Gerald Markowitz

A 'Gift of God'?: The Public Health Controversy over Leaded Gasoline during the 1920s

The intent of this paper is to show that as early as the 1920s public health experts, government officials, scientists, corporate leaders, labor, and the public were acutely aware of the dangers posed by the introduction of lead into gasoline. A spirited and often heated controversy arose with debates centering on issues of health and public policy that remain current today. By examining this controversy, the authors of this paper illustrate how, at every stage of the debate, the political, economic, and scientific issues were inextricably intertwined.

Persistent pollutants: a brief history of the discovery of the widespread toxicity of chlorinated hydrocarbons.

Rachel Carsons Silent Spring is often depicted as the beginning of a broad societal concern about the dangers of DDT and other pesticides. Attention to the other chlorinated hydrocarbons, specifically PCBs, is seen as an outgrowth of the late 1960s environmental movement. Carsons work was clearly critical in broadening the history to include the environmental impact and set the stage for the path breaking work decades later by Theo Colburn and others on endocrine disruptions associated with other synthetic chemicals. This article reviews the development of the understanding the dangers of the chlorinated hydrocarbons in the decades preceding Carsons book. Although little noticed, Rachel Carson makes this observation herself.

Industry Challenges to the Principle of Prevention in Public Health: The Precautionary Principle in Historical Perspective

Historically, prevention of disease has been a cornerstone of public healthpractice. In the 19th century, the provision of pure water, the engineeringefforts to remove sewage, and sanitation were hallmarks of urban reform. Inthe 20th century, vaccination and early treatment of communicable disease,such as syphilis and gonorrhea, and well baby services, for example, emerged ascentral activities of health departments around the nation. Yet, in recent de-cades, as public health has expanded its scope to address issues of environmen-tal and industrial health, the apparently clear-cut public health mandate toprevent disease has often come into conflictwith private industries’ self-interest in avoid-ing public health or state interventions in itspractices.In recent years, the stakes have been dra-matically raised as nation states have soughtto address issues affecting the health of theglobal community. For the most part, untilthe late 1990s, environmental disputes havebeen local or national in scope, such as thoseat Love Canal, New York; Times Beach, Mis-souri; or Convent, Louisiana. But lately, thearguments have taken on international di-mensions especially during and after thedebates over the Kyoto Protocol on GlobalWarming. Issues, which were once of inter-est only to particular companies and localcommunities, are now of concern to multi-national corporations and the world. Forexample, the Business Roundtable—foundedin 1972 as an association, representing 200of the nation’s largest corporations, to

Vinyl Chloride Propellant in Hair Spray and Angiosarcoma of the Liver among Hairdressers and Barbers : Case Reports

Abstract Two cases of angiosarcoma of the liver (ASL) are, to the best of our knowledge, the first literature reports of such cases identified among hairdressers and barbers who used hair sprays containing vinyl chloride (VC) as a propellant. The cases were exposed to VC aerosols between 1966 and 1973, for 4–5 year periods. Modeling indicates estimated peak levels of VC exposure ranging from 129 ppm to 1234 ppm, and average exposure ranging from 70 ppm to 1037 ppm, based upon assumptions of use and number of air exchanges per hour. As ASL is a sentinel cancer for exposure to VC, identification of these cases raises concern about the contribution of VC to hepatocellular carcinoma (HCC), a much more common type of liver cancer, as well as other VC-related cancers among hairdressers and barbers. Had manufacturers acted in a responsible manner, VC never would have been introduced as a propellant into consumer products such as hair sprays, pesticides, and paints.

The Struggle over Employee Benefits: The Role of Labor in Influencing Modern Health Policy

After organized labor failed to institute national health insurance in the mid-twentieth century, its influence on health care policy diminished even further. This article proposes an alternative interpretation of the development of health care policy in the United States, by examining the association of health policy with the relationships between employers and employees. The social welfare and health insurance systems that resulted were a direct outcome of the pressures brought by organized and unorganized labor movements. The greater dependency created by industrial and demographic changes, conflicts between labor and capital over the political meaning of disease and accidents, and attempts by the political system to mitigate the impending social crisis all helped determine new health policy options.

Corporate Responsibility for Toxins

From the beginning of its history, industry has responded to calls for government regulation by arguing that voluntary compliance was sufficient to ensure that it acted responsibly. Here we outline three cases that raise broad policy questions concerning the degree to which we can trust industry to control its own behavior with regard to industrial pollutants. First, we outline the experience of Americans with the lead industry, the producer of a well-known industrial toxin. Second, we look at the silica-using industries, whose central mineral caused innumerable deaths and disabilities to exposed workers in the 1930s. Finally, we trace the efforts of the plastics industry to keep knowledge about the carcinogenic potential of vinyl chloride secret from the government.

Race, foster care, and the politics of abandonment in New York City.

Following the end of the Great Depression of the 1930s, the sectarian system of foster care services in New York City practiced open discrimination. African-American children were generally segregated in a small number of overcrowded and understaffed all-Black institutions. As the African-American migration to the city accelerated in the years following the outbreak of World War II, a small group of psychologists, jurists, philanthropists, and social workers began a systematic challenge to this system. This paper explores the role of racism in shaping New Yorks foster care system and the experience of African-American children who were forced to depend on services originally organized to serve Whites. It also looks at the ways race affected the way children were typed--as mentally ill, delinquent, or even criminal--in response to the structural realities of a system that sorted children into separate types of institutions according to race. The paper also provides the background for understanding the landmark challenge to segregation of children in sectarian and public institutions represented by Wilder v Sugarman.

Politicizing science: the case of the Bush administration's influence on the lead advisory panel at the Centers for Disease Control

Since the 1970s, the CDC has depended upon independent scientists and policy consultants, who are experts in the field to gather information and provide advice to the CDC regarding policy initiatives for a variety of toxic materials. One of the most important safeguards of the scientific integrity of governmental policy and research has been the 258 scientific advisory committees to the various branches of the CDC that presently help policymakers decide on the appropriate means of addressing serious scientific issues. These advisory committees, while not possessing the actual power to reshape policy, are important in their role as the font of expert opinion available to various CDC chiefs. During the past two years, the Bush administration has sought to short-circuit the traditional manner in which appointments to the committees have been made and to substitute a process that by and large has reflected its own well-known anti-regulatory and anti-environmental agenda. In this paper we will look at this process, focusing on one important committee that has been responsible for protecting the nations children from the devastating effects of lead on their neurological well-being.

The Illusion of Medical Certainty: Silicosis and the Politics of Industrial Disability, 1930–1960

No firm differentiation existed between social and medical standards on silicosis, the salient industrial health problem of the 1920s and 1930s. As a result, professional groups, government and labor officials, and insurance executives negotiated about the causes and consequences of the disabling condition. Debates in the 1930s formed the basis for amending state and federal compensation systems for work-related disease. If attention to silicosis declined after World War II, disputes continued about diagnosis and functional criteria for identifying pulmonary and occupationally based impairments, and about appropriate policies for treating and compensating people disabled through the course of their work.

Workers, Industry, and the Control of Information: Silicosis and the Industrial Hygiene Foundation

This essay focuses on the early history of industry and professional relationships around silicosis, the debilitating occupational lung disease, through a study of the role of the Industrial Health Foundation, an industry-sponsored group which has played a critical role in shaping the nations agenda regarding industrial disease. From its start during the Depression, it has portrayed itself as an industry-sponsored agency that depended upon detached, disinterested professionals and experts to develop effective programs to address occupational disease. As an organization that brought together professional industrial hygienists, business groups, government officials, academics and researchers it serves as a means for understanding the intertwining of industrial and academic agendas. We explore some of the issues that arose regarding public policy and scientific investigations, asking: Under what conditions is it appropriate for professionals and scientists to work together with industrially sponsored organizations? What are the pressures that shape research questions, the range of possible solutions, and the control of scientific data? How can technically trained individuals avoid real or perceived conflicts of interest? At what point does the ostensibly disinterested goals of professionalism conflict with the self-interest of the sponsoring organizations?