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l , DEC 17 1?3S American Council on Science and Health A Message from the Executive Director Fiscal year 1985 was a fulfilling and exhilirating one at the American Council on Science and Health (ACSH). ACSH's scientific advisory board continued to grow and now totals over 140 individuals. ACSH's new publications proliferated. They cover a range of topics from obstetric anesthesia, Reye syn- drome, dioxin and PCBs, to the relationship of diet and cancer. We welcomed a continuing surge in our media coverage and the almost daily opportunities we had to communicate ACSH's scientific findings through a variety of media settings - literally hundreds of national and local radio telephone interviews were done by ACSH staff, as well as many local television appearances - and the number and frequency of appearances made by ACSH scientists and executives on network pro- grams such as Today, the McNeil-Lehrer News Hour, ABC's Nightline, and others increased significantly. After four years of national prime time schedul- ing, ACSH's syndicated radio commentary series, HEALTHLINE, continues to thrive. Radio pro- gram directors now also call us to request HEALTHLINE "specials" on public health issues being addressed by their stations. Riding the crest of HEALTHLINE's tremendous popularity and impact, we decided to produce a new, related radio project - this time a series for kids, by kids. The pilot, called NO KIDDING, involved seven- and eight-year-olds interviewing and questioning prominent scientists and physicians on topics including nutrition, smoking, auto safety,, food packaging and preservation, drugs, and family relationships. NO KIDDING was enthusiastically received as a "special" by our regular HEALTH- LINE stations. To our surprise, we found that NO KIDDING was of as much interest to adults as it was to children. We plan to produce it on a regu- lar basis next year, along with HEALTHLINE. We at ACSH still experience great frustratiorrin observing the major gap which separates public opinion from scientific consensus on topics such as the safety of food additives, pesticides and phar- maceuticals. However, we also see progress being made in narrowing that gap, as ACSH strives to correct the problem by ending the silence on the part of the scientific community. Dr. Elizabeth M. Whelan With the voices of ACSH scientists now being heard not only nationally but internationally, the doomsday edicts which have brought us so much bad news about the quality of our food, environ- ment and health over the past two decades are beginning to be reevaluated. It is our hope that through ACSH's continued efforts, more and more Americans will come to recognize and appreciate that our nation is healthier than ever before - and that we "never had it so good:." We can only jeopardize our good health by pursuing false leads, giving attention to hypothetical health risks, and letting pseudoscientists take the leader- 1

ship role in resolving critical issues related to nutrition, chemicals, the environment and health. Our continued growth is directly attributable to the solid foundation of concerned and dedicated scientists and physicians who make up ACSH's Advisory Board. These men and women are com- mitted to bringing the American consumer sound, balanced scientific information about health risks: On February 6, 1985, the Wall Street Journal edi- torial page described us in this way, ". . . the American Council on Science and Health knows the difference between a health threat and a health scare:" We do indeed know that difference - and, with the ongoing support of our distin- guished directors, advisors, funders, members, and other friends, ACSH will continue to commu- nicate that difference to the American public. Elizabeth M. Whelan Executive Director INTRODUCTION The American Council on Science and Health is a,consumer education organization concerned with issues related to food, nutrition, chemicals, pharmaceuticals, the environment, and health. ACSH is an independent, nonprofit, tax-exempt association. The nucleus of ACSH is a board of more than 140 physicians, scientists, and policy advisors - experts in a wide variety of fields who review the Council's reports and participate in ACSH semi- nars, press conferences, media communications, and other educational activities. ACSH was founded in 1978'by a group of scien- tists who had become concerned that many important public policies related to health and the environment did not have a sound scientific basis. These scientists created the organization to add reason and balance to debates about public health issues and to bring these common-sense views to the public. With these goals in mind, ACSH produces a wide range of publications including peer- reviewed reports; a bimonthly newsletter covering current health issues; an informal quarterly news- letter covering ACSH activities that involve advi- sors, executives and staff; consumer information flyers; and proceedings from ACSH seminars and conferences. In addition, ACSH produces a nationally syndi- cated radio commentary series, hosts annual semi- nars and press conferences, and presents an annual award to an outstanding scientist for his or her achievements. ACSH also directs an in-house internship program for students in health science fields. ACSH representatives participate in legis- lative and regulatory hearings, radio and televi- sion programs, public debates, and other forums; and ACSH's research findings receive extensive coverage in the news media. ACSH maintains offices in New York City and Summit, New Jersey. The Council's executive staff, as well as its research and educational pro- grams, are headquartered in New York. Member- ship, accounting, and the publishing, sales and mailings of ACSH publications are handled in Summit. 2

HIGHLIGHTS OF 1985 t The third annual ACSH media seminar was held on November 19, 1984 in New York City. This year's topic was "Perspectives in Cancer Preven- tion." Dr. John~Higginson of Georgetown Univer- sity's Institute for Health Policy Analysis was the keynote speaker. ACSH's fourth annual award for outstanding achievement in the health sciences was presented to Dr. Bruce Ames, University of California at Berkeley. Edith Efron, author of The Apocalyp- tics: Cancer and the Big Lie, was given a special award for outstanding scientific journalism. Thirty-eight scientists and~ health professionals joined ACSH's Board of Scientific Advisors, bring- ing the total to more than 140. Seven new scientific reports were published and three previous reports updated because of perti- nent new information: Ms. Edith Efron, author of The Apocalyptics: Cancer and the Big Lie, accepting ACSH's Special Award for Outstanding Scientific Journalism at the American New Reports:  ' "Low-Cal'orie Sweeteners" "Dioxin in the Environment: Its Effect on Human Health" "Searching for a Way Out: Smoking Cessa- tion Techniques"  "Reye Syndrome" "PCBs: Is the Cure Worth the Cost?"  "Diet and Cancer" "Obst'etric Anesthesia: A Guide to Pain Relief During Childbirth" Updated Reports: "Wood as Home Fuel: A Source of Air Pol- lution" "HealtM and Safety Aspects of Video Dis- play Terminals" "Antibiotics in Animal Feed: A Threat to Human Health?" Council's Third Annual Seminar on "Perspectives in Cancer Prevention," held in New York City on Nbvem- ber 19, 1984.

SCIENCE AND POLICY LV<~,yn 9 Out # ~ytti NU(~ ~ S~nok~nq ~~, crsiwtlnn Tj ircHnii{Urs ACSH Reports ACSH produced seven new scientific reports and updated three previously published reports during FY 1985. Low-Calorie Sweeteners, released in July 1984, presented in-depth discussions on the scientific histories of aspartame, saccharin and'cyclamate; as well as a glimpse of future low-calorie sweeten- ers still in the developmental stage. Our position statement carried the opinion that all three sweet- eners should be available to the public. Each has its own technical advantages and disadvantages,, and the health issues raised in opposition to their use have been shown to be more theoretical than real. Dioxin in the Environment: Its Effect on Human Health looked into the scientific evidence available on this issue and questioned whether the enormous public concern over potential health damage from dioxin exposure is warranted. Evi- dence suggesting that dioxin causes cancer or birth defects is based primarily on animal experiments. Genuine conflict exists in the scientific community about the validity of direct extrapolation of labo- ratory data to estimates of human risk. Careful study of chemical plant workers exposed to dioxin over many years or to large concentrations of the substance because of accidents has shown no long- term health effects. It is noteworthy that increased rates of cancer and birth defectshave not been detected in Seveso, Italy, where some 37,000 people were exposed to dioxin following a chemical accident in 1976. R~Fwd i'DIOXtN , r..~ a 'C for ~~;~ Seven reports were published this fiscal year and three previously published reports were updated. The ten reports include. (top)', PCBs: Is the Cure Worth the Cost?; Low-Cabrie, Sweeteners; Reye Syndrome; Diet and Cancer; and Health and Safety Aspects of Video Display Terminals. (Bottom row) Wood as Home Fuel; Dioxin in the Environment: Its Effect on Human Health; Searching for a Way Outr Smoking Cessation Techniques; Obstetric Anesthesia: A Guide to Pain Relief During Childbirth;, and Antibiot- ics in Animal Feed: A Threat to Human Health? The updated reports in the collagee include: Wood as Home Fuel; Antibiotics in Animal Feed: A Threat to Human Health?; and Health and Safety Aspects of Video Dis- play Terminals. ACSH's Smoking or Health: It's Your Choice report, issued in January 1984, has been one of the most popular publications ever produced by our organization. During the past twelve months we have received over 2,100 individual requests for it. Searching for a Way Out: Smoking Cessation Techniques was a logical sequel. As Mark Twain said: "It's easy to quit smoking. I know because I've done it thousands of times." The report reviewed a wide variety of smoking cessation tech- niques. While not endorsing one particular pro- gram or method over another, it did provide guid- ance and information for those interested in "kicking the habit." Reye Syndrome offered answers to many of the questions asked by concerned parents about this frightening condition. Although survival has improved dramatically in recent years, more than 20 percent of children who develop Reye Syn- drome die. Although the evidence linking salicy- lates (such as aspirin) to the syndrome is not con- clusive, ACSH believes that the data are suggestive enough to warrant that parents avoid giving medications containing salicylates to chil- dren with chickenpox or influenza-like illnesses: Few chemicals have received more publicity than the polychlorinated biphenyls (PCBs). PCBs: Is the Cure Worth the Cost? traces the history of these materials and the reasons for concern over their impact on public health. ACSH concluded that while bona fide health considerations must take precedence over economic consequences, America's fear of chemicalsinthe environment 4

Dr. Walter Willett of the Harvard School of Public Health during his presentation on diet and cancer ACSH seminar. seems to be fueling an escalating corrective pro- gram that' is costing taxpayers billions of dollars. PCBs are symbolic:of the situation. All studies to date have suggested that heroic, exceedingly expensive measures to remove PCBs from the envi- ronment are unwarranted and that time itself is an important factor in resolving the situation. It is noteworthy that, as with dioxin, individuals occu- pationally exposed to PCBs at much higher levels than the general public would encounter do not have increased risks of serious, long-term health problems such as cancer. All ACSH reports are reviewed before publica- tion by members of the Board of Advisors having expertise in the issues discussed. The finished reports represent a consensus view of those review- ers. Most ACSH reports have 15 to 25 reviewers. Few topics have been debated as vigorously in the scientific and popular press in recent years as thosee involving the causes and prevention of cancer. In the past two years, the American public hasbeen bombarded with messages urging us all to make substantial changes in our diets in order to reduce our risk of cancer. Understandably, many Ameri- cans have concluded that the evidence linking specific dietary factors with cancer is sound and solid, and that it justifies making major efforts now in choosing foods which will minimize our at the 1984 chances of getting cancer. In Diet and Cancer,. ACSH exarnined the question of whether the link between diet and cancer reflects accurately the scientific evidence. An unprecedented 49 review- ers participated in the creation of Diet and Can- cer. They agreed that there is insufficient evidence to warrant establishment of a public policy of guidelines for diet modification for all Americans for the purpose of reducing the risk of cancer. The use of pain-relieving drugs is a standard part of obstetric practice in the United States, as it has been for many decades. Concerns still persist, however, over the possible adverse effects off obstetric anesthesia on mother and child. In Obstetric Anesthesia: A Guide to Pain Relief Dur- ing Childbirth, ACSH summarizes the known risks and benefits of different forms of pain relief as an aid to women and their partners in making an intelligent decision regarding anesthesia during labor and delivery. Although the safest form of pain relief during childbirth is complete reliance on psychological methods, this is often impossible or inappropriate. Women who choose or must receive anesthetic drugs for labor and delivery are not placing themselves or their childreni at undue risk. Wood as Home Fuel, published originally in October 1981, and updated in October 1982, was 5

Dr. William Cahan, Attending SurgeonPThoracic Service at Memorial Sloan-Kettering Cancer Center in New York and ACSH Advisor, giving the audience at ACSH's seminar on "Perspectives in Cancer Prevention" a vivid look at the effects of tobacco on the lung, updated again in September 1984 with the inclu- sion of recently published articles on chronic health problems caused by inhalation of smoke from chemically preserved wood, steps taken by Oregon and Colorado to develop and enforce per- formance standards for wood stoves and fire- places, and additional safety tips suggested by the Insurance Safety Institute for Wood Stoves. During FY 1984, ACSH became actively involved in the debate over the use of subthera- peutic levels of antibiotics as animal growth pro- motants. The Council released its report on this topic, Antibiotics in Animal Feed: A Threat to Human Health? at a news conference chaired by ACSH Associate Director Dr. Richard A. Green- berg in Washington, D.C., in December 1983 and submitted its findings on the subject to President Reagan, with a letter outlining the disadvantages of banning antibiotics in animal feed. The contro- versy escalated even further during FY 1985 with the publication by Centers for Disease Control scientists of their study of the epidemiology of a Salmonella newport food poisoning outbreak in four midwestern states. While the CDC study concluded that the affected patients were infected by eating hamburger originating from a beef cat- tle herd fed subtherapeutic chlortetracycline for growth promotion, ACSH believes that there is considerable doubt that a cause-effect relationship has been established. The updated report, pub- lished in May 1985, discussed the large body of new information which became available subse- quent to the November 1983 original edition and concluded that there continues to be no evidence that discontinuing the use of penicillin and the tetracyclines as feed additives would improve human~health. Last year's Health and Safety Aspects of Video Display Terminals was the single most popular ACSH report' in terms of both volume sales and single copy requests. The updated version, which contains a greatly expanded discussion about pos- sible reproductive hazards; is equally in demand, with more than 6,100 copies purchased in the six months since its publication. Thexecent great increase in the public's concern about reproduc- tive hazards has no scientific basis. The first reports scheduled for publication in FY 1986 are Premenstrual Syndrome and a second edition of Irradiated Foods, first published in October 1982. An updated Fast Food and the American Diet and reports on hay fever, nature's carcinogens, sugar and health, and the air bag/ seat belt controversy should be in print before winter comes. 6

New Advisors and Directors Thirty-eight scientists accepted invitations from the ACSH Board of Directors to join the Board of Scientific Advisors in FY 1985, bringing the total of ACSH advisors to more than: 140. Thirty-four ACSH advisors are M.D.s. Two new members were elected to ACSH's Board of Directors. They are Dr. Richard A. Greenberg, Hinsdale, 11. and Mr. Dwight C. Reed, Hilton Head Island, S.C. Scientific Presentations by ACSH Representatives ACSH Associate Director Dr. Richard Green- berg visited Australia in September, where he pre- sented the keynote speech on "Meat-The Last Roundup?" at the Second Australian Conference on Agriculture and Human Nutrition in Sydney.In Brisbane, Dr. Greenberg spoke to the CSIRO Meat Research Laboratory staff, where he dis- cussed the areas of concern about meat and meat products in the U.S. and how ACSH is addressing those concerns. He also addressed a joint meeting of the Queensland Institute of Food Science and Technology and the Nutrition Society of Queens- land, where his presentation focused on nutri- tional aspects of processed meats. Dr. Greenberg spoke on a variety of nutrition topics at a meeting of the Nutrition Society of Victoria, and he dis- cussed ACSH and its activities at a meeting of the New South Wales Department of Agriculture. ACSH Executive Director Dr. Elizabeth Whelan traveled to Milan, Italy in October, to present a paper on "Saccharose: Its Role in Human Nutrition" at the International'Sympo- sium on Sugars and Sugar Substitutes in Human Nutrition. The paper was co-authored by Dr. Whelan and Dr. Fredrick Stare, Professor of Nutrition, Emeritus, at the Harvard School of Public Health and Chairman of the ACSH Board of Directors. Dr. Whelan was one of the speakers at a paneli presentation on the role of the media in science reporting held in New York in December. The event was co-sponsored by Scientists and Engi- neers for Secure Energy and the Specialized Jour- nalism Department of the Polytechnic Institute of New York. Dr. Greenberg was the featured speaker at the January meeting of the Environmental Improve- ment Committee of the PENJERDEL Council, a Dr. John Higginson (right) accepts ACSH's Fourth Annual Award for Distinguished Scientific Achievement on behalf of Dr. Bruce Ames. Dr. Norman Borlaug (left)y Nobel Laureate and ACSH Director, presented the award at ACSH seminar,. November 19,,1984. tri-state (Pennsyl!vania, New Jersey, Delaware) business and professional association. His talk focused on "chemical phobia"'and the current controversies over artificial sweeteners, EDB, PCBs, lead in gasoline, dioxin, formaldehyde and polyvinyl chloride. In April, Dr. Whelan addressed the Annual Meeting of the Millers' National Federation in Washington. Her topic was "Evaluating Food, Chemical, Environmental and Health Issues." In May, Dr. Greenberg spoke on "Does Feeding Antibiotics to Food Animals Constitute a Threat to Human Health?" at the Spring Meeting of the. Food Research Institute, University of Wisconsin, Madison. 7

THIRD ANNUAL ACSH SEMINAR Dr. Norman Borlaug, Nobel Laureate and ACSH Director, addressing a question about diet and cancer to the panel dur- ing a floor discussion at ACSH's Third Annual Seminar. "My operating room could aptly be called 'Marlboro country.' In the operating room the surgeon sees,, all too often, the triumph of the ciga- rette makers' art." With these words and with illustrations that graphically depicted the effects of tobacco on the lung, thoracic surgeon Dr. William Cahan of Memorial Sloan-Kettering Cancer Center opened the ACSH symposium "Perspectives.in Cancer Prevention," held at the Roosevelt Hotel in New York City on November 19. Dr. Cahan, an ACSH Advisor, gave the serninar audience a fresh and devastating look at the role of tobacco in cancer causation from his special perspective as a physi- cian who treats lung cancer patients. Controversies over the roles of diet and the envi- ronrnent, respectively, in cancer causation high- lighted two other seminar presentations. Dr. Walter Will'ett of the Harvard School of Public Health challenged others in the scientific community who claim that we should modify our diets now in an effort to prevent cancer. Although he acknowledged that diet may= be the "number two" cause of cancer in America, Dr. Willett warned that "information about the roles played by specific dietary factors is generally inconsistent and incomplete. It is my own belief that the data that we have right now on the relationship between diet and cancer are not sufficient to serve as a basis for strong specific dietary recommenda- tions." Dr. John Higginson gave the seminar audience some insight into the role of environmental factors in cancer causation~ and traced the history of scien~ tists' understanding of this subject. Dr. Higginson is currently a Senior Scientist at the Universities Associated for Research and Edtzcation in Pathol- ogy, Inc:, but he will be moving to Georgetown University early this year, to become a fellow in the Institute for Health Policy Analysis there. ACSH's Fourth Annual Award for Distin- guished Scientific Achievement was presented at the seminar's luncheonsession. Unfortunately, Dr. Bruce Ames of the University of California at Berkeley; recipient of the award, was unable to attend the seminar due to illness. Dr. Higginson accepted the award on his behalf fromiACSH Director Dr. Norman Borl'aug, and read Dr. Ames' acceptance speech. In his prepared~ remarks, Dr. Ames said "I am particularly pleased to have this honor because I value the effort that the American Council on Science and Health has made to bridge the sub- stantial gap between the scientific community and the public at' large. In particular, ACSH has played'a a lead'ership role in educating the public to distinguish the cancer risks that matter - such as smoking - from those that are negligible - such as EDB or saccharin. This distinction, though crucial, has so far been very poorly communicated to the public, and is only imperfectly reflected in present regulatory practices:" Dr. Ames also warned that the need for distin- guishing important cancer risks from less serious ones "has become even greater with the recent recognition that chemical substances capable of causing mutations are not uniquely, nor even pre- dominantly, of man-made origin." A special award for Outstanding Scientific Jour- nalism was presented at the seminar to Edith Efron, author of The Apocalyptics: Cancer and the Big Lie. In presenting the award to Ms. Efron, ACSH Executive Director Dr. Elizabeth Whelan called The Apocalyptics "explosive" because it "not only tells you why the popular wisdom about environ- mental cancer causation is wrong, it also reveals exactly howthe `big cancer lie"evolved and the e 8

0 counterproductive effect it: has had on this coun- try's attempts at cancer prevention." ACSH Director Dr. Stephen Sternberg chaired ® Dr. Stephen S. Sternberg, Attending Pathologist, Director, entertaining a question from the floor at the Memorial Sloan-Kettering Cancer Center and ACSH morning session of ACSH's Nbvember 19, 1984 seminar. Pre-registration conversations before the opening of a seminar on November 19, 1984 on "Perspectives in Cancer Prevention." the seminar's morning session, and Dr. Fredrick Stare, Chairman of the ACSH Board of Directors, chaired~ the afternoon session. 9