was happening to the workers in Louisville was directly related to their occupation.

DR. LEMEN: That's right.

MOYERS: The strange disease first reported in 1965 was occupationally related.

DR. LEMEN: That's correct.

MOYERS: So the industry was withholding from government, from the public health community, crucial information.

DR. LEMEN: In my opinion, that's true.

MOYERS: What did they know at the time? What did they know by 1974?

DR. LEMEN: They knew of the disease acroosteolysis, they knew that that had been occurring in workers exposed in this industry. They knew that there were animal studies that had been conducted in Europe that had shown cancer in laboratory animals. So they had an indication that there was a disease problem occurring in this industry.

MOYERS: Again, what difference might it have made if in 1973 and 1974 the industry had told the government, shared the information with the government?

DR. LEMEN: I think it could have curtailed the epidemic of this disease. As we see today, the knowledge that came out in '74, which brought great light to this whole issue, I think stopped an epidemic that would have continued to go on for many years had it not been brought to light in 1974. So if it had come to light a year before, two years, five years before, I think we would have stopped unnecessary disease that occurred because no action was taken.

MOYERS: Could it have been that inside industry people said, "Look, this is new. We're just in the beginning of the chemical era in America, beginning with World War II forward, and there's a lot going on we don't know. We need more time to actually study what the effects of chemicals are in our commerce"?

DR. LEMEN: Well, I think that that's a tone that probably was projected by the industry. We need to finalize this, we need to study it to the end to see what's happening. But at the same time, as a public health official, when we know that we have a potential for a disease, we need to take the action that's at hand.

In 1965, Sir Bradford Hill, a noted British biostatistician, gave an address in which he laid out criteria for causation of disease, particularly relating to causation of disease in this modern era of chemicals, and he listed things such as biological plausibility and a whole list of things. But at the very end of his address he said, "Science is always changing, and it does not give us the luxury..." and I'm paraphrasing "...to not take the action that's necessary with the knowledge that we have at hand today."

So had they taken action with the knowledge they had at hand back into the 1960s, angiosarcoma of liver may never have occurred in these workers in 1974 in the Louisville plant.

MOYERS: You've spent a great deal of your time, a great deal of your life, analyzing what happened when the industry commissioned its study of the effects of vinyl chloride on workers. How did that effort start?

DR. LEMEN: Well, the effort started because the industry was getting enough information that they decided they better pull together and look epidemiologically, because they weren't going to rely solely upon the animal studies. They wanted to look and see were their populations experiencing mortality that was different than the general population. So I think they did it because they wanted to cover themselves to make sure that they were showing the best face that they could.

They were trying to study their workers. But I think they wanted to continue the study for many years. As a matter of fact, that study is still ongoing, and they continue to re-analyze that population, even though we have identified so many flaws in that population that it's not a very meaningful study at the present time.

MOYERS: When you look at these documents, it does seem that the single purpose of these studies by the industry was to prove that those cancer rates among vinyl chloride workers was not significantly different from the general population. That seems to me -- as I look at the documents -- to be what the industry is trying to prove.

DR. LEMEN: That's my interpretation, also. And I think they went about designing their studies, from my analysis, in such a way that they could do that. They included workers in their study that were probably not ever exposed to vinyl chloride. They included workers, in some cases, that weren't exposed that maybe were counted twice. They had workers that were lost to follow up that they were unable to account for. So the cohort, in my opinion, was not a complete cohort, and we've pointed that out on many occasions.

And we asked for the data, as OSHA did, in the early 1970s. And in the later part of the '70s, the industry study people could not give them the raw data upon which they had done their analysis. So there was no way to tell whether the analysis was correct or not correct. And that's very clearly documented in the OSHA material that was put forth in this whole vinyl chloride story.

MOYERS: I'm going to back up for a minute. This is the copy of the interoffice correspondence of November 24, 1959, written to a medical doctor who is one of the company's doctors. Just read the line that's highlighted there.

DR. LEMEN: "Vinyl chloride monomer is more toxic than has been believed."

MOYERS: Now, what does that mean to you as a doctor?

DR. LEMEN: It means to me that, in the past, they have thought it was not a very harmful substance. But now they know, beyond a shadow, that this is a much more toxic chemical than what they've been dealing with.

MOYERS: And the date on that is?

DR. LEMEN: The date on this is November 24, 1959.

MOYERS: Four years after the worker in Louisville noticed the disease in his hands.

DR. LEMEN: That's correct.

MOYERS: And they've come to the conclusion that this stuff is dangerous?

DR. LEMEN: That's correct.

MOYERS: What should they have done when this memo was circulated?

DR. LEMEN: I think they should have immediately taken precautions in preventing the workers from additional exposure. They should have enclosed the systems. They should have kept the workers from being in contact with the material. They should have taken the most stringent actions possible to prevent the workers from having contact with this toxic material.

MOYERS: Instead, what did they do?

DR. LEMEN: Nothing. And I think they're playing very fast with the lives of workers. I think that if they had taken action when they initially thought this to be as toxic as they said in their 1959 memo, we wouldn't be sitting here today talking about the risk of disease among vinyl chloride workers that developed into this very tragic cancer of the liver -- angiosarcoma.

MOYERS: Here's another memo. We're back now to May 12, 1959, a letter from a biochemical research laboratory to the director of the Department of Industrial Hygiene and Technology, the B.F. Goodrich Company, Akron, Ohio. Would you just read that highlighted part and interpret it for me.

DR. LEMEN: "We feel quite confident, however, that 500 parts per million is going to produce rather appreciable injury when inhaled seven hours a day, five days a week for extended periods." This was written in 1959. And in my opinion, from the other memo that was written, that would have not been protective.

MOYERS: This would not have protected the worker?

DR. LEMEN: That's correct.

MOYERS: So they were leaving the workers exposed?

DR. LEMEN: Yes. That's a very high concentration.

MOYERS: Five hundred parts per million.

DR. LEMEN: That's correct.

MOYERS: So what's the layman to make of this?

DR. LEMEN: That they were not taking protections for the worker that they should have been taking.

MOYERS: And it was 15 years after this that the four workers in the Goodrich plant in Louisville died.

DR. LEMEN: That's correct. And that's because they opted to not take action, but to continue studying the situation, when they should have taken action when they first had any indication that this was as toxic a chemical as it was. They opted to continue studying, when they could have taken preventive measures. At the same time they continued studying, it would have been very effective to continue studying, but to take the preventive measures to evaluate whether or not the preventive measures were effective in stopping the disease. That's what they should have done. They didn't do that. They should have put the two things together.

What they did was opt not to do the preventive measures and just continued to study, to see what happened. That was the wrong thing to do.

MOYERS: Is it accepted in science to organize your inquiry to find the result you want or need?

DR. LEMEN: No, it's not.

MOYERS: What is good science?

DR. LEMEN: Good science is to design a study that will determine whether or not there is an effect from the exposure to the chemical. And you should design that study with the greatest amount of power, the greatest amount of ability to detect whether or not there is an effect. Therefore, you should study those workers that are most directly exposed and eliminate workers that don't have exposure. That was not done.

MOYERS: Go to the pool of affected workers, not the pool of workers who might be on the margin of the process?

DR. LEMEN: Absolutely. They didn't do that. They included all the workers.

MOYERS: Is it true that workers who could have been exposed to vinyl chloride, but were no longer working for the company, were not included in the study?

DR. LEMEN: That was my understanding. And those people should have been included because they may have had effects. If you have workers that have left employment, they may have left because they were sick. They may have left because they had had some reason to leave. And excluding them from the study gives you a very biased result.

MOYERS: As we looked at these documents, my colleagues and I were flabbergasted to learn that the companies actually prohibited their researchers from contact with the workers and with their medical records. Did you find that?

DR. LEMEN: I did find that. I found that strange. It seems to me if they're going to do a complete follow-up, they're going to have to look at the workers. They're going to have to try and trace those workers. They didn't do that.

MOYERS: What did they look at?

DR. LEMEN: They looked at the information that was readily available.

MOYERS: They also looked at the death certificates to find the cause of death. But could that be misleading?

DR. LEMEN: It could be misleading. One way of doing a study is to do a mortality study. But once you find in the death certificates, you need to also look at that information much more closely. But looking at death certificates alone may not give you the entire picture.

It may give you a very limited picture of what's going on, due to misdiagnosis in the death certificate, due to competing causes of death. Say, a person may actually have a cancer, but die of, say, a heart attack. And it would be coded on the death certificate as dying of a heart attack, even though the underlying cause of death may well be a cancer.

MOYERS: How can you do a study about people affected by a rare disease and a chemical if you don't talk to the people who actually have it in their hands and in their system?

DR. LEMEN: Well, I think they were prohibited from talking to the workers simply because the industry did not want to have a scare occur. And if they felt that they were talking to the workers, they thought they might have a very big scare occurring, and it would affect the industry. I think it was wrong. I think they should have talked to the workers. I think they should have tried to trace all of the workers and find out what their health status was.

MOYERS: What kind of results are you going to get if you don't talk to the Bernie Scaggs while they're still alive?

DR. LEMEN: You're going to get limited results, if that. You may have very misleading results.

MOYERS: The companies themselves, according to the documents, were asked to estimate a workers' exposure to vinyl chloride as "high, medium or low." What are the implications of that?

DR. LEMEN: When I looked through the material I never found a definition of what they meant by high, medium or low. That that was left arbitrarily to each individual plant to make those connections. And I saw no uniformity in that. So, to me, those designations of "high, medium and low" in this study are bogus.

MOYERS: So one plant, say, the plant in Louisville, the manager might say, "Well, we had a high concentration," and the manager of the plant in Akron might say, "Well, we had a low concentration," but there was no mathematical measure taken to define high, low and medium?

DR. LEMEN: Not that I found in going through this data. And I've been looking at it for well over four years now.

MOYERS: Was anything ever done to correct these flawed results, to go back and do good science?

DR. LEMEN: In reviewing the records, I could find no evidence that they had ever tried to correct many of the faults that were pointed out to them by OSHA and even by other scientists that had reviewed the data.

MOYERS: In 1991, Dr. Otto Wong--is that name familiar to you?

DR. LEMEN: Yes, it is.

MOYERS: Had been hired by the Chemical Manufacturing Association, the industry trade group, to update the vinyl chloride study. And he published his results in a scientific journal. Do you remember what he found?

DR. LEMEN: He found an excess of liver cancer. I think he found an excess of brain cancer and other cancers. And his results at the time were consistent with what we had been seeing in other studies that had been done in other parts of the world.

MOYERS: Is it correct to say that his study established for the first time a link between vinyl chloride and brain cancer, the very same cancer that killed Dan Ross?

DR. LEMEN: I certainly think it was one of those studies that did do that, yes.

MOYERS: What was the reaction within the industry?

DR. LEMEN: They were upset. They were concerned. They didn't get to see a draft of the publication before it went to press. And so they held a meeting, and they talked about it, and they wrote a response to the journal saying that they disagreed with the results of Dr. Wong. And unprecedented to me in any other scientific journal, Dr. Wong, in turn, wrote his own retraction, which I have not seen done in scientific journals, that you publish a study and then after severe criticism by the sponsors of the study, you write a retraction of what you found.

MOYERS: He took it back.

DR. LEMEN: Yeah.

MOYERS: That is astonishing.

DR. LEMEN: To me. I've never seen that before.

MOYERS: Based on all of your work, would you say that industry-sponsored, industry-funded science is bad science?

DR. LEMEN: Not necessarily, no. But I think that it's gotten a rap of being bad science because of situations such as the vinyl chloride story. I think industry is capable of doing good science. But I don't think that they are going to be able to prove that they're doing good science unless they put all of the controls on their science so that it's an open process. It has to be open. It can't be hidden. Industry needs to open up their process and bring in the right people to do the science and make it a transparent process, so that there's nothing underneath the table that can be questioned. Science is easy to manipulate -- just in the case of vinyl chloride, by the selection of the cohort, putting together a group of workers to be studied when a majority of those workers probably didn't even have exposure to the chemical that you are interested in studying. That's manipulation of the science.

MOYERS: How are laypeople like me, citizens, supposed to decide what is good and what is bad science?

DR. LEMEN: That's hard. It's real hard. That's why I say that the industry should adopt a transparent process, where they are above board in everything they do, so that there's no question. They should put together panels of scientists that are very knowledgeable and have no ties, financially, to the industry or to the organization that they are studying. And they should put all of their science above board, on the table, so that it's transparent. I think the word "transparency" is the most important thing that the industry could adopt in doing studies of their own industry.

MOYERS: But if the industry did that, if the industry adopted transparent science studies, wouldn't the industry be giving away their trade secrets?

DR. LEMEN: No, I don't think so, not at all. There are ways of doing science without giving away trade secrets. You don't have to give the formula of a product when you're doing a study.

MOYERS: That's what they say, by the way; that "We don't want to exposure our trade secrets."

DR. LEMEN: Well, I think that that's a very easy blanket to hide behind.

MOYERS: Eventually, over a long period of time, despite these efforts that you've described and others have told us about by industry, the government finally did reduce the exposure of workers to vinyl chloride, to one part per million--

DR. LEMEN: That's correct.

MOYERS: That’s an acceptable, tolerable level?

DR. LEMEN: Well, vinyl chloride is a carcinogen. And for most carcinogens, we're really unable to identify a concentration below which there is not a risk to some individuals developing cancer. And I think because vinyl chloride is a carcinogen, that the only way that you can assure no cancer developing in an individual is to have no exposure whatsoever. And that's what they should be striving for. The one part per million was an upper limit to address. But the real issue and the OSHA standard was to limit the exposure to the extent possible, so that no worker is exposed to this material.

MOYERS: Can we live in a risk-free commerce?

DR. LEMEN: That's a very hard question. It's very hard to live in a risk-free environment. We can certainly eliminate risk, as best we can, to a chemical. And if it means enclosing the system so that the worker doesn't have any exposure to it, then it should be done. You can enclose systems to where the chemical reaction and the exposure occurs within a closed system. That's an acceptable method of engineering controls.

MOYERS: Could this have been done with the kettles in Louisville?

DR. LEMEN: In my opinion, we have the engineering ability to do that.

MOYERS: Are all chemicals carcinogenic?

DR. LEMEN: No, not at all. There are a vast majority of chemicals we're exposed to that are not carcinogenic. One of the problems we have is that we haven't adequately tested chemicals to determine which ones are and which ones aren't. But in my opinion, only a few chemicals are probably carcinogenic. But have we identified all of those? No. Are we looking? No.

MOYERS: We're not looking?

DR. LEMEN: No.

MOYERS: Fifty years into the chemical revolution we're not looking?

DR. LEMEN: Not adequately, no.

MOYERS: How long is it going to take us to find out what we need to know?

DR. LEMEN: If we go at the rate we're going today, we'll never get there. What we have to do is to do pre-testing of chemicals before they come onto the market. We need to look at them and determine, through various tests, whether or not these chemicals are potentially capable of causing cancer. And in those chemicals where that potentiality exists, then we should do everything in our power to either find a substitute for that chemical or to protect the worker to the maximum extent possible from exposure to those chemicals.

MOYERS: Most of the ordinary people you talk to will say that they think that, they assume there's a regulatory process in place that will protect them from the harmful effects of chemicals, that the government is doing its job. Is that right?

DR. LEMEN: In my opinion, that's not right. If you look at OSHA -- let's take OSHA as one example. The standards that OSHA has on their books today, the majority of them, are based upon science that was available in 1968, not on science that is available in the past 20 or 30 years. OSHA has only promulgated standards on a few-dozen chemicals. The rest of those were start-up standards that the Congress allowed OSHA to adopt from consensus organizations that were in existence at the time OSHA came into existence in April of 1971.

MOYERS: Thirty years ago.

DR. LEMEN: Thirty years ago. OSHA attempted, in the late 1980s, to update those standards, and they were unable to do so because of trade associations and challenges to the ability of their organization to do that. So what we're experiencing today, on a major number of chemicals in the workplace, we're letting people be exposed to chemicals in the workplace today that were designed, as far as protection factors, to protect them based on the science that we had in 1968 and thereabouts.

So there's no update of the majority of these chemicals. So workers today are being exposed to concentrations of those chemicals the same as workers in the '60s were being exposed. No update to protect workers has been done on the vast majority of chemicals in the workplace.

MOYERS: Is this a concern only to workers, to occupational hazards in the workplace?

DR. LEMEN: No, not at all. Workplaces are places where workers have intense exposures. But those exposures don't stop at the factory walls. They oftentimes go outside the workplace into consumer products carried home by the worker because they don't change their clothes. But these products, when they're used in the environment, can be just as dangerous to the individuals exposed in the environment as they are to the workers that are manufacturing or using the chemicals in the workplace. They don't respect the factory wall and say, "When I leave the factory wall, I'm safe."

MOYERS: Why haven't we made more progress in the last 30 years?

DR. LEMEN: Because I don't think we've wanted to. And the reason I say that is because I think we've been so based upon trying to get ahead economically that we've sacrificed the individual, the human in the process of doing so. I don't think that we have put in protections because the industry has told us that we'll lose jobs, it'll cost money. And I think, as the American public and the public-at-large, we believe that. That's not necessarily true. Good public health and good prevention would be protecting the worker in the workplace so that they have a longer life, fewer medical bills and protecting the consumer so that they can enjoy the products for a much longer period of time.

MOYERS: But here's the paradox: Today we're living longer, living healthier. Isn't that an argument that things are going pretty well?

DR. LEMEN: Well, I think it's an argument that our longevity has gotten a lot better as a population as a whole. However, what about those individuals in the workforce or those individuals exposed to chemicals that are susceptible to those chemicals and die at age 45, 46, much before the expected life span of the general population? Those people are the ones that I'm concerned about. I want to see all of us expand our life span, as you were just discussing. But in the process, we have to protect those susceptible individuals that are exposed to concentrations that are unacceptable to chemicals in the workplace and in the consumer products. Those are the ones that are at high risk that we should be most concerned about.

MOYERS: People like Mr. Ross and Mr. Skaggs.

DR. LEMEN: That's right, exactly. Look at the angiosarcoma cases. Those weren't in 76-year- old men. Those were in younger men -- they were much younger than that -- that could have another 40-year life span had they not been exposed to vinyl chloride.

MOYERS: You've been at this a long time. You've been in public health since when?

DR. LEMEN: 1967, actually.

MOYERS: And you served many years in the public health field here in Washington for the government. You've seen the process up there, you've seen politics, you've seen hearings, you've seen it all. What have you learned about the process? How does it work? What happens when the government issues a regulation? How does the industry respond?

DR. LEMEN: Well, usually, the process is one that is very politically oriented. It's one that the industry will respond, depending upon what the regulation is, to protect the industry, not to protect the worker, but to protect the economics of the industry. And when a chemical is put forth to be regulated, it will be determined as to what economic benefit it would have to be regulated, as compared to what economic incentive it would have not to be regulated.

MOYERS: So let's say the government says, "We've really established, to our satisfaction, that this particular chemical is toxic, that is, hazardous to your health." What's the first thing industry is likely to say?

DR. LEMEN: They're probably going to challenge that and say, "What do you base your science upon?" And then the government is going to have to produce that science. And then the industry is going to hire a cadre of scientists to look at that material and to do what they can to credit it or discredit it. Most of the time it's discredited, in my experience.

MOYERS: How so?

DR. LEMEN: By saying that the government didn't do enough research, the government didn't look at the right populations, the government didn't look at all of the biases or confounding factors in consideration, that there could be other factors such as lifestyle that could affect the results of the study. So they're going to try and tear it down as best they can, to say that you didn't do your homework, government, so therefore how can you expect us to accept your regulation?

MOYERS: Of course, if corporations can cook the science, so can government.

DR. LEMEN: That's true. I would hope that the government is beyond that. But I think that there have been cases, possibly, where that may have occurred. But I think that in the majority of cases the government does do good science, and the government does base their science upon the best-available data that they have in doing that science.

MOYERS: And it's made public.

DR. LEMEN: It's always made public.

MOYERS: When you got ready to propose a new standard, what would happen? Would you hear? Would you get letters? Would you get called?

DR. LEMEN: Almost every chemical has a trade or a lobby organization that represents that chemical. And once an agency starts to do recommendations for regulation or do regulation, those trade associations are out to support the interests of the chemical industry or the chemical that's being proposed for regulation. And so you definitely hear from them. They want to see what your science is, what it's based upon, give us all of your data so that we can reanalyze it and come up with our own results. And that's available to them.

MOYERS: Who is doing that for the Rosses and the Skaggs of the world?

DR. LEMEN: Well, unfortunately, not very many groups are doing that. But we do have some consumer groups that do do that. I think that they do exist, but there are very few, and they don't have the funding that the industry trade association groups have.

MOYERS: In a public health organization like the one you work for, is it obvious when the political winds are changing from one administration to the next?

DR. LEMEN: Oh, very definitely. You get cuts in funding, you get cuts or hiring freezes so that you can't hire scientists. You get a lot of discreditation of the government employees. I mean, in certain administrations that have come in, the government employee is looked down upon as a second-class citizen. There were times when I was with the government that I felt like I was a second-class citizen because there was such negativity placed upon being a public health servant or a public servant in the government. So each administration brings their own set of values, and a lot of times the scapegoat happens to be the public servant.

MOYERS: Your work in these documents has made it clear that we waited too long to ask the right questions about vinyl chloride. What about other chemicals like PCBs, DDT, chemicals that have now been banned? We also waited too long on those, didn't we?

DR. LEMEN: Absolutely.

MOYERS: Why?

DR. LEMEN: Because of the same reasons that happened with the vinyl chloride. The industry wanted to put off as long as they possibly could taking any action that might prevent the deleterious effects of these chemicals.

MOYERS: And they, the industry, has the power to really slow it down, doesn't it?

DR. LEMEN: Oh, absolutely. We've seen that in vinyl chloride, and we'll see it again.

MOYERS: Where should the burden of proof be?

DR. LEMEN: It should be that the chemical is guilty until proven innocent.

MOYERS: By?

DR. LEMEN: By the industry that manufactures the chemical. They have a responsibility not only to the worker, but to the consumer of that chemical, to assure that what they're putting into the marketplace is not going to cause adverse health effects.

MOYERS: So we shouldn't put anything in the market until it's proven safe?

DR. LEMEN: In my opinion, that's true.

MOYERS: What would that mean economically?

DR. LEMEN: I think it wouldn't mean a lot if all of the industry adopted that same approach. I think we could survive very well if we all were on the same level playing field.

MOYERS: Who's in charge of the process now?

DR. LEMEN: The industry.

MOYERS: Regulating itself?

DR. LEMEN: They're in charge of doing that. The government is supposed to, but the industry has so much control through the lobbying efforts that they actually indeed do control it themselves.