So, we started [the genomics initiatives] . . . and the National Institute of Environmental Health Sciences has become a major player at the National Institutes of Health. It used to be, quite frankly, that they didn’t see us as important to the mission of the National Institutes of Health, to protecting public health. But now we are a major part of the Institutes—we are integrated with the National Cancer Institute, the National Human Genome Research Institute—and they see how important our work is for public health (Field Notes, NIH December 2001).
As described in the following pages, the genomics initiatives have also transformed profoundly the research practices of many environmental health scientists.
To date, environmental health scientists have established two broad ways of studying gene-environment interaction. First, scientists seek to identify genetic susceptibilities that make some people more vulnerable to being harmed by environmental exposures. In this framing of gene-environment interaction, scientists acknowledge the harmful effects of environmental contaminants, but genetic variations in individuals’ responses to them are the crucial problem to be explained. Second, scientists examine how environmental chemicals affect human genetic material, whether by causing DNA damage (e.g., mutations) or by altering gene expression (e.g., epigenetics). In this framing of gene-environment interaction, scientists acknowledge human genetic variability, but the effects of environmental exposures are the crucial problem to be explained. Although environmental health scientists have long been interested in how environmental pollutants damage DNA (Frickel 2004), they describe the broad integration of molecular genetic and genomic techniques as a “revolution” in their field (Field Notes, NIEHS 2002).
In recent years, this molecular revolution has redefined what it means to do environmental health research in the United States. As a leading molecular epidemiologist44 recalled, in the early 1990s, when he first arrived in the department of environmental health sciences at a prestigious school of public health, his colleagues challenged the molecular biological focus of his work:
There was a lot of reluctance to accept the concept that molecular biology had something to say in environmental health. There were many, many older faculty people who weren’t even willing to accept that. [They said] . . . “This is not right. This is bullshit. You are not studying environmental health.”
However, he continued, over time “those people started losing their funding and we started getting our funding. And then the emphasis shifted . . . now we really have created a large group of [scientists studying] molecular biology in the department” (Interview S20). Departments of environmental health science across the country now teach and conduct molecular genetic and genetic research as part of their standard coursework and in the context of interdepartmental programs.45 Environmental health scientists advocate for research on gene-environment interaction by claiming that protecting population health requires investigation of “how the environment operates at the molecular level.”46
The development of molecular genetic and genomic technologies and practices within the environmental health sciences has not gone unnoticed by other key actors in the arena of environmental health politics. The EPA and FDA have launched partnerships with the NIH and NTP to explore the application of molecular techniques in risk assessment and regulation. One such initiative, Tox21, endeavors to create a system of environmental risk assessment and regulation that replaces whole animal bioassays with in vitro methods that will evaluate the effects of chemicals by examining changes in cell lines (NRC 2007b: 1).47 The chemical industry has taken a keen interest in these developments; in 2001, the International Council of Chemical Associations held a workshop and subsequently promulgated their recommendations for “best practices” for emerging “-omics” technologies48 (Henry et al. 2002). Environmental health and justice activists have responded to the emergence of molecular genetic and genomic techniques both with curiosity about their potential for enhancing advocacy efforts and with intense criticism of what they see as the limitations and dangers of looking for the causes of human health and illness through a molecular genetic lens.
The critiques of EJ activists highlight the population health implications of environmental health research. A critical issue is whether environmental inequalities are an underlying cause of pervasive health disparities in the United States (Brulle & Pellow 2006; Evans and Kantrowitz 2002). There is evidence that income is often directly related to environmental quality; likewise, there is evidence that poor environmental quality is related to multiple physical and psychological health outcomes (Evans & Kantrowitz 2002: 324). These associations hold for exposure to a wide range of suboptimal environmental conditions (e.g., hazardous wastes and other toxins, ambient and indoor air pollutants, water quality, ambient noise, residential crowding, housing quality, educational facilities, work environments, and neighborhood conditions). Thus, it is possible that “the accumulation of exposure to multiple, suboptimal physical conditions rather than any singular environmental exposure” may accounts for the inverse relationship between income and a wide variety of health outcomes (Evans & Kantrowitz 2002: 304; see also Williams et al. 2010). Consequently, researchers have suggested that integrating data on environmental inequality and its health impacts into the existing research on health disparities is critical to efforts to understand the causes and identify solutions to the ongoing problem of health disparities between demographic groups in the United States (Brulle & Pellow 2006). These concerns about health inequalities have shaped the meanings of research on gene-environment interaction in the environmental health sciences, as well as the efforts of scientists and regulators to build consensus around the potential applications of genomic knowledge in risk assessment.
NOT JUST GENETICIZATION
In its analysis of the ascendance of research on gene-environment interaction in the environmental health sciences, this book contributes also to recent efforts to push social scientific analysis of molecular genetics and genomics beyond the geneticization thesis. Geneticization refers to “an ongoing process by which differences between individuals are reduced to their DNA codes” (Lippmann 1991: 19). Fundamentally, this approach asks us to consider whether and how genes are understood to be the primary cause of health, illness, and other forms of human variation. The concept of geneticization has been at the center of much social scientific analysis, where it often serves as connotative shorthand for a number of interlocking concerns about the myriad potential negative social implications of genetics; however, research suggests that the consequences of molecular genetics and genomics are more complex and contingent (Freese & Shostak 2009). Moreover, I contend that if, following the lead of the geneticization thesis, our analyses focus primarily on the extent to which scientists continue to study environmental causes of variation in human health and social outcomes, we miss the opportunity to observe profound changes in how genes, environments, and human bodies are conceptualized and operationalized in scientific research.
Therefore, in contrast to the geneticization thesis, I draw on the work of social theorists and historians of science to conceptualize the ascendance of research on gene-environment interaction as the molecularization of the environmental health sciences (de Chadarevian & Kamminga 1998; Kay 1993; Rose 2007). The molecular vision of life visualizes, operationalizes, and seeks to act upon life itself—including genes, environments, bodily variations and behaviors—at the submicroscopic level (Kay 1993). The molecularization of biology and medicine began in the 1910s, bringing profound changes in understandings of the causes and appropriate treatment of disease. Broadly speaking, contemporary uses of pharmaceuticals, vitamins, and hormones in biomedicine have their origin in the molecular vision of human health and illness (de Chadarevian and Kamminga 1998: 4; Sturdy 1998). However, even as some disciplines, such as biology, have been extensively molecularized, others, including the environmental health sciences, continued to conduct many of their operations well above the molecular level. For example, while specific domains of toxicology have made use of molecular biological technologies and concepts (Frickel 2004), many of the most important indices of toxicity used in toxicological risk assessments exist at what scientists describe as the “phenomenological” level: body weight, organ weight, level of activity, tumors, and death.49 In environmental epidemiology, researchers historically focused on the relationships between exposures, disease, and death at the population level, without looking inside the “black box of the human body”