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~ I Health Scares Make Headlines ....................................1 Pitfalls in Packaging Pollution ......................................2 The Nixon Health Programs ........................................4 New Standards for Noise Levels ................................6 Vol. 3/No. 1• Published for the Advancement of Preventive Medicine • March/April/1971 ( Guidelines Needed for Family Shopping Lists, As Health Scares Continue to Make Headlines soap often leaves a gray scum on clothes and clogs washing machines. Thus, relearning how-to clean clothes and dishes with soap is also a subject for debate. No one has yet suggested, as far as we know, that it is time housewives began checking shopping lists with family doctors before reactivating their charge accounts, but apparently most of the other alternatives are now being investigated. And to support health requirements that medical science can't yet correct or control, there is a raft of new laws and court decisions which, often, are just what the doctors would have ordered. Much of the legal aid that has mushroomed is traceable to the highly activist Consumer Protection Movement. Still more responsible, however, is a kind of remedial fallout from government and industry responses to The Environmental Crisis. Far from being transitory, the prevention of health hazards by makers of writs and resolutions can be expected to escalate both further and faster. It recalls, too, that over the centuries preventive medicine has frequently drawn support and solutions for its most vexing problems from sources outside the medical profession. Detergents in Decline: After a year or more of conflict- ing claims and counter-claims, detergent makers now , seem destined to follow a route once prescribed for the manufacturers of cigarettes, cyclamat•es, and DDT. De- laying actions are plentiful, and scientific studies are being cited both in support of these products and to assault their effects on environmental resources and human health. Under debate are (1) the seemingly well- established claim that detergents with phosphates are polluting lakes and waterways by provoking an exces- sive growth of oxygen-absorbing algae, and (2) the less certain charge that enzyme detergents can cause skin and lung problems. Federal legislation appears likely, but may not be entirely necessary. Already a number of states-New York, Washington, Colorado, North Carolina, Florida, Con- necticut, Oklahoma, Maine, Wisconsin, among others- are considering bills to restrict or specify phosphate content in detergents, or ban the sale and use of such products altogether. Enzyme additives, on the other hand, are now being gradually and voluntarily removed from detergents made by the major U.S. producers- signaling an end to the $80-million pre-soak market. Shifting to Soap: As often happens, the solution to one problem ushers in new concerns. Unlike detergents, A man from Maytag's test laboratory has said: "Provid- ing clothes aren't too dirty, soap can be used safely in soft water without damage to machines:" But a detergent maker contends: "The consumers will be the ones to suffer. They will get inferior products that won't clean clothes well. The clothes will wear out quicker and not feel as soft. And their washing machines will break down more often and wear out sooner." In Suffolk County, N. Y., where all detergents are now banned, ecology groups and Girl Scouts have launched a "Wash With Soap" educational campaign at supermarket locations, and county agents are distributing a leaflet on "How to Wash Successfully with Soap:" Mercury is More or Less: Warnings about mercury poisoning, increasingly frequent this past year, are often closely followed by statements that "the con- tamination problem was not as bad as had been believed:' Reassuring as such reports may be, the key facts are: significant mercury contamination was detected in the waters of 23 states; commercial and sport fishing was banned in some lakes and rivers-of 12 states; large stocks of mercury-tainted tuna and swordfish were recalled from markets by the U.S. government; and mercury pollution of air, food, and waterways has been reported by scientists in many countries around the world. To provide some perspective, mercury is a heavy, silvery metal liquid at room temperature. It is poisonous in continued P. 7 "We ought to take all our money out of DDT and put it into mercury:' Saturday Review. /

The American Health Foundation Newsletter The American Health Fottndi?tion, Inc. EDITORIAL E3OARD 2 East End Meflue Giihert Cant. Charrrran Ne'.v York, N.Y. 10021 Delbery Jones. Ed tor (212) 628-6300 OFFICERS AND BOARD OF TRUSTEES: President Ernest L. V'Jynder, M D. Secretary Thomas J Ross• Jr. Vice President AmerrcanA:rlin ,,inc. Executive Vice President David L. Davies Treasurer Warner G Cosgrove. Jr. Managing Partner Shields & Company - Honorary Chairman: David J Mahoney President. Norton Simon, Inc. 7RUSTEES. Chairman William J. Levitt Chairman. E3oard of Directors Levrtt and Sons, Inc Louis V. Aronson. 11 President Ronson Corporation Mrs Charles A. Dana Waffer E. Hanson Senior Partner Peat. Mar.vick, Mitchell & Co GeorgeJames. M D., M.P.H- Dean Mount Sinai School of Medicine G. William Moore President Fieldcrest Mifls. Inc. Joseph M. Murtha President Sandgren & Murtha, Inc. Robert R. Pauley Maxwell tv1. Rabb Partner Strcock & Stroock & Lavan Fredrick E. Rathgeber Executlve Vice President The Prudential Insurance Companyof Amenca BC?ARD OF SCIENTIF'!C CONSULTANTS: Chairman George James. M D. M P H Dean 6tount Sinai School of Medicine Alvin Freiman M D Ch ef of Cardcfogy , Memorial Hosp;tal ' for Cancer and Allied Daeeses Soi R. Baker, M D Associate Clinical Professbr of Radiology Unr: ers!fy od Californ,a a; LosAngeles Les•er greslow. M D. M P H. Detr, c` Prevr~iil':e eno JoCJa! Med:cine SCh?JI Of ?:'Pid!C6^:e Ur,: ersity of Cah'o, nia at Los Angeles Gi'bert Cant Medical Editor &Consuitant Time. Inc. John Cassel. M, D_ M P H Depnrtment of Ec:demiolor,y Uncversrty of North Carol:na Jeromw Cornfield. >."• A Prof e ;sor cf Biot.-_•rsf-cs Scnool of Pubic I te ::n Un,,ersmryof Pittco gh PE`,o-J DLboS.PhD Pr „ t Ev.. ... i=,? D Herman E. Ht:fak•oe. W D.. M P H De Lamar Prof«asc•or oi Public Heaith Pra:tice Columbia Univr,rsirj Takeshi Hrrayania M D Chief of EoEdem:^Sr.^y Drn~ron Nationaf Cancer C,e'iteriJnpan; Edward Vd. iCarn ii•J S.E B:. M 5 E.E. tJice Presir9ent , Revlon. Inc Marvln Kus't;hnr+r• ty!',D Professor of Paih~olo{!y dy"c•dicai Center New York University G. E Livinuston. Ph.D. Profes:;r and I?ont•,tor of Fcod Science 'rror;ram irstitute of Nwr:non Soences Columbia University Gotthard Schet::er M D Profes,ur of ".tc,J-canF Urdversi: v of !-!e!delberg ;Gerrnany'r Mcrton K Sr, hwArtz. Ph D Chairman, G't of E?,o"',emi~try >orClr;cr :r.c+~=:6n,rD~sea,•:; Thco.:?ore 3 v-rn !+.~I!.,~ r.t D tJlrc•._tor jf S:f P,rb~~s'r.r,rf by Th~. A"?er~.cn'? t.f•:,~ih rourrteuon• Ir.c.. a n•m •p.c.ht ta.=.r:,c.^,~r, tt:rrorat,'r,n l:;.t~,rf fr.r ~~.;ushr,r. erli,c:,r`-onal. ':crrmumr_z• s:+: Car^ V-c., arf. !tt•r:? .ru, ne•...e~;, . !r.'., i, .. .: ..r.. :,it.. ;'rOjr.xo--;.n r-u'.^ .. ,•11r:. , .. ... !•, . H. . Ih Puunr.',1Ucn 2 L tr.i Fnd ,.e .,,, . tJ••v.. .a~.. N Y tt.. ;1 L4 a Pollution Control Programs for U.S. Packaging Offer Too Many Promises, Too Little Planning by Joseph M. Murtha' Many people in marketing, in industry generally, and in government, consumer protection, conservation, science, and public health-not all, but many of these people are beginning to sound a lot like the fortune- teller whose wares are touted from a street corner. They are deeply concerned, and quite properly, with what has come to be called The Environmental Crisis. With pollution of our air and water- ways. With waste disposal. With the population explosion. With the wasting away of our natural resources. And with the quality- Mr. Murtha of-life, not only for the next gen- eration, but for our own. Now. Today. There has been a great national outcry, and it has been followed by an avalanche of proposals, panaceas, and programs. I take the position, however, that we have been promising too much, and planning too little, and that I-Care cam- paigns alone will not do the job. Indeed, a massive, coordinated, national effort is needed. For the lesson we have learned most clearly from the ecologists is that everything is related to everything else. This has been shown to be true in nature, in science, in the life cycle, and now there is increasing recognition that it is also true in marketing, communications, and corporate management. Moving Too Slowly: It is my feeling that industry has moved too slowly, too cautiously, and that industry, as a whole, is far behind the times in its resolve to reduce and control pollution. The initiative, if it can be called that, has been controlled and accelerated by health and conservation groups, government, and con- sumer advocates. Industry has been "reacting" mostly, and probably depending too much on the powers of persuasive advertising to confirm its claims about environmental protection. This is a rather harsh view of industry's participation in what may be our most serious national problem, and I don't'mean to overlook the many good things that industry is doing. I would doubt, for example, that the reclamation and recycling programs now being con- ducted by companies like Reynolds, Kaiser, General Foods, St. Regis, National Steel, Coca Cola, and so many others are motivated by their profit-making potential. I am even more certain that they are not, as has been charged, some kind of gimmick. Charting the Course: These programs are going too far, costing too much, requiring too much planning, cutting too deeply into profits in a time of recession and re- trenchment, to be characterized as window-dressing. I think they should be encouraged, supported, and ex- panded still more. I think that those who have not yet started them, should start them, and that this is being done, too. Not fast enough? Perhaps. But before we

could land a man on the moon, there was 15 or more years of multi-billion dollar effort, research, training and trials. And it is at this level we must now approach our environmental aspirations and problems. Packaging in Perspective: The packaging industry, in particular, is highly visible-and vulnerable. It is the grand-daddy of American litterbugs, according to some. .It is the whipping-boy for opportunistic politicians, according to others. In truth, packaging is being keel- hauled from all sides, and needs to set its house in order. It is looking for new directions, new solutions, new guidelines. And it is doing more, much more, than government recognizes and more than consumers can understand or appreciate. Yet, we continue to hear, both from government and the public, that increased degradability must be built into packaging. Even within the packaging industry, many research programs are giving more and more attention to new kinds of self-destructive materials. And there are a number of promising areas, including: steel cans with- out any external coatings for protection; packaging papers formulated with water-soluble coatings; edible films that can be consumed with the product, or by animal and insect life; plastics which can be degen- erated under ultraviolet light; glass containers which dissolve in water after the container is broken or scratched; and packaging with multi-wall construction in which a corroding agent in the inner wall remains inactive until the container is opened. If we ask structural designers to use these materials, however, we will be sacrificing a great deal in terms of product protection, which is still the basic function of packaging. We might quicken the pace of disposa- bility, but we would also be inviting packaging- failures in the store and in the home. So I can only view most of these self-destructing materials as an exercise in marketing chaos, and the beginning of more consumer protection complaints. No Simplistic Solution: For the years ahead, I have concluded that the best and perhaps the only long-term solution for solid waste disposal is through reclamation and recycling of raw materials. There is little recogni- tion, however, that packaging represents only 13% of the total volume of solid waste, and very little of the packaging used and discarded by consumers is now being returned to industry for recycling. I do not mean to infer that the technology needed for reclamation and recycling is now generally available, or that the development of such technology is any easy matter. In fact, there are great problems to overcome in virtually every type of reprocessing of used packag- ing materials. If any really substantial progress in the recycling of packaging materials is to be made, then it must be preceded by comprehensive improvements in the collection and handling of solid waste at the community levels. And the extent of our success in this area depends upon our ability to understand and moti- vate the consumer's value judgements, leadership from government and industry, and a reordering of the economic priorities involved. COMPONENTS OF COLLECTED SOLID WASTE BY PROPORTION OF WEIGHT GLASS tiET~,A,L ~ '~ /~ GARRAOE 7% p The Price-Tag on Pollution: What's more, if the fight against pollution is to be won, most officials and ex- perts are agreed that it must be waged simultaneously on all three fronts-air, water, and solid waste. Over the next five years alone, the environmental clean- up job is expected to cost the U.S. more than 71-billion dollars in new spending-and of that total 4-billion dollars is for disposal of solid waste. Ultimately, consumers everywhere will have to foot the bill, whatever it turns out to be. And before the con- sumer can be assessed through higher taxes and higher prices, government and industry must do their thing. Build more control systems. Start more reclamation programs. Continue the research. Pass new and more laws. Try new production techniques. Recycle all that can be recycled. On and on and on, and I haven't even skimmed the surface of what needs to be done. Accounting for Our Actions: In all of American indus- try, we are going to be living with pollution problems, the consumer protection movement, and a proliferation of new legislative requirements from now on. We are being called on to account for our actions and our in- tentions. Further delay and wishful thinking about packaging materials that will self-destruct themselves are not acceptable in these militant, revolutionary times. I am reminded of a statement by Alfred North Whitehead to this effect: "The major advances in civili- zation are processes which all but wreck the society in which they occur." I do not think that industry is apt to be "wrecked" or that society will be either. I can see, however, that industry may soon have to conduct its affairs under new legislative guidelines, and that this is already happening. I can see that there may soon be more tax penalties than tax incentives, and that this also is already happening. I can see that leadership and envi- ronmental protection from industry, and by industry, is needed more than ever, and that this is happening all too slowly. "Mr. Murtha is the president of Sandgren & Murtha, Inc., industrial designers and marketing consultants, and a member of AHF's Board of T-ustees. ~

. Preventive Medicine: Mo-Ning from Labs to Laws In a series of messages to Congress, President Nixon has made it clear that preventive medicine is about to get a booster shot. The first inkling came on January 22 when, during his annual State of the Union address, he said: "I will propose new programs to encourage better preventive medicine, by attacking the causes of disease and injury, and by providing incentives to doctors to keep people well rather than just to treat them when they are sick:' A week later came The Budget Message, which included this statement: "During the current session, I will send a message to the Congress that will set out a national health strategy for the seventies and propose significant changes in the Federal role in the Nation's system of health care. This strategy will seek to expand preventive care, to train more doctors and other health personnel, and to achieve greater equity and efficiency in the deliv- ery of health services:" Congress to Advise and Consent: As he continued, and in the days and weeks that followed, President Nixon endorsed and recommended a vast range of health care reforms and innovations. Many are concepts that have long been advocated by practitioners of preventive medicine. Others are an extension of curative health services which are desperately needed. Now the full thrust of the President's call for "a new national health strategy" is on the record. It came on February 18, again in a message to Congress. Preventive medicine, so often the stepchild of our medical schools and programs, has been given top priority in planning the nation's health care system. Before this priority becomes law, however, Congress must act and, in acting, changes in the President's proposals are inevitable. Some of the proposals that warrant special consideration, both in Congress and by medical authorities generally, are restated here for future reference purposes.... Excerpts from President's Health Care _llessage "In most cases, our present medical system operates episodically-people come to it in moments of distress, when they require its most expensive services. Yet both the system and those it serves would be better off if less expensive services could be delivered on a more regular basis. "If more of our resources were invested in preventing sickness and accidents, fewer would have to be spent on costly cures. If we gave more attention to treating illness in its early stages, then we would be less troubled by acute disease. In short. we should build a true'health' system-and not a`sickness' system alone:' Delivery of Services: "In recent years, a new method for delivering health services has achieved growing respect. This new approach has two essential attributes. It brings together a comprehensive range of medical serv- ices in a single organization so that a patient is assurod of convenient access to all of them. And it provides ` 4

needed services for a fixed contract fee which is paid in advance by all subscribers. "Such an organization can have a variety of forms and names and sponsors. One of the strengths of this new concept, in fact, is its great flexibility. The general term which has been applied to all of these units is H. M.0.-Health Maintenance Organization:' Advantages of H.M.O.'s: "Under traditional systems, doctors and hospitals are paid, in effect, on a piece work basis. The more illnesses they treat, and the more service they render, the more their income rises. Th.is does not mean, of course, that they do any less than their very best to make people well. But it does mean that there is no economic incentive for them to concen- trate on keeping people healthy. "A fixed-price contract for comprehensive care reverses this illogical incentive. Under this arrangement, income grows not with the number of days a person is sick, but with the number of days he is well. Patients and practi- tioners alike are enthusiastic about this organizational concept. So is this Administration. That is why I am now making the following additional recommendations: 1) "We should require public and private health insur- ance plans to allow beneficiaries to use their plan to purchase membership in a Health Maintenance Organi- zation when one is available. 2) "To help new H.M.O's get started-an expensive and complicated task-we should establish a new $23- million program of planning grants to aid potential sponsors in both the private and public sector. 3) "We should provide additional support to help spon- sors raise the necessary capital, construct needed facili- ties, and sustain initial operating deficits until they achieve an enrollment which allows them to pay their own way. For this purpose, I propose a program of Federal loan guarantees which will enable private spon- sors to raise some $300-million in private loans during the first year of the program:" Blue Cross' , , , of rising big share ... hospital costs Blue Crosa ® Total ,50 . is 0 1 I w ,. t! ta tsw 1955 rhio tvBS liio tt7B0 D.ta- Health insurance Counc,l, Blue Crosa •65 '66 •67 •66 '6D•7o Dete: Deot. of Labor Business Week National Health Insurance: "In the last 20 years, the segment of our population owning health insurance has grown from 50% to 87%, and the portion of medical bills paid for by insurance has gone from 35% to 60%. But despite this impressive growth, there are still serious gaps in present health insurance coverage. "I am proposing that a National Health Insurance Stan- dards Act be adopted which will require employers to provide basic health insurance coverage for their em- ployees. In the past, we have taken similar actions to assure workers a minimum wage, to provide them with disability and retirement benefits and to set occupa- tional health and safety standards. Now we should go one step further and guarantee that all workers will receive adequate health insurance protection. "I am also proposing that a new family health insurance plan be established to meet the special needs of poor families, who would not be covered by the proposed National Health Insurance Standards Act.... Our pro- gram would also require the establishment in each state of special insurance pools which would offer insurance at reasonable group rates to people who did not qualify for other programs: the self-employed, for example, and poor risk individuals who often cannot get insurance:" Better Than Before: If there are loopholes yet to be filled, and there are, it is nonetheless true that benefits of the President's plan would be far greater than those now available. Apparently, the group to benefit most will be middle-class Americans, some 150-million em- ployees and their families, whose medical costs have out-distanced their ability to pay in recent years. Under the health-care package presented by the Presi- dent, all employers will be required to purchase private medical insurance. Employees would pay 35% of the cost of premiums until 1976; and 25% thereafter. Medi- caid was substantially altered by the new insurance plan, but Medicaire continues with few profound dif- ferences. For catastrophic illness, total payments can go as high as $50,000-far above most existing policies. Other provisions include all maternity care, with no "deductibles;' and well-child services, with coverage of childhood vaccinations and periodic checkups by pediatricians. Building froni Strength: In reviewing the President's proposals, our purpose has been to focus attention on those aspects most closely identified with preventive medicine. There are other elements, however, which deserve general approval, because they will help improve the existing health care system. These include: new grants to aid our financially-distressed medical schools; the providing of health personnel in rural and slum areas having few or no doctors; assistance for students from disadvantaged backgrounds to become health professionals; expansion of research on cancer and sickle cell anemia; and a 50% increase over 1971 levels in the training of allied health personnel. It is being said the President did not go far enough, and that he is promoting the insurance industry. It has also been said that he is offering "something for every- 5

one;' and wooing votes for 1972. Upon reflection, it seems to us, his intent has been to build from the strengths that now exist, while setting the stage for a continuing series of reforms. It is a comprehensive and financially responsible plan. Perhaps the President's own words are the best measure of its resolve.... The New Strategy: "The toughest question we face is not how much we should spend, but how we should spend it. It must be our goal not merely to finance a more expensive medical system, but to organize a more efficient one.... It does little good to increase the demand for care unless we also increase the supply. Helping more people pay for more care does little good unless more care is available. This axiom was ignored when Medicaid and Medicare were created-and the nation paid a high price for that error. The expectations of many beneficiaries were not met, and a severe inflation in medical costs was compounded. "It will not be easy for our nation to achieve this goal. It will be impossible to achieve it without a new sense of purpose and a new spirit of discipline .... Nineteen months ago I said that America's medical system faced a`massive crisis: Since that statement was made, that crisis has deepened. All of us must now join together in a common effort to meet this crisis-each doing his own part to mobilize more effectively the enormous potential of our health care system:' President Sends Noise Level Plan to Congress With Warning it's Time for Leaders to Listen After years of complacency by Federal officials, the case for effective noise abatement laws is about to get a full Congressional hearing, and a hopeful constituency of anti-noise groups is waiting impatiently to hear what happens. Fully aware of their anxieties and numbers, President Nixon submitted (2/8/71) his plan for new noise level standards, while telling Congress that U.S. citizens have "rightly become increasingly annoyed" by growing levels of noise which can "interrupt sleep, dis- turb communication, create stress, produce deafness and other adverse health effects'." Indeed, noise can do all this and more. But just how much more even the experts don't know with certainty, for extensive research is still needed. One prominent acoustical physicist has 'said: "Noise, like smog, is a slow agent of death. If it continues to increase for the next 30 years as it has for the past 30, it could become lethal'." Another scientist contends common household noise is likely to be the unsuspected cause of ailments that have a psychosomatic component. Most investigators now agree that prolonged exposure to any extreme noise- industrial, household, urban, music, etc.-will result in a definite hearing loss. Many also believe or suspect that a wide range of physiologic, emotional, and mental dam- age is directly related to noise levels-especially sudden, sharp noises. I $ Losses Crescendo, Too: Union officials in the U. S. have estimated that 60% of their workers are subjected to noise that exceeds an acceptable level. They also claim about $2-million annually is spent in workmen's compensation cases as a result of noise levels. Even more discomforting, however, is a newly available report from the World Health Organization. It estimates that more than $4-billion is being spent annually on acci- dents, worker inefficiency, lost work time and compen- sation -all because of industrial noise. The WHO report was cited by Congressman William F. Ryan at a recent noise abatement forum in New York City. Mr. Ryan had set the theme for the forum's conclu- sions in saying: "I insist that concern for the cost of preventing and reducing noise be replaced by the reali- zation that it costs less to control noise than to endure noise:" Setting New Standards: If and when enacted, the plan now before Congress will authorize the fledgling En- vironmental Protection Agency to (1) set standards for noise levels on transportation and construction equip- ment, and (2) require the labeling of consumer products to indicate their noise characteristics. The new stan- dards would apply to equipment used in interstate commerce, which means that Federal limitations will be in effect even if local and state laws are not. The labeling requirement, on the other hand, permits con- sumers to make their selections on a basis that will encourage the development and marketing of quieter products. No Noise Level for Lawmakers: Despite mounting pub- lic pressures for strong anti-noise laws, the President's plan is expected to clash with other programs and other priorities. No time was wasted, for example, in noting the Administration is also seeking more money for the SST, which produces sideline noise greater than Federal levels set for subsonic commercial jets. To date, moreover, the only Congressional attempt to define "acceptable" noise levels was the Walsh-Healy Act of 1968. It finally established a maximum decibel level of 90 for industrial settings. At this level, you have to shout to be heard. White House calls for a still lower range may not fall on deaf ears. But they will bring a predictable discord into the coming decibels debate- probably beginning at the 90-plus level. A Definition of Decibels: Physicians, engineers, and acoustical physicists measure sound in decibels. Ac- cording to Medical World News, a decibel represents the smallest difference of loudness that can ordinarily be detected by the human ear between the loudness of two sounds. The same medical journal also points out: * "Conversation in a relatively quiet setting ranges around 60 decibels, and the roar of traffic or sounds of factory machinery are typically at about 80 decibels. Anything above 80 is likely to be uncomfortable. At 90 or above, the experts start worrying about effects on health:" o"One common household appliance, the food blender, emits 93 decibels, and a subway train screeching around 6

a curved track goes up to 95. The motorcyclist revving up his bike generates 110 decibels, and a jet plane taking off will assault unprotected ears with 150. Some other decibel levels of everyday noisemakers include: garbage disposal units, 80; rivet.ing guns, 110; textile looms, 106; power lawnmower, 96; farm tractor, 98; and a news- paper printing press, 97:' •"The lowest audible sound is defined as one decibel. Louder sounds are measured on a logarithmic scale ac- cording to the power with which the sound assaults-or tickles-the ear. Thus, a 20-decibel sound is 10 times as loud as one of 10 decibels, and 80 decibels is a million times louder than 20. Surprisingly, a dropped pin, the proverbial softest sound, actually can reach several decibels, especially when it lands on a library flooi?' Health Scares (cont.) most forms, metal or vapor, and in organic and inorganic compounds. Its major industrial use is in making chlo- rine and lye, and it is also used in dental fillings, most paints, batteries, and in sprays to kill fungus-to name but a few outlets. No one knows the threshold level for mercury poisoning. The FDA has set a limit of 0.5 parts per million as the maximum permissible amount in food- stuffs. As a guideline for safety, even this limitation is not absolutely reliable. Until new legislation arrives, and more is learned about the sources of mercury contami- nation, court injunctions and stiff penalties for all con- tributors to air and water pollution will continue to be the best kind of prevention. Fending for Food: Legislative solutions to the food- additive controversy are likely to be long in coming, but new FDA actions are expected soon. Caution is required, because the issues are highly complicated, essential research is lacking, and experts frequently disagree over available data and the standards to apply. It is against this background that Jean Mayer, professor of nutrition at Harvard, recently wrote: "After the recent spate of headlines on the inherent dangers of additives such as cyclamates and antibiotics, one can almost understand the suspicion voiced by some that there is a massive plot afoot to poison the popula- tion of the United States. Obviously, such is not the case; We must remember that our food supply today is actually much safer than it was in the past when spoil- age and microbe infestation exposed the public to the constant threat of gastroenteritis, not to mention typhoid, cholera, tuberculosis, and a variety of other food-borne diseases:' Malnutrition, moreover, is recognized as a far more urgent problem. Almost half of the world's 3.6-billion people are said to be undernourished, and it is estimated that 10,000 die every day of starvation. Population control'is seen as one answer. Among many other often 'cited measures are aid (financial and technological) to under-developed nations, and the "Green Revolution"- an effort by agricultural scientists to increase world food production with new high-yield seeds, chemicals, and new farming methods. WE MAY BE ON THE WAY TO ZPG 5.0 4.5 4.0 3.0 2.5 2.0 Births 1920 1930 1940 1950 C-3 proj®ctions 1970 1980 Fortune Population Growth Projections: Census Bureau records charted above show possible future annual birth rates. "C" assumes U. S. families will average 2.8 children each; "D"projects 2.5; and ZPG only 2.1. Defusing the Population Bomb: What must be the best indication to date that Congress is really serious about the population growth issue came last December. It was titled The Family Planning Services and Population Research Bill, approved by both houses, and signed into law by President Nixon. Passage of this act authorized $382-million in 1971-73 for services, research, training, and educational material, while requiring that a five-year program be submitted to Congress within six months. Other factors which seem to mitigate the awesome over-population claims of recent years are also at hand. In its February issue, Fortune magazine reported: "A number of reasons have been advanced for the trend to smaller families. One is the pill. Another is the rising cost of properly raising and educating children. Beyond these, concerns about pollution, the environment, and the possible overcrowding of parts of the U.S. have to- gether somewhat tarnished the ideal of the immediate y1I

post-World War II families-a lot of children in an idyllic suburban location. The new attitudes have been ex- pressed organizationally by the Zero Population Growth movement. "In order to achieve zero growth, women, on the average, would have to limit themselves to 2.1 children each, a process that would halt population growth in 70 years if begun now. This, it will be observed, is not far below the indicated current level; and many demographers believe that the U.S. is already on the road to zero growth:" The DDT Dilemma: Rewarding as it may be to have so many lawyers and legislators on their side of the fence, advocates of preventive medicine have not reached a millennium. For a ciassic example of medicine and law in common pursuit, take DDT. The elusive victory it represents was reviewed only recently (1/22/71) in Life magazine by Don Moser: "Today the status of DDT is in constant, and confusing, flux. The use of the chemical in this country has dropped radically overr the last decade, in considerable degree because many insects have grown resistant to it, and it has been replaced by other chemicals. A number of states have placed varying degrees of restriction on it, a's has the federal government, until today it is used in really large amounts only on cotton.... But the pesticide industry has various channels of appeal. Until the ap- peals are exhausted-and the process could take months or even years-DDT formulators may continue business as usual. "Moreover, DDT is still shipped and used abroad in huge amounts. And it is only one of a host of chemicals with which we have contaminated the natural scene- insecticides such as dieldrin and aldrin, weed killers such as 2,4,5-T, and industrial chemicals such as mer- cury and polychlorinated biphenyls. Decisions about all of these chemicals-and the hardest decisions about DDT- still lie ahead of us. I Dr. Ilill Joins AIiF as Nutrition Section Head Peter B. Hill, Ph.D., who joined The American Health Foundation's research staff in mid-February, has been named Head of the Division of Nutrition's Section on Lipid Metabolism. His acceptance of the appointment was announced by E. L. Wynder, M. D., president of AHF. Prior to joining AHF, Dr. Hill was senior biochemist at Wallace Laboratories, where for the past few years he has conducted an investigation of lipid metabolism in monkeys. He is a member of the American Heart As- sociation and the New York Academy of Sciences. After graduating from Cambridge University (B.A. with Honors) in England, Dr. Hill obtained his M.S._ in bot- any from McMaster University in Hamilton, Canada, and his doctorate at Rutgers University. His articles on agents affecting lipid metabolism, and other inves- tions, have been published in numerous U.S. and Canadiari medical and scientific journals. "Since it first came into widespread use during World War II, it has been a force for good beyond compare; it has transformed world agriculture, and as a destroyer of vectors of deadly disease it has saved literally millions of lives.... Tt has [also] been reviled not only as destruc- tive to bird life but as an agent that can cause cancer and genetic mutations in man, that dangerously con- taminates mother's milk, and that can destroy the oxygen-producing plankton of the oceans. "It presents the classic environmental problem. How do you weigh the good it does against the evil? How do y ou measure the worth of a bale of cotton against the worth of an eagle? How do you evaluate a life saved today t against one perhaps destroyed in some future genera- tion? Or measure a disease eliminated against one ulti- mately caused?" The American Health Foundation. Inc. N, r'. :': YOI k, Ci }• P.arr.,it ~~o 5?~•2 2 East End Avenue New York. N.Y. 10021 3