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F I8?ERYIBW WITH It 'ING J. SELIKOFF W.w.i..a+1/1`~r ;`tIIYE HAVE ONLY FOUND ~ THE MOST OBYIOUS' ~ OF.a: CANCER'S AGrENTS. , a- 7 -a iA. As director qf the Environmemtal Sciences Laboratory at Mount Sinai , Hospital in New York City, Dr. Irvinp J. Selikoff has earned a worldwide creputation for tracking down the environlneratal causes of cancer. , His ,,reaearch' led to a tecent advisory from. the Health, Education & WeVare >.Dept, urpinp medicaLsurueillance of workers who had been ezposed'to asbestos and could develop rraesothelioma, a rare form of laeng cancer.,Dr. •Selikoff's tests of Michigan residents found adverse health effects follow- ing the aceidentkl distribution five years, ago of the f[re-retardant polybrominated'biphenyl (PSa) in a food'supplemevt.t fed to cattle. He has done extensive research on the effects of vinyl chlori.de, lead, benzene, ~and'o6her inrlustrial, . materials. In an i'itterDiew with. aUStxEB4. IPEEB. Environment Editor Charlene Canape and McGraw-Hill World:News correspondents Judith H.Dobrzyreski and Jane S. Shaw, Dr. Selikoff said that we will continue to discover cancer-causing substances in our environment; but that the knowledge gained from combating such threats ,could ultimately be the means of winning the war on cancer. Are the environmental hazards and aectd.nts we have qen so -. far /ust the fip of the. icsberp? ls there worse newa for us down the road? The tip-of-the-iceberg simile doesn'.t properly deseribe what has been happening. The diseases we're now seeing have their rootA in the 1930s„1940s,1950s, and 1960s, when the idea thatt much of disease might be exogenous-[caused by factors]i outside of us-was not' appreciated. The present is the legacy of an inadequate past. .. xf,, iVhat percentage of cancer Is caused by environmental factors? That is a difficult question to answer because it assumes that we know what's causing most cancer. We know that the causes are exogenous,,but'we:don't know what they are. For ; example, people in Japan tend to have a great deal of stomach cancer and'people in this country comparatively little. When Japanese move to the U.S~, their first-born have the same low ; rates as all the other Americans. On the other hand) peoplee who live in the U. S. have a good deal of colon cancer. The opposite is true in Japan, and yet when Japanese move to the. r„;U. S. they get the same high rates as all other Americans. < My guesstimate would be that 95% of all cancers are caused .by environmental factors. But I would be hard'putto tell you the other 5%. ri ,a:. -eta > When did we Hrsf link wnser to eroyenous factors? Our awareness began with the discovery of the marked effect of cigarette smoking on the risk of lung cancer-the most common cancer in men. It was clear that we had to look in other cancers again for causes outside of us. So we havee been looking, and, unhappily, we have been finding. It's unpleasant, but in one sense it's good. If most cancer camee from poorly programmed genes within us, there is not much at the moment that we could do about it. But for the first time in human history, we have the opportunity of preventing cancer.Now„it doesn't mean we'll use this knowledge, neces- sarily. That will depend upon good judgment, enthusiasm~. ENVIRONMENT responsibility„and concern. It's no longer, a scientific problem. It's a political one in that sense. .,. „ . . .. '-1r.. Do you think that we will continue to find substances that we can correlate with cancer, one right after another? No question in my mind'that'this is the case. We have only found the most obvious so far. Our investigative techniques are, from a scientific point of view, insensitive and crude. We will not know for another 20 years whether the chemi- cals introduced in the 1960s are hazardous. We need better methods than we now have to identify things without'waiting to see the dead' bodies in the street. Since we have been sensitized by the vinyl chlorides and benzenes„we're looking at everything with a critical eye. We are no longer satisfied with the phrase, "There is no evidence that: ..:" What~ we wantito know is: "We have investigated and found no evidence that. . . ." There's a big difference. ._ , . , , Considering that the generation now 25 to 35 years old fs the first to grow up inYhrs chemical environment, doees that mean we will aee cancer In epidemio proportions 20 or 30 years from now when these people reach middle age? • ?"• ` I would like to question something that we should look forward to a situation of epidemic proportions. Twenty percent of all Americans now living will die of cancer. We consider that an epidemic. Secretary of Health, Education & Welfare Jbseph Califano has been provoking us to~look into prevention: This for many, scientists is rather new. Physicians are generally trained to treat something that exists. Business is in the same position. Industry, is being asked to examine what'they're doing to prevent diseases,three decades away. Chemicals hsve made our lihrstyle comfortable in some ways. Can we work out the problems so we cen still have some of the adrantayes without the hazards? . . ~ . Solving this probl@m is not beyond'us. We tend to under- estimate, what we have alteady shown we can do. Our BUSINESS WEEK::October 30, 1978 156aa 4

r T Congress in the last 16, years has ~ amplished much for When scisntiih bsyl~ understand the mechanisma of e ewar which it is not always given ocediti any of the regulatory and how the body reacts to outside /actors that cause dCrease, approaches are new, and they've been well thought outi We're then might we come to the time when we won't have to tstt~ not administering theas well'as we could aure that a true chemicals ons by on.? ' - - But, again, I think we're learning. Yes„ we may, or we'll be able to test them in laboratory .' systems without looking at the human experience at all.'At The e.A and oau seem to be ipnorinp the complex health ellects the moment, we're very insecure about some of our animal that can occur when arars/ hazardous substanees interact. why studies, because what happens in a rat is not necessarily what - 1/ more att.ntion not being paid to this phenomenon? happens in a mouse• But' it's not all that bad; Because if;t ` Our laboratory colleagues have been telling us for many caus'es'cancerinmice, and then suceessivelyin rats, hamsters, "; years that there are multiple factors in some cases, but only in -` guinea pigs, and dogs, one would have to be very, brave to saj 1968 was this shown for human beings. E'. Cuyler Hammond "it's not going to happen in man. [of the American Cancer Society] and I'reported that asbestos "" workers who don't smoke tend' not to die of lung cancer, What can the arerape citizen do to protect himself or hersell whereas those who do smoke have much ~ more lung cancer Irom environmental hazards? ' than all other smokers Many things the individual can't do If you want oleaa~{ '. People aren'texposed to one chemical. If there's a standard ' water, it's not up to you, The individual worker can protesti'~ . for a certain solvent, that leveliis what is permitted. But if ` but he'll protest himself out of a job. We need'our society to ~ ~ there are two: solvents in that environment, we haven t do these things. If it's expensive to provide a safe working , considered what people are supposed to do i• t place, and it often is, it's got to be industrywide;,otheraviee that company is at a competitive disadvantage. ; Whet comphx sets ol fseton w beinp atudied now? ~ S But what the individual I can do with regard' to his own . Perhaps 60% or more of all blue-collar workers, who are ' personal environment is,important. Let him change clbthes most exposed to hazardous materials, have a history of before he goes home from a lead smelter so that he doesn't cigarette smoking. Somebody with anemia is more susceptible give the lead to his,kids. Let him not smoke cigarettes so he to lead poisoning. Those exposed to radiation at Hiroshima and Nagasaki have a tendency to develop leukemia. But Japanese scientists have found that if they had worked~ with Sj benzene afterwards, they have three times as much leukemia as the other people who were exposed, How do we deternNne risks and beneRts when we determine whether to ban a substance? I am not enthusiastic with regard'to banning anything. In the Ul S:, we have not adopted this approach. On the contrary, the most toxic things, such as radiation and'beryllium, we've not banned. We've controlled. Now; sometimes'controls are so :onerous and so expensive that in the marketplace the product is abandoned, which, in a sense, may be a form of banning. What we do not' want to do is to pay for new products at the expense of human illness and human disease and human life. We have no evidence at this time that there is any exposure to a cancer-producing agent that's absolutely safe. There is in scientific terms no evidence of a'threshold." But there is evidence that as you reduce the exposures, you are reducing the risk. If there are a few fibers or molecules left, theoreti- cally somebody somewhere might get cancer from~it. At that point, a societalidecision has to be made. Industry, labor, or science may not like the decision, and each can raise its voice. We have the mechanisms to do that: This has been an important contribution by CAngress. Why Is it that moro members of the medical profession an not willing to come forward and speak out on environmental hazards and the eMeeb on health? There are more than there used to be. But most members of the medical profession have not been working in preventive medicine. They've been exploring how to treat disease: But why has it taken so long to move toward preventive medi- cine? - • , The unhappy lessons we've been learning about agents that cause cancer in the workplace are relatively recent. The first vinyl'chloride factory in the U. S., which was the first in the world, was built in 1938, and you don't see the diseases of vinylichloride very rapidly. Mesothelloma takes from 12 to 40 years to develop after exposure to asbestos. There were probably about 414 million people at one time or another working in U.S. shipyards during World War II in work environments contaminated with asbestos. Now, we're going to see many cases, as the incubation period passes. What about those Individuals who here been exposed to hasard- .ous materials? These people are now at high risk. What kind of surveil- lance do we have for these groups? We don1 have a mecha- nism to db this. Our medical'care tteatment! has been based upon the treatment of illness once it' appears, not for early diagnosis„not for treatment long before it's too late- . ~~; Will we see problems down the road,, too,h with the children of those who have been exposed? The whole question of genetic change is a potentially immense problem. We don't know most of the things causing birth defects, one of the most common of all illnesses, and one of the:most heartbreaking. The whole question is very imper-; fectly understood. We hardly know how to approach it. t•, . . .. . I~b'_ "_ .. • ..•. .. , il(, Do we have drugs that can speed the elimination of chemksle' : from the bndr! . . . There's some research being done on it: We're doing so here. There a been a study at the University of Virginia Kepone in which a drug called cholestyramine was u grab hold of the Kepone in the bowel. Because the dtug resin, it is not absorbed and'takes the Kepone out with it whole'area is one for urgent toxicological research. Have you seen a change in lnduitry'so attitude toward deeBpp with thess problems? I think so. Many companies are really trying. F.xocon for example, has brought first-rate scientists into the company Remember that these are new problems for much of mdus- f try. I've been told' that what we really need, among many other educational projects, is a course in Toxicology for Tycoons. That's not a bad suggestion. iT+.-<  : , . ENVIRONMENT • i-