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Dr. Bertram Carnow discusses the environment and pollution

BROADCAST: Aug. 24, 1973 | DURATION: 00:55:24


Interviewing Dr. Bertram Carnow about environmental health, air pollution, and occupational diseases.


Tap within the transcript to jump to that part of the audio.


Studs Terkel I suppose every person when he goes to work each morning comes home from work, wonders if it's fog, or smog and there is coughing, and science and medicine have made advances and, yet, we know there are new ailments in the world. There's something called pollution. Something they call new kinds of poisonings. We're really talking about the quality of life, and the best man I could think of to talk about it is Dr. Bertram Carnow, who knows more about the new ailments in the world that afflict us. The new plagues that we, we or institutions bring upon us. Dr. Carnow is the professor and head of the Department of Occupational and Environmental Medicine, University of Illinois School of Public Health. He's on the Environmental Health Resource Center, and he's an Advisor General, he's an adversary when the government asks someone to offer an opinion that challenges the accepted one. Where do we begin? We talk about how advan--we--our health and pollution and how you and I feel and people listening in the world.

Bertram Carnow Well, I think that we begin by trying to define where we we're at, Studs, and I think that we're unquestionably at a crossroads. Everybody knows this now in regard to a whole series of things. The American people are becoming schizophrenic and anxiety-ridden. They're being told either you have an automobile or you walk, or you have pollution. Either you have air conditioning and energy or you'll have pollution. They're being given a choice of either being deprived of something that's become essential in industrial society or exposing themselves to something that they know is bad for their health. And I think that the first thing we have to do is try to define where we're at, where we're going, and then how do we begin to make rational decisions about what's real, what's good, and what is the essence of the quality of life. And I think that we've gotten lost. And I think that we have begun to document what the consequences have been of getting lost, the serious consequences.

Studs Terkel The first question is raised always in either/or terms, isn't it? Either/or?

Bertram Carnow That's right, because what's happening is that we permit, because there is no direction, structure, and real organization, we permit things to reach a point where they achieve crisis proportions. And then the alternative, the reaction to this, the solution to this, is usually poorly conceived and begins to enhance a whole new set of problems. We, I think, don't have the vaguest idea about the enormity of this question and let me tell you a horror story which might set this in perspective. Some time ago, my wife, Virginia, who is involved in this work with me, and I were asked to consult for the city of El Paso because they had a very large smelter that was belching out huge quantities of sulphur dioxide which is a toxic gas that we have in Chicago, too. And I asked to see the emission data. The material, you know, what is this plant putting out so that I'd be prepared to discuss it intelligently. And when I looked I found that this plant was putting out 800 tons of lead a year. Now, lead's immutable--it comes out and it stays there, it doesn't go away. And it comes out in the air and I spoke to the health commissioner and I said, "Well, what about lead poisoning? I don't know about sulphur dioxide, but you've got to have lead poisoning in El Paso." And he checked with all the pediatricians and he said, "We haven't seen a single case of lead poisoning in El Paso." Well, there's a little town near the smelter called Smelter Town, it's a Mexican-American community, workers and children of the workers who work in the plant, and the rest of El Paso is separated by a little mountain. And so we said, "Well, give us blood specimens from these children and from the children on the other side of the mountain, and let's see what we find." And we found about 30 kids with blood, with lead poisoning. And we found kids with all sorts of symptoms and all sorts of abnormalities. And then the company came in and tested the kids, and they found more kids than we did. And 45 children had to be hospitalized. Well, they tried to clean up the town. The lead was everywhere. It was in the air. It was in the dust in the homes. It was in the soil. We went down three inches in the soil, and the lead content there was enormous, which means it has been going on for 50 years. In addition to the fact that the lead was also blowing into Juarez, Mexico. And ultimately what happened was that the families were moved out, the town was abandoned, they were put into public housing, and the place is leveled. And today in El Paso there's a small wasteland where nothing will live.

Studs Terkel Now, why didn't the authorities know it would--what did they think it was?

Bertram Carnow Well, what--nobody knew. Nobody thought about it. The kids had--you see, when you get lead poisoning you don't have it written across your forehead. It's a bellyache. It's a lethargic child-- Sleeps all

Studs Terkel

Bertram Carnow Retardation. Sleeps all the time, it may be a retarded child. And ,so, you say, "Well, it's a, you know, quote cultural, deprived, schools are not good." You can say a lot of things.

Studs Terkel Yeah.

Bertram Carnow And they, all of them may be true. But there's an additional fact--I recall the priest saying to me, he said, "My God" he said, "It was under our noses all the time." and literally it was.

Studs Terkel This raises the question before we go on to talk about the amount of energy and you finding out the direct incidence of lung cancer and pollution and heart attack and pollution and the effect of aerosols. New word used these days, new thresholds, a phony word. The smelter. Right? There's a smelter that provides jobs. There's the Alcoa plant along the Ohio River I saw that provides jobs and pollutes the whole community. This is a question that often comes up, doesn't it? Must the smelter exude lead poisoning?

Bertram Carnow No.

Studs Terkel Or is there another way? Ah.

Bertram Carnow No, there are controls, and the interesting thing is that the reason that they got a pass from the government was because they had all of the controls, but there were two things: They had some openings in the building, so a lot of lead blew out. They had a slag pile. And the wind blew the lead from that. And one of the things that it's alleged that they did, I didn't see it but I was told this, is that they had precipitators which collected all of the dust during the day and then it has to be cleaned out. Well, rather than clean it out, they turn it off at night and just blow it out at night when nobody's looking. Now, I say I didn't see this, but this is what they said.

Studs Terkel So, now we come, remember at the very beginning, it must be either/or.

Bertram Carnow No, absolutely not.

Studs Terkel We come to the big

Bertram Carnow question. Absolutely not.

Studs Terkel Jobs or jobs and illness and death, or no jobs and health, you see.

Bertram Carnow No. No. These are not the choices. These are choices that are being given to the people, but they're not real choices. I think that there are many ways to go about this thing. Number one, you have to begin to predict. Now, the Environmental Health Resource Center, which is part of a state agency, the Institute for Environmental Quality, is trying to do that. We're trying to define what are the hazards, environmental hazards, that the people in Illinois face? Based on our economic growth, where will they go in the next 10 years? And if you know that, you can begin to turn off these things without interrupting economic growth, without affecting the people's health, and so on. Because at the same time that you're planning and distributing your problem and developing new technologies to control these bad effluence, you also are surveying the population to make sure that they're being protected. And this is where they made their big mistake in El Paso. They were looking at the plants and they were looking at the precipitator, but nobody was looking at the people.

Studs Terkel Ah. So as you see it, of course, there has to be the whole general.

Bertram Carnow That's right.

Studs Terkel So about a couple of weeks ago, your findings made the front page of the newspaper. Arthur Snyder, the science editor of "The Daily News" had a long story about it. And we come now to us, Chicago, but all over the country, and you found a direct incidence of lung cancer and pollution.

Bertram Carnow Well, we have found a whole series of things. We've been involved in this for a long time, and I think that except for the federal government doing much of the research on some of these air pollutants like sulfur dioxide and so on. And there were problems with doing these studies. The problems are difficult. The problems are complex. You see, people work in different places. People live in different kinds of homes. They have different kinds of heating systems. You know, there were a lot of poor people, for example, who the landlord turns the heat off on very early in the evening. A lot of these people open their gas ranges and use the gas for heating. Well, that has to be vented because that puts out a lot of carbon monoxide. It puts out a lot of nitrogen compounds. And I've been very concerned about this for a long time, because particularly, you know, to keep the cold out, you take all the windows, you put the towels and blankets and newspapers around them, and then you turn on the gas. Now even when the gas is burning, I'm not talking about gas that's going when there's not no fire. But even with the fire, you still put out a lot of carbon monoxide, and a lot of nitrogen, these are toxic materials. I'm very concerned about this kind of thing, but it's very complex. Some people smoke, some don't, we know cigarettes, for example, do a lot of damage to the lungs. Probably more than almost any other factor in our society.

Studs Terkel What about the cigar in my hand that I'm puffing right now?

Bertram Carnow Well, cigars are not quite as bad, although if you inhale them, they're worse than if you don't. With cigars, there's a tendency toward cancer of the tongue.

Studs Terkel Or the lip.

Bertram Carnow Or the lip.

Studs Terkel A la Freud.

Bertram Carnow That's right. The same thing with the pipe. Cigarettes get down deeper, and, so, they deal with cancer of the lung. Now, how do you separate what does air pollution do, what the cigarettes do? Well, we did a whole series of studies looking at this, and we examined not only groups of people, but whole states. Dr. Paul Meier at the University of Chicago and I looked at the 48 states and the big cities and we looked at 20 different countries and we began to examine this. Now, people say, well, with all of the complexities and people moving around, and lung cancer is a disease that takes 20 years to come on, how can you show relationships when you know the story about if given a fulcrum and a big enough lever you can move the world, well, given a large enough computer, and given enough variables into that computer, you can get answers that are really valid. And so we looked at this and we found that the more the air pollution, and we used a thing called benzopyrene as an index of pollution because benzopyrene is one of the pollutants, it does cause cancer--

Studs Terkel What's it called?

Bertram Carnow Benzopyrene.

Studs Terkel And this is the result of--

Bertram Carnow Well, it's been in the coal, it's in cigarettes, it's in industrial smoke, if you paint it on the skin of rats it'll cause cancer, if you have dogs breathe it in, it'll cause cancer, and dogs never get lung cancer. So we use--

Studs Terkel You say dogs never get lung cancer?

Bertram Carnow Not spontaneously, no. But if you get them to breathe benzopyrene, they will get lung cancer, and so will guinea pigs and so on. So we use that as an index of pollution, knowing full well that there are a lot of other things in the air that might also be related. And we found that for every unit of this material, there was a five percent increase in lung cancer. And it's our estimate that if you reduce air pollution by 60 percent, you'll reduce lung cancer by 20 percent. And if you get people to quit smoking, and the Lung Association in Chicago and other places have been working very hard at this, as has the federal government, you can get people to quit smoking you'll knock out another 70 percent. Now, you know what this means. Lung cancer was relatively rare 30 years ago. In women it was so rare, it was reportable in the medical literature. Last year, it killed more men than all other cancers combined. And while other cancers have leveled off or have gone down, lung cancer continues to skyrocket.

Studs Terkel So now we come to an interesting point here. You mentioned cigarettes, but suppose that many people have cut out cigarettes. You're now implying lung cancer from none cigarettes, from another aspect. Now we come to industrial pollution, don't we?

Bertram Carnow Right. Right. Right. And, you see, again, what we're coming down to is this: We look at the diseases that Americans are dying from. Now in 1900's, one out of every seven men over the age of 45 died from TB. Today, there's still a lot of people dying from TB in selective areas: Puerto Ricans, Indians--

Studs Terkel Blacks.

Bertram Carnow Eskimos, Blacks, Mexican-Americans, so on. But for the rest of America, the deaths from lung--from tuberculosis are very small. So we have in many areas conquered infectious disease. When we conquer poverty, we'll conquer the rest of infectious disease because infectious disease breeds where there are poor people, but more than that, Americans are dying from industrial types of diseases. Now, people don't think of heart attacks as industrial type disease, but it's the product of an industrial society. It's the product of cigarettes, stress, high-cholesterol foods, carbon monoxide in the air, all of the other things that are there. A man did a study on rabbits and he showed that if you took rabbits, fed them a high-cholesterol diet like the average American eats, you know, butter, fatty meats, eggs, and all this, and then expose them to carbon monoxide, he had an incredibly rapid development of hardening of the arteries. Now, over a million people in this country die from diseases of the heart and the large vessels. Over a million people a year. And the terrible problem with the diseases that are killing Americans, heart attacks, lung cancer, bronchitis and emphysema, stroke, these diseases all are very quiet, they are very insidious, they take 30 years to develop, or 20 years, and when they come on, they either kill you immediately or they kill you very soon after.

Studs Terkel Now these are the diseases that affect people of all economic strata.

Bertram Carnow That's right.

Studs Terkel No one is immune from these.

Bertram Carnow That's right. Nobody is immune from these diseases. And women didn't get much lung cancer, but they've been liberated, they'll buy cigarettes, and--

Studs Terkel Do you remember Dr. Maude Sligh, that marvelous woman who worked with mice [at?] University of Chicago?

Bertram Carnow Yes.

Studs Terkel She was the [first?] person I remember who spoke of women having, as you say, rarely lung cancer. And then she said they started smoking, and then she started doing some surveys.

Bertram Carnow Last year 12,000 women.

Studs Terkel But now we're talking about more than cigarettes, obviously, more than a personal habit, we're talking now about institutions and industry and pollution.

Bertram Carnow Sure. Because you see, unless we begin to ferret out all of the causes of these diseases, and each one of them has more than one cause. And unless we begin to practice preventive medicine, that means eliminating the cause, we're not going to make any impacts on longevity in this country, because once a man has a heart attack, you know, he's there. He may function after that, but not like it was before. Lung cancer, the cure rate five percent, ten percent.

Studs Terkel Has there been, by the way, this is the usual question, has there been a real breakthrough, or my real question is, suppose there were a crash program similar to the one, say, making instruments of destruction. You know, it'd say instead of emphasis on the Pentagon and the technicians and scientists that work to destroy, to make new kinds of napalm, bacteriological death, suppose that same energy were devoted to attacking cancer. You think by this time we'd have been closer to a breakthrough?

Bertram Carnow Well, you see, you ask that question and yet, if you looked back a minute on what we were talking about, if we can cut air pollution in this country by half, and get people to quit smoking, you'll remove 95 percent of the cancer that's killing more American men than all other cancers combined. So we have a lot of the answer. Now, we don't have the answer to the mechanisms of what makes a cell change. And I agree with you. I think our priorities are weird. You know, we have to begin to direct our efforts in this area, otherwise we're going to be in serious trouble. But I think, again, that there are handles, and there are ways to go, and part of our problem is that we have to know the way to go. You see, we again are reacting to emergencies. We take the automobile and we say, "Okay, it's got a lot of pollution. And what's the solution to that? We're going to get a catalytic converter and we're going to put that on the automobile, and that's going to take out a lot of the hydrocarbons and a lot of the nitrogen and a lot of the oxidants and so on. But it's going to do other things, and we haven't evaluated that. You know, there's some sulfur in gasoline; now, normally it comes out and has dissipated. But now when it comes out of a converter, it may come out as sulfuric acid mist.

Studs Terkel You know, I'm not up on mechanics and automobiles, but I know not Ralph Nader alone speaks of the automobile that can be non-polluting, that is [there?].

Bertram Carnow Oh, sure.

Studs Terkel Yet, the industry, of course--

Bertram Carnow Well, there are two things: there's an automobile that can be non-polluted, and there also, you know, is the thing called public transportation, which in the long run is going to be the only way to go.

Studs Terkel So we come to that, don't we?

Bertram Carnow Yeah, the automobile kills hundreds of thousands of people each year. Fifty thousand accidents, maims millions. It costs us incredible amounts of money, and has become the focal point to the whole economy, which is one of the reasons why we can't do anything about it. You see, we've been caught in this bag and are in danger, I think, of committing technocide, you know, which is--

Studs Terkel Technocide.

Bertram Carnow Technocide. We're being pulled by the thing, and even those who would like to do something about it find that they get caught up in "We need the automobile." It's become a symbol of virility, a 440 horsepower car is become the big thing, you're not a man without that and a Marlboro in your mouth. And the other thing--

Studs Terkel Even though you're a dead man.

Bertram Carnow Even though you are, yes, even though you're a dead man. We've been caught up in this and then we get into this thing, "But look at all of the millions of jobs that are involved with the automobile," and so on and so on. And how do you stop this kind of

Studs Terkel Well, here we come back again, don't we, to the either/or matter.

Bertram Carnow That's right. Well, what this means is planning and phasing and retraining and understanding where we have to go. Because it's obvious that we just can't continue to produce more automobiles, build more highways, and so on. You know, ultimately we're going to wipe ourselves out.

Studs Terkel Your point is there are alternatives where--

Bertram Carnow Oh, sure.

Studs Terkel Man can enjoy the quality of life in the last part of the 20th century without these plagues.

Bertram Carnow Absolutely. Absolutely.

Studs Terkel Mass transportation for one.

Bertram Carnow That's right. That's one big answer to this question. You see, one of the things that everybody has to understand is that, there's a question here of exponential growth. I think people have to know what exponential growth means.

Studs Terkel Ex- what?

Bertram Carnow Exponential growth, because that's the thing that's going to destroy us or destroys us.

Studs Terkel What is exponential growth?

Bertram Carnow Well, what it means is this: You know, if you have money and you invested it at seven percent in the bank, and you leave the interest in, your money will double in 10 years, because not only is the original money working, but it keeps increasing and then you're working on the increase. So when you start with 100, you're not just increasing by seven each year, you're increasing the first year 100, the next year 107, and so on and so on. This is like the story of the man who gave this potentate a marvelous chess set made of hand-carved ivory, and he said he'll give him forty pieces of gold, and he said, "I don't want that." He says, "You have this chess board. Just give me one grain of rice for the first square, and double it for each square." And by the time he got to the 30th square, he had broken the bank. This is what exponential growth is. Now what that means is that when you get to a high point, doubling one time can cause catastrophe, so that if catastrophe occurs, it will happen very suddenly. Because you go from a small amount and then you double and double and double. And then when you double something big, you get something which becomes overwhelming. Now, the Club of Rome, I don't know if you know about this.

Studs Terkel I think you should talk a little bit about the Club of Rome.

Bertram Carnow Well, these are a group of scientists who got together, concerned about the future, and they had MIT, the people at MIT, to look at the whole question of growth, the limits of growth, because it's all tied up, you see. And what happens is you have a bunch of feedback loops, you know, you have industrial growth and you produce machines, which produce more industry, and that can afford to feed more populations, you have more people, and then you have an industrial society, more education, more scientific discovery, less people dying, and so you create a situation where one thing chases. Again, exponential growth of industry, exponential growth of people, exponential growth of energy. Our energy is doubling every 10 years. Now when you say doubling, you know, a doubling 50 years ago is this tiny amount of money--of energy. A doubling now becomes frightful, you see, because you're talking about doubling billions instead of doubling millions.

Studs Terkel So the whole species, man, is liable to die of the plague called progress.

Bertram Carnow Technocide, yes.

Studs Terkel Technocide. We come to this crazy irony. You say there are alternatives and this is the point we're talking about, throughout are these alternatives, you see.

Bertram Carnow Now, you know, what are the alternatives. Let's take energy, because this has become a very big thing now, where the Rockefeller Foundation has set up a whole series of task force to look at energy and to look at the future, to look at it politically, to look at it socially, to look at it economically. And the American Public Health Association has asked us to set up a national task force for the Ford Foundation to look at the health effects of energy alternatives. So for the first time we're beginning to look at the future, what are our alternatives in energy and which one do we use, and what we've done is this: We haven't finished the report yet. But what we're doing is this: We're taking each energy process. We're taking coal and we're starting all the way from exploration all the way to its ultimate use. And we're saying if you double the use of coal, for example, we can determine, based on whether we just want a skyrocket in energy, whether we want to keep on going the way we're going, whether we want to go down, how much energy we're going to need by the year 2000, by the year 1980. We call it Megawatt sea.

Studs Terkel Call it what?

Bertram Carnow Megawatts.

Studs Terkel Megawatts.

Bertram Carnow Yeah, this is the pure energy we need. And then we know how many heat units, we call this BTUs, we need to get those megawatts, and we know how much coal you have to burn to get these BTUs. So we can determine how much coal we need, and then we say, "If you're going to double the amount of coal you mine, how many workers will be killed in accidents? How many more men will get coal miners' disease? How many people will be killed in transporting the coal? How many people will it affect in terms of air pollution? And so on and so on. And we try to determine a health cost for coal and then we look at nuclear energy, and we say, "What does this mean? How many people will get sick and die from nuclear energy?" Nuclear energy is the one that frightens me the most. I think we're probably going to have to go nuclear because if the American people are going to demand the amount of energy that they seem to be demanding, we're not going to be able to get it from just fossil fuels. Now, one of the things I think is an alternative is reducing the demand. You know, for example, if we insulated homes better, you could reduce energy needs by an incredible amount. All you have to do is insulate a home better.

Studs Terkel As you're talking, this is very interesting to me. Dr. Bertram Carnow is my guest and he is about the best, the most best-versed man there is in the country in the matter of polluted ailments and progress and plague. He just said if they insulated homes better, he also talking about if there were better craftsmanship. If people were more--had a sense of personal worth about their work. If the ledger were not the prime impulse of institutions, you talk about all these matters, too, that are related to everything.

Bertram Carnow You see, when you talk about architects, you're talking about health professionals. When you're talking about engineers, as far as I'm concerned, you're talking about health professionals. Now they just see building a bridge or a house with a certain tensile strength and a certain distance, certain math at a cost. I see building a house as a structure where humans can live with dignity and we build, you know, what is a rational society. And it does come down to pride. It does come down to a sense of worth, it does come down to creative effort, and it comes down to more than that, it comes down to looking at what is the objective of what that we're doing. People don't look anymore at where are they going or why are they going there. And this, I think, relates to this whole question.

Studs Terkel Of course. It's funny--

Bertram Carnow You know, in terms of workers, of course, as you have pointed out, this is becoming a very serious problem.

Studs Terkel There's something else here and we come back to that recurring theme we cannot escape, and that is the specialist. The specialist, the man who builds that bridge, it's a great bridge, but it has no connection with the rest of society. And, of course, this is Lewis Mumford's theme throughout. This is what's been obsessing Mumford all his life, who was a generalist in the best sense, that everything you do is related to something else. And this, in a sense, is the core of the play.

Bertram Carnow It obsesses me, too, which is why I've been working in the School of Public Health, because I have working with me chemical engineers, industrial hygienists, toxicologists, physiologists, I even have one young minister who had a church in Gary and who apparently saw hell in the coke ovens and has decided that the way to go was to look at diseases of workers and try to define how to turn those off so that these kinds of people, the creative people, the people who look beyond their discipline and their way of doing it, you know, let me talk about one other thing, but I would like to get back to nuclear energy, because I think that's a critical question. The question of threshold. See, there's a contest going on.

Studs Terkel Could we just for a moment, you use that word threshold. And this leads to something new, a new word in a vocabulary. Dr. Bertram Carnow is my guest and he's head of the Occupational Environmental Medicine Unit at the University of Public Health, University of Illinois, and advisor in many commissions, and we'll return in a moment to the matter of progress and the new plagues in the world and they need not be. In a moment with Dr. Carnow. We were just talking about thresholds. It's a new word we hear, don't we, a lot. The new threshold.

Bertram Carnow Well, we're hearing a lot more about it. It isn't known in an industrial sense. There has been for years promulgated a level for most of the common toxic substances used in industry which is supposed to be a level at which a worker can work for eight hours a day for all of his working life. And one of the things that we're finding out is that threshold, really, is a non-existent word. How we use it. But, you see, when you deal with it with a working population, you're talking about what we call a survival population. What happens is that you have a work group. They seem to be able to work under certain conditions of pollution, and they don't seem to be affected. But what's happened is the ones that have been affected, have been driven away, will have died. And, so, what you're examining is really a safe level for a select population. Now, one of the things that anybody physiologically knows is, that each individual might have a level which may be safe for him, for any toxic material, but it may not be safe for him if he's got a bad cold. It may not be safe for him if he didn't eat a good meal or if he's fatigued. So even within a single individual there is no safe level of anything. It varies with his state of being. But between individuals there is certainly none. Now, we have developed air pollution standards. They're a necessary first step. And what they did was they went out they looked at levels which our people doing studies found hurt the people they were studying, and they said this is a level that seems to hurt people. Let's add a safety margin and call down a standard and that's a good first cut because we had very little to go on. But we have to go beyond that. We have to begin to say, "Who are the risk populations? How many asthmatics do we have? How many newborns are there in a population? How many people with chronic lung disease? How many people with heart disease? And what does air pollution do to them?" And then we can say, if we double the level of air pollution, we're going to kill 1000 more people, 2000 more people. And this is the only way to make decisions because you can't have a non-polluted world. The question is, how do you protect most of the people? And it may ultimately come to a point where we say, "If we reduce the pollution less than this, we're going to have to turn off air conditioning or lights, and a lot of people will suffer from that physically because the sick people will die in un-air-conditioned areas more than they will in air-conditioned areas. We have that quantity on the one hand, and then we say "Okay" when we look at the high-risk populations. This may increase deaths among five people or 10 people. Let's take those people and remove them from this thing, because you see, there's a contest going on all the time, because people, humans, and their environment, the environment is always hostile. There are germs, there are pollutants, there's heat, there's cold, and people are in the contest. Now, everybody has a bag of defenses. Newborns don't have as much. Old people don't have as much. Asthmatics don't have as much to fight off pollution. But this contest is going on all the time. Now, if you can fight off this environmental insult, this is called adaptation and that means you live. If the insult is so strong or your resistance is so low, then you're overcome.

Studs Terkel Yeah.

Bertram Carnow And you die. This is what death is. Now in a clean environment, in Shangri-La, you get old gently, gracefully because the environment is not very hostile and--

Studs Terkel Go ahead, I'm sorry.

Bertram Carnow No, ultimately you die. But, for example, if you fill a room with chlorine, everybody in that room will die because nobody can adapt.

Studs Terkel Ah, now we come to it. The environment, the natural environment need not be always hostile. Isn't the fact that--we'll come now to aerosols, this matter of chlorides and cleaning up. The fact that some germs are more or less natural to this--

Bertram Carnow Oh, sure! Now, now, you know, without germs you can't live, because they process foods. And when I say hostile, I say that the environment is continuously changing and the organism, the human, has to change also in relation to it. In that sense it's hostile. You'll have to take in food, you have to process oxygen, you have to get rid of waste. You have to fight off bacteria all the time, and given a reasonable chance you can do it. But if the environmental insult increases, if you add to these germs irritant gases that break down the defenses of the lungs, then you permit those germs to invade and destroy.

Studs Terkel Yeah. What about these new commercial products such as aerosols that are supposed to clean us?

Bertram Carnow Well, this is the other thing that that bugs me so much. You know, we create industrial society and we say we want to create better things for more people and a better life for everyone.

Studs Terkel Through chemistry.

Bertram Carnow Through chemistry or whatever it is, everybody's got his own thing. And then what happens? You know, first we were told, you know, cigarettes and it's virile, and you're grown up if you smoke, and and we were all psyched out with this thing. You know, during World War Two we were on K rations and three times a day we got four cigarettes in that package. That was our dessert. And we all smoked because of that. And that became a crutch. You know. And now--

Studs Terkel That's where I learned to smoke, by the way.

Bertram Carnow That's right, that's where I learned to smoke. Of course. Of course. And it's a continuous fight to keep from smoking again. It's an insidious and deadly habit. And then, you know, we're told other things, that the car is a thing. And, so, we become alienated from each other. You know, one of the nice things about riding on public transportation is people look at each other, occasionally they smile particularly if there's a child there. Adults tend not to smile at each other. There's a child doing something cute, people seem to relate to each other more. But otherwise we were isolated in a steel and glass tank and--

Studs Terkel And there's something else, Dr. Carnow. Bert, there's something else here, the air-conditioned car with windows closed. It's just--this is related. Not only to what you're talking about, isolated, the isolation of the air-conditioned car. I think I was passing out some leaflets for the Farm Workers Union in front of all the food stores in town. And I was able to reach a lot of people, but couldn't get at those whose cars were air-con--didn't hear me, didn't see me, there they were, isolated in the glass booth.

Bertram Carnow That's right. That's exactly--

Studs Terkel This is part of it, too.

Bertram Carnow Sure. I think it is part of it, it's part of alienation of society. This, certain aspects of television, people don't communicate anymore. Now, that's part of our problem and we have to, because, you know, it's a closed system. But to get back to this other thing, we've now been sold a huge bill of goods. We've been told that the biggest, new, greatest thing in our lives are aerosols in a number of different ways. Number one, I think the American people have all been convinced that they smell bad and they've been convinced that they should all smell the same. And we now have a something which makes us all smell the same. Having been convinced that every opening in the body is unclean. You know, this is, this deprecates humans. It undignifies us. I remember my father was a printer, and he used to come home and he'd smell from printers' ink, and we used to love to snuggle up and get that thing and that was him. Well, now everybody smells in the same deodorant. And how can anybody tell who anybody else is?

Studs Terkel It's funny you mention that your father smelled of printers' ink and there was his uniqueness, a guy I know remembers the Depression. His father was a carpenter. He'd come home, he'd smell the sawdust on him, you see, now if we all smell the same, we become the things, don't we? Go back to that again.

Bertram Carnow And, you know, some 400 million dollars' worth of underarm deodorants. Now, there are a lot of people who are sensitive to these things. They cause irritant rashes. You inhale these things; for example, they've now come out with a big improvement and now they've made a dry deodorant with talc. Well, talc is deadly if it's inhaled. There's a disease called talcosis. It's like silicosis. Now, what does it mean that somebody begins to use this and uses it the next 30 or 40 years? Talc under the bombs. Talc all over the body, talc after the shave. Now what the heck was wrong with putting talc on your hand and putting it on your face? When you push something out of an aerosol, you'll put it into a size that is millions of an inch in diameter, which means it gets down into the lungs where it can do all the bad things that it's gonna do and has a lot of trouble coming out. Now, we don't know what they do. That's what concerns me even more, we just don't know. You take something like furniture polish. And furniture polish is deadly. If a child swallows a teaspoon or two of furniture polish, it may be enough to kill him. But putting it in a spray. Now, we don't know what happens to it when it gets down into the lung. But you have to understand that between the air sacs of the lung and the blood there are just two cells thick, that's two or to five millionths of an inch thick, and there a lot of things that can get across that membrane. And there are a lot of irritant materials. Oven cleaners. There is carbolic acid, which goes under [unintelligible] disinfectant and you see on television, they say spray the nursery and spray the this and spray the that, well, those things are toxic. We don't know what carbolic acid does when it gets down into the lungs of an infant.

Studs Terkel So we're talking about commercials that kill.

Bertram Carnow No, commercials that are potential killers. I don't know whether they are killing or not. We are part of a huge experiment. We may not know the answer to this for 30 years. You see, they're insidious.

Studs Terkel We'll be sanitized, but sanitizedly dead, is the point, like a cosmetized corpse.

Bertram Carnow Something like that there may well be the case. And part of the problem of doing research on this is that it takes many years to find the answer. I've had two women who unquestionably had thesaurosis.

Studs Terkel What is thesaurosis?

Bertram Carnow Ah, it's a new disease. Thesaurosis is disease from hairspray.

Studs Terkel Thesaurosis from hairspray.

Bertram Carnow Yes. Now, hairspray is a what we call soluble, and for most people it may not be bad, but there are people who are sensitive to it, who may have allergies to it, and there may be impurities in it, and people use it in incredible quantities every day. I got a letter from a young girl who saw an article I wrote on this, and she did something which won a first prize in high school. She took two plants and put them in the bathroom and then she put a piece of plastic. And every morning when they went in to spray their hair, they sprayed the piece of plastic and they sprayed one of the plants. And when she got through, she had an exhibit which showed this plastic covered with this terrible gunk, and that plant had died and the other plant lived. And I think that people have to recognize if people are going to use these sprays, and why they use them I don't know. You see, first of all, you get cheated, you don't get as much in the can. Secondly, they're under pressure. And the potential for exploding is always there if they get hot. And thirdly, they're delivered in a size which gets them into the lung and makes them dangerous. Now, these two women are both beauty operators. They were relatively young women, they came in with a severe unremitting cough. They never stopped coughing, one of them carried a little jar of water in her purse so that she could sip at it, which helped her with her cough. She died at the age of 42. And both of them had this density in their lungs on the X-ray that represented pounds and pounds of that material which had gotten on it.

Studs Terkel So thesaurosis could be a new occupational disease of a beauty operator.

Bertram Carnow Yes.

Studs Terkel What you're saying. Like the asbestos workers and the lungs.

Bertram Carnow Well, but you see beauty operators, if they are sensitive to the hairspray, they get out of the business. I am more concerned about the people in the homes all over the country who are using this day after day after day who may not know that they are sensitive to this, who may get colds or may get chest pain, or may have difficulty in breathing and not know it was from this.

Studs Terkel There's sort of an exquisite irony, a horrendous irony, to what you're saying, Dr. Carnow, throughout the new inventions to make us cleaner to improve quote unquote the quality of life that caused new plagues into the world that are not necessary because some of these particular products are not necessary, either.

Bertram Carnow Well, this was what I started out with at the beginning. The question of quality of life relates to rational-decision making about those things which are really important to us and those things which are not. And we're reaching a point now where we have to begin to think very carefully about the decisions we make. For example, I say we're going to have to have nuclear energy. Well, what have we done? The federal government has elected to go what we call "fast breeder." They're going to go to a form of nuclear energy which is very economical because as you use uranium you produce plutonium which you can then use again. So it gives you an unlimited source of energy. Well, what are the hazards of this? First of all. the possibility of an accident is much greater because they work at a much higher critical temperature. Secondly, you're producing plutonium 237 which is one of the deadliest things known to man. One one-millionth of a gram of plutonium, one one-millionth of a gram. That's smaller than a grain of sand. Injected under the skin of a guinea pig will give it a cancer. Now they are talking by 1985 of producing 30 tons of this material. They are talking by the year 2000 of producing 100 tons of this material. They're going to be shipping around the country. This material in very small quantities can make an atomic bomb. You know? So they say, well, they'll be very careful about it. Well, there was a shipment of uranium hexafluoride that was supposed to go from Missouri to Ohio. For 15 days it was lost. They found it in Boston.

Studs Terkel So it's possible that shipment lost if something leaked out that could have done it in for the 250 million Americans, too, possibly.

Bertram Carnow Well, I don't know about--well, it was spread out all over the country, it could, yes. And you see, plutonium 237 has a half-life of 24 and a half thousand years, which means that once it's in the atmosphere, it's there for the next thousand generations.

Studs Terkel What you're saying is, we live so close to self-imposed genocide, don't we? In a way.

Bertram Carnow I think that yes. You see, we say, "Okay, we'll contain this material." You know? But what if a tenth of one percent gets away? A hundredth of one percent? There was an accident at Rocky Flats in an experimental nuclear plant. And I guess they cleaned out the material and they had some plutonium-impregnated oil. And that was wind-blown. And so are grams of airborne plutonium circulating, and you got to understand that after 24 and a half thousand years, half of what was put in the air now will still be there, and the next 24 and a half thousand years half of that. So we're building and creating deadly things and we really don't have the means for controlling it. Now, there are nuclear reactors, breeders, which don't make pure plutonium. They may not be quite as efficient. They may not have been produced by the big company which is pushing the liquid metal fast breeder, and so on. There are other things too, you know, all of these atomic energy things produce waste which has to be stored and continuously cooled and continuously stirred because they get so hot that they will melt right through their containers and on and on. And in Washington, the state of Washington, they're leaking into the ground. Now the AC says, "Well, they are leaking in the ground in such quantities that they will never get to the water table." Now, how do we know that?

Studs Terkel You're talking about several things now, aren't you, Dr. Carnow? There's a touch of madness in the air. There's such a mindlessness in the name of progress, and there's also the ledger, too. There's the buck, isn't there? The buck that may make it for the guy but kill his kids and himself, too.

Bertram Carnow Oh, yeah, well, this is, you know, it's been happening in everything. Everybody who lives in a flooded house out in those Western suburbs because these homes were built on a floodplain, and everybody knows you don't build a house in a floodplain, know that this is true. You know, democracy doesn't mean that if you can get a piece of land for 200 dollars an acre you can build a town on it. It doesn't work that way, not in a closed system. We have to begin to plan. Where we build, how we build, how we live, what we do, where we go, and we're not doing it.

Studs Terkel So this is what we're coming to now, aren't we? I mean, this is the point you're making throughout, this is the undercurrent of all your conversation, is everything is related. Now, you, have you suggested, you as the adversary member of some of these commissions, have suggested--

Bertram Carnow Well, I'm not always the adversary member. I think that a lot of these commissions are genuinely concerned and interested in carrying out studies. The National Academy of Science, for example, carried out a very complex series of studies. And this was the one in which we elaborated the relationship between lung cancer and air pollution and so on. But I think that there is some recognition now at a federal level that there must be more planning. There must be more predictive capacity, and we can do that. Our computers, our models, our bioengineers, our systems analysts can do these things, then you don't have gasoline shortages. You don't have power shortages, you don't have brownouts, you don't have anything, you've planned. You know. And I think if you plan, then you can accomplish. This is an abundant world. It has a great deal. You know, they say we have a shortage, well, the coal is there, we just haven't mined it because it's easier to mine high-sulfur coal than it is to mine low-sulfur coal. There's enough coal under Illinois to, billions of tons, which can take care of us for many, many, many years. And again we come to the whole question of useless energy, the kind of energy that's used to light up buildings all night that don't have to be lit up all night, the kind of energy that goes into all sorts of products which are meaningless products. The kinds of air-conditioning systems we have, incredibly inefficient. You know, I'm sure that they can design air-conditioning systems that are much more efficient. We're building buildings now without windows. This is incredible, because you shut out lights, you shut out breeze, you shut out everything. And you say we are contriving a system where you have to use total energy. You have to have lighting all the time. You have to have air conditioning all summer and you have to have heat all winter. And nothing of what nature gives us is utilized. It doesn't make any sense.

Studs Terkel Which leads, of course, to the question of solar energy, doesn't it? That hasn't been use much.

Bertram Carnow Sure. There are a lot of new kinds of energy. Now, solar energy is a big problem in two ways. Number one, we haven't got the batteries or the storage facilities. We have to find new ways of storing energy, because solar energy is intermittent. The second thing is, with solar energy, is that it can only be done in certain parts of the country where you get a lot of sunshine and so on throughout the year and so on, and then you have a problem of transmission of energy because when you transmit energy you lose some of it. Okay, people are working on that. They're working on a thing called "superconductors" where you create a very cold environment in a conductor and at that point you use very little energy because there's very little resistance. Now, the problem with superconductors, if they spring a leak, they can be disastrous. There are, again, a multitude of solutions, each of which has its positive and its negative features. We have the capability, given the manpower, given the ability to train good people--and the federal government's taken that away from us, they took away all of our training grants--to train new kinds of people.

Studs Terkel Why'd they do that?

Bertram Carnow You'll have to ask them. I mean, you take NIOSH. The, we have a new safety and health act. They tell us we need 60,000 people, trained. I head up a Department of Occupational Medicine. No training money. All taken away, all training grants have been--that means we can't train people that are master of science or Ph.D. level unless they can afford it or by themselves and unless the state sustains all of the expense. Why they did this, I haven't the vaguest notion. It has to do with the kind of insane priorities that--

Studs Terkel We come to a number of things as we near the end of this conversation and before I go on said, oh I must ask a question. You've heard Dr. Carnow cough several times, and I'm puffing a good distance from my cigar. Is my cigar smoke depriving you of oxygen? It is, isn't it?

Bertram Carnow Well, it's not so much depriving me of oxygen, but it's irritating--

Studs Terkel Well, out it goes.

Bertram Carnow It's

Studs Terkel irritating, well, that's-- I promised myself long ago, once upon a time I was bawled out by Nader--

Bertram Carnow Well, that's all right--

Studs Terkel And I forgot.

Bertram Carnow Well, we--

Studs Terkel And I--here it is, out again, and I've got to remember. I always ask my guests, "Do you mind if I smoke?" And they should really reply, as Helen Broderick once said to Lester Crawford in an old vaudeville act, "I don't care if you burn." Back to the subject at hand. And that's, there are alternatives, if the priorities were there. And doesn't the ordinary person, now we come to something else, the authorities, the specialists, we always listen to the experts' expertise. What you're saying is understandable to everybody, pretty much, isn't it?

Bertram Carnow I think so. I think that we can explain to everybody. There is a problem in that these things are frequently oversimplified. And then the choices given to people are bad choices. But I think that, sure, the people want to know. I think that the people can know. I think that we can teach--I give the same lecture to medical students and to six-year-olds in grade school. You just change the language a little bit, but you can give them the same lecture with the same concepts and they both understand. Sometimes I think the medical students are more opinionated, they don't understand quite as much--

Studs Terkel Because we know this is happening in many parts of the country where nuclear reactors are being put in--

Bertram Carnow Oh, sure.

Studs Terkel And they suddenly they become, they know about it.

Bertram Carnow That's right.

Studs Terkel And the authorities become very upset--

Bertram Carnow Given the right kind of nuclear reactors, given using it at a certain level of efficiency so you don't get close to where you might have an accident, given keeping it away from people, given the kind of safeguards to prevent contamination of the air and the water, given all of these things, it becomes a relatively safe, efficient way of producing energy.

Studs Terkel So where does this leave us now as we near the end of this conversation with Dr. Carnow, Bertram Carnow, and pollution, energy, and quality of life and new plagues that need not be?

Bertram Carnow Well, you know, I think if I have to summarize this, Studs, I would say, number one, we have to define, really, what is it that we want. Where do we want to go? What commitments are we prepared to make? That's number one. Number two, we have to become informed, and the American people are capable of becoming informed, and they want to become informed, without things being oversimplified or used by one political force or another to sell something, or used by Madison Avenue to sell them an aerosol bill of goods that they don't want. Number three, we have young people who I think are thinking in a new way. We have to be given the ability, the facilities, to teach them because there are a thousand new professions. There are architectural health experts. You know, I'm a physician who talks to you about engineering and superconductors and energy, solar energy and so on. This is a new role for me as a--

Studs Terkel Yet, isn't it right, aren't you, in a sense--

Bertram Carnow Not only right, it's essential because unless you get this kind of multiheaded specialist--

Studs Terkel See, see, you are what Lewis Mumford is talking about, the generalist, that is, a man who is a specialist in his particular field, but a generalist and sees that what he does is related to everything else.

Bertram Carnow Everything else, of course. And it certainly is. And I think people with tubular vision are just avoiding dealing with the realities of life. But there are answers. And I think that man can be a reasoning animal. And I think that man can survive as a species. Now again, you know, when we talk about non-survival, we're not talking about everybody dying, we're talking about the structure, the fabric being destroyed. And I think that to avoid that, to maintain us as a viable society, indeed, achieving what we want to do, achieve the highest quality of life, we have to begin to define what's real, what's unreal, what's good, what's bad, what's meaningful, and I think we can do that.

Studs Terkel Thank you very much, Dr. Carnow, and coming back to the subject again of what is real and what is fictitious, what is necessary, what's unnecessary, what is rational, what is insane, basically comes back to that, and, so, we started talking about pollution. It's pollution, of course, of the mind as well as the body. Dr. Carnow is my guest, professor of, the head of the Department of Occupational Environmental Medicine, University of Illinois School of Public Health and a variety of other associations, medical director of the Lung Association. More important than that, an all-around man. Thank you very much.

Bertram Carnow Thank you, Studs.