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Jonathan Campbell

Helping people take charge of their health

by Paul Brodeur, March 1, 1999

The January 11, 1999 issue of The New Yorker contains a Comment piece (the magazine's equivalent of an editorial) in which a staff writer named Malcolm Gladwell delivers some opinions about the carcinogenicity of trichlorethylene (TCE), the chemical that a jury, in 1986, found W. R. Grace & Company responsible for dumping into open ground and contaminating drinking water supplies in Woburn, Massachusetts. W. R. Grace subsequently settled the case by paying eight million dollars to the families of eight leukemia victims (most of them children), who had lived in the neighborhood where the dumping had occurred, and had allegedly drunk water from TCE-contaminated wells. In his New Yorker Comment piece, Gladwell uses the movie "A Civil Action,"--an account of the Woburn tragedy based upon Jonathan Harr's book of the same title, and starring John Travolta--as the starting point for the following statement regarding the carcinogenicity of TCE:

"It is taken as a given that the chemical allegedly dumped, trichlorethylene (TCE), is a human carcinogen--even though, in point of fact, TCE is only a probable human carcinogen: tests have been made on animals, but no human-based data have tied it to cancer. [Emphasis added.]

On January 15th, after checking with officials of the National Institute of Environmental Health Sciences' National Toxicology Program, I wrote to David Remnick, editor of The New Yorker, asking him to consider an accompanying letter to The Mail, a section of the magazine that publishes letters from readers to the editor. In my letter to The Mail, I pointed out that several studies published in the peer-reviewed medical literature had tied TCE to the development of cancer in humans, and cited by volume, number, and page one that had appeared, in 1998, in the highly respected Journal of Cancer Research and Clinical Oncology. I went on to point out that more than half a dozen studies published in the peer-reviewed medical literature show that TCE causes liver tumors in mice and kidney tumors in rats. The fact that TCE is a carcinogen in multiple species, I explained, is why the International Agency for Research on Cancer (IARC) has listed it as a probable (more likely than not) cancer-producing agent in humans. I ended the letter by saying that TCE was widely used in the electronic industry as a solvent for cleaning circuit boards.

On January 22nd, an associate editor at The New Yorker, to whom Remnick had referred my letter, wrote to inform me that the magazine's fact checker had done some further research, and that "The study you cite was the only one we could find that turned up a link between TCE and cancer." The associate editor then cited a 1991 study that had been conducted by researchers from the National Cancer Institute, and had appeared in the prestigious British Journal of Medicine, which showed that "'Detailed analysis of the 6,929 employees [of an aircraft maintenance facility] occupationally exposed to trichlorethylene... did not show any significant or persuasive association' between TCE and cancer of any type." She went on to inform me that "Given that there is the one study showing a link, what Gladwell wrote may seem like a semantic wriggle, but I really think that it isn't, and that there isn't enough data to show a 'tie.'" She told me that as a result the magazine would not be able to run my letter.

During the next ten days, I was travelling. Before leaving home, however, I asked a medical-scientist friend to download MEDLINE and provide me with copies of any studies that had been published in the peer-reviewed medical and scientific literature regarding the capacity of TCE to produce cancer or other disease in humans. When I returned, a thick envelope awaited me. It contained copies or abstracts of 42 studies--ten of which suggested that TCE was carcinogenic in humans. One of the studies was entitled "An Analysis of Contaminated Well Water and Health Effects in Woburn, Massachusetts." It had been published in September, 1986, in Volume 81, No. 395 of the Journal of the American Statistical Association, and it had been conducted by researchers from the Harvard School of Public Health and Boston's Dana-Farber Cancer Institute, who had found that drinking water from the very same TCE-contaminated wells described in "A Civil Action" was at least partly responsible for elevated incidence rates of childhood leukemia in Woburn.

Among the other studies downloaded from MEDLINE was a copy of the 1991 investigation cited by The New Yorker associate editor as having shown no persuasive association between TCE and cancer of any type, as well as a copy of a follow-up study of the same workers that had been conducted by researchers for the National Cancer Institute (NCI), and published in Occupational and Environmental Medicine, in 1998. Reading both studies in their entirety proved interesting.

For example, the 1991 study found almost twice as many deaths as expected from cancer of the biliary passages and the liver among white male workers exposed to TCE, who had died after 1980. In the follow-up study, non- significant excesses for non-Hodgkins lymphoma and for cancers of the oesophagus, colon, primary liver, breast, cervix, kidney, and bone were found workers exposed to TCE. In the conclusion section of the follow-up study, the NCI researchers stated that their findings did not "strongly support a causal link with trichlorethylene because the associations were not significant, not clearly dose related, and inconsistent between men and women." However, they went on to declare that "Because findings from experimental investigations and other epidemiological studies on solvents other than trichlorethylene provide some biological plausibility, the suggested links between these chemicals and non-Hodgkins lymphoma, multiple myeloma, and breast cancer found here deserve further attention."

Meanwhile, the issue of The New Yorker dated February 8 had come out with an article entitled "The Cancer-Cluster Myth" by Atul Gawande, a research fellow at the Harvard School of Public Health, who declared in a parenthetical statement on page 36 that a sevenfold increase in the occurrence of a cancer is "a rate of increase not considered particularly high by epidemiologists."

On February 8, I wrote a second letter to David Remnick in which I enclosed the abstracts or copies of five studies showing a link between exposure to trichlorethylene and the development of cancer in humans. I drew his attention to the fact that one of these studies dealt with the wells in Woburn that W. R. Grace had been found responsible for contaminating with TCE. I pointed out that since TCE and similar halogenated hydrocarbons are widely used as pesticides, solvents, cleaning agents, degreasing agents, cutting fluids, propellants, and refrigerants, millions of Americans are being exposed to them on a daily basis.

In my letter of February 8, I went on to tell Remnick that Gawande's assertion in "The Cancer-Cluster Myth" that a sevenfold increase in the occurrence of a cancer is "a rate of increase not considered particularly high by epidemiologists" was absurd on the face of it. In this regard, I drew his attention to a second letter to The Mail that I was enclosing.

The final paragraph of my letter to Remnick read as follows: "Finally, let me say that I trust my pointing out errors of fact in two recent issues of The New Yorker will be taken by you in the spirit in which it has been given. I have high regard for the magazine on whose staff I served for thirty-eight years, and I wish you great success in your stewardship of it."

In my accompanying letter to The Mail, I once again pointed out that Gladwell was in error when he claimed that no human-based data have tied trichlorethylene to cancer, and cited five medical or scientific journals in which such data had been published in recent years. As for Gawande's dismissal of the importance of a sevenfold increase in the occurrence of a cancer, I pointed out that "Non-smoking workers exposed to asbestos--one of the most deadly industrial carcinogens ever discovered--suffer a fivefold increase in lung cancer," and that "one-pack-a-day smokers of cigarettes--far and away the most deadly carcinogen ever discovered--suffer a tenfold increased incidence of lung cancer."

After reminding the reader that occupational exposure to asbestos has killed at least half a million workers in America in recent years, and that cigarettes have and will continue to kill millions upon millions of people in the general population, I pointed out that "Obviously...a sevenfold increase in the occurrence of a cancer caused by a single carcinogen has to be considered dangerously high, particularly if significant numbers of people are exposed to that carcinogen."

My letter to The Mail concluded as follows: "Not to consider it [a sevenfold increase] as such would be a way of overlooking the fact that one in every three American men and one out of every four American women is today developing cancer in his or her lifetime. There's a word for that kind of incidence--no matter what the disease. The word is epidemic."

On February 10, David Remnick wrote me a letter of reply that read as follows:

"Thank you for your letters and the attached excerpts and information. It seems to me what we have here is not a matter of right and wrong and fact versus, well, something else, but rather a legitimate debate in which you disagree with both Gladwell and Gawande. You ask if I mind your sending them: Of course, I don't. But I also trust you know I am sincere when I say that we went to great lengths to ensure the accuracy, as best it can be established, of both pieces. The traditions at The New Yorker have not changed where that is concerned."

Alas, Mr. Remnick, they have. Slowly but surely, ever since Tina Brown took over the magazine in the autumn of 1992. Under the 35-year editorship of William Shawn, from 1952 to 1987,and under the five-year editorship of Robert Gottlieb, from 1987 to 1992, errors of such magnitude as I have pointed out to you would have been highly unlikely. But, had they occurred, for the editor of The New Yorker not to have acknowledged them--either in a Department of Amplification or a statement of correction issued to avoid the appearance of downgrading a major potential public health hazard--would have been unthinkable. The magazine that published Rachel Carson's seminal "Silent Spring" has lost its way. It is not too late, however, for you to bring it back.

Respond to: paulbrodeur@juno.com

Paul Brodeur was a staff writer at The New Yorker for almost forty years. In 1968, he alerted the nation to the massive public health hazard posed by asbestos, and has written four books on that subject, including "Expendable Americans" and "Outrageous Misconduct: The Asbestos Industry on Trial." The articles in The New Yorker upon which those books were based won a National Magazine Award, a Sidney Hillman Foundation Award, and the Silver Gavel Award of the American Bar Association.

Brodeur's pioneering articles on the destruction of the ozone layer by man-made chemicals won the Journalism Award of the American Association for the Advancement of Science. As a result of these articles, he was named to the United Nations Environment Program's Global 500 Roll of Honour for outstanding environmental achievements.

His articles on the health hazards associated with exposure to microwave radiation were published as a book entitled "The Zapping of America," which was listed in the New York Times Book Review as one of the notable books of 1977. His three-part series of articles on the cancer hazard associated with exposure to the electromagnetic fields given off by power lines won a public service award from the American Society of Professional Journalists. These articles were published as a book entitled "Currents of Death." Subsequent articles on the power-line hazard that appeared in The New Yorker were published as a book entitled "The Great Power-Line Cover-Up."

Brodeur's memoir, "Secrets: A Writer in the Cold War," was published in 1997. It recounts his experiences as a counter-intelligence agent in Post-War Germany and as a longtime staff writer at The New Yorker, and it was listed in the New York Times Book Review as one of the notable books of 1997.

paulbrodeur@juno.com