Risk assessment and regulation at the EPA generally have focused on the ambient environment, that is, on assessing and controlling, via public policy, chemicals in the environment that may pose a threat to human health. There are a few examples of laws in which biological variations among humans are incorporated in regulatory processes. For example, the Clean Air Act of 1990 and the Food Quality Protection Act of 1996 had specific provisions for the protection of sensitive groups within the general population, such as children and people with asthma. Likewise, there are a few instances of regulators recommending that the risks posed by exposure to environmental chemicals be remediated by an individual behavior.24 However, the predominant approach to protecting the health of the public vis-à-vis environmental risks has been to control the emission and concentration of harmful chemicals in the air, water, and soil.
This population-level approach contrasts with the individual-level approaches, focused rather on clinical interventions and on behavioral and lifestyle factors, that are central to both biomedicine and the “dominant epidemiological paradigm” (Brown 2007). Insofar as health care utilization, behavioral, factors, and lifestyle factors are seen as individual choices, individual-level approaches tend to hold individuals responsible for their health status (Brown 2007: 20; Petersen & Lupton 1996). In contrast, in public policy approaches, the state retains the responsibility that it acquired in the eighteenth or nineteenth century—the precise timing varying across national contexts—to secure the general conditions of public health by maintaining clean air, water, and food (Rose 2001: 6).
These public policy applications of environmental health science, in turn, have reinforced the alignment of environmental health research with public health. The NIEHS and NTP track the uptake of their research by regulatory agencies as a measure of the contribution of their scholarship.25 Likewise, environmental health scientists emphasize the potential of their research to intervene at the “front end of disease, or disease etiology, and prevention” (US GPO 2007: 21). Among the consequences of the historical alignment of the environmental health sciences with public health and public policy approaches is that, in order to defend their jurisdiction—and maintain their funding—environmental health scientists must articulate their contribution to public health and maintain clear boundaries with biomedicine.
The public policy applications of environmental health science increase the scrutiny given to such science, which is regularly challenged in regulatory reviews and in litigation. In the United States, the centrality of scientific knowledge in environmental regulation and the readiness of the courts to adjudicate complex scientific questions have given litigating parties incentives to reframe fundamentally political and economic cleavages as disputes over scientific evidence (Jasanoff 1995: 67; Michaels 2008).26 As a toxicologist noted grimly, “The court cases occur when trying to apply [research] findings to regulations” (Interview S38). Such challenges may center on claims about specific, local exposures and their effects on a community’s health (Allen 2003; Brown & Mikkelson 1994; Corburn 2005) or on whether and how it is necessary to regulate substances commonly used in industrial manufacturing of widely distributed consumer products (Jasanoff 1995; Markowitz & Rosner 2002).
Both industry and environmental health advocacy groups have established their own research institutes, as well as collaborations with university-based environmental health scientists, as a means of participating more fully in this arena (Brown et al. 2006).27 Fundamentally, this means that environmental health research is frequently and publicly contested. That said, these contestations take very different forms. As I discuss later in this chapter, environmental health and justice advocates argue broadly for more protective and democratic approaches to environmental risk assessment and regulation. In contrast, in the past half century, regulated industries have invested significant financial and institutional resources in the politicization of scientific uncertainty, seeking to convince the judiciary and the public that the evidentiary base for environmental regulation is “junk science” (Michaels 2008; Oreskes & Conway 2010; Ong & Glantz 2001).
“Better Living Through Chemistry”28
An improved understanding of environmental health risks is important because economic development plays a vital role in the U.S. and world economy and to human welfare . . .
Testimony of Lynn Goldman (US GPO 2007:66)
Today’s chemical industry includes companies producing a staggering array of products that are central to contemporary life. According to the American Chemistry Council (ACC), the trade group that represents the $720 billion industry, chemical production in the United States encompasses five product segments: pharmaceuticals, basic chemicals (i.e., commodity chemicals produced in large volume and with broad applications), specialty chemicals (i.e., low-volume, high-value compounds with very specific applications), agricultural chemicals (e.g., pesticides and fertilizers), and consumer products. Our homes are full of chemical products, such as vitamins, prescription and over-the-counter drugs, vinyl flooring, cosmetics, soaps, lotions, shampoo, pantyhose, DVDs, diapers, and household cleaners; most of us use multiple chemical substances each day (Altman et al. 2008).
Chemical production has contributed to the expansion of the American economy and remains a major component of it; the ACC proudly describes the U.S. economy as “chemistry dependent.” Nearly 800,000 people were directly employed by the chemical industry in 2010, and the ACC estimates that for every job created in the business of chemistry, 5.5 jobs are created in other sectors of the economy. In 2010, chemical products accounted for 12% of U.S. exports.
Despite the role of chemistry in creating what the ACC calls the “American standard of living,” both the specific products of the chemical industry and the industrial manufacturing processes through which they come into being have been the subject of contentious politics for over a century. Concerns about conditions within factories—and their effects on workers’ health—gave rise to broader questions about the health consequences of chemical exposures outside these concentrated industrial settings (Seller 1997). For over a hundred years, the chemical industry has contended that its voluntary compliance with health safeguards will be sufficient to protect the health of workers and the public. However, as noted by public health historians, “there have always been those inside and outside of government who believed that voluntary compliance . . . is not sufficient to safeguard the public’s health for the reason that industry’s financial interests often prevent it from doing what would be socially responsible” (Markowitz & Rosner 2002: 3).
Advocating for Environmental Health and Justice
To answer the question of why some communities are more affected by some disease, NIEHS must continue to assess the degree to which environmental exposures disproportionately impact specific communities, to understand the effects of multiple and cumulative exposures, and ultimately what types of intervention will effectively reduce those disparities in health burdens.
Testimony of Peggy Shepard (US GPO 2007: 72)
Another defining characteristic of