July 1994 (vol. 10, #5) 1601 N Tucson Blvd #9, Tucson AZ 85716 c 1994 Physicians for Civil Defense

Once expected to be eliminated as a public health problem, infectious diseases remain the leading cause of death worldwide and are among the leading causes in the US. Infectious diseases account for 25% of all visits to US physicians. The direct and indirect economic cost is estimated to be $120 billion per year.

``The spectrum of infectious diseases is expanding, and many infectious diseases once thought to be controlled are increasing,'' according to a recent report from the Centers for Disease Control (CDC) (MMWR 4/15/94).

Contributing to the emergence of infectious diseases are social and behavioral changes, e.g. economic impoverishment; war; population migration; urban decay; globalization of food supplies; travel; sexual behavior; and use of day-care facilities.

While pathogenic microbes proliferate, the public health infrastructure is decaying. The Institute of Medicine of the National Academy of Science cites the curtailment of prevention programs; inadequate communicable disease surveillance; and lack of trained personnel (e.g. epidemiologists, laboratory scientists, and vector and rodent control specialists). Public health measures increase in importance with the development of microbial resistance to many existing drugs (e.g. malaria, gonorrhea, and pneumococci).

Pathogens Protected by Law

The CDC notes that ecologic change (e.g., deforestation and reforestation) may benefit the microbes. Not mentioned are the causes of some of the ecologic and social change (forcible intervention by the federal government) and the diversion of funds into surveillance for and abatement of minor ``pollutants'' and hypothetical carcinogens.

The protection (or actual creation) of swamps (``wetlands'') makes breeding grounds for mosquitoes. Mosquito-borne diseases are increasing in many areas of the world. These include dengue, yellow fever, malaria, and encephalitis. Although encephalitis was not found to be a problem in recent Mississippi floods, there are alerts in Florida near the sacred Everglades: high school football games have been cancelled because mosquitoes like to feed at dusk.

Mosquito population control is further hampered by the continuing loss of existing pesticides and the absence of new ones. New amendments to the Federal Insecticide, Fungicide, and Rodenticide Act (FIFRA) are pending before Congress. Both the Anti-Pest and the Anti-Anti-Pest forces are displeased by the proposed legislation.

FIFRA doesn't go far enough, in the view of Physicians for Social Responsibility (PSR). Testifying on June 15, PSR Associate Director for Policy Joseph M. Schwarz cited the group's long-standing concern for the ``particular vulnerability of infants and children to environmental contaminants.'' Having previously saved the Planet and children's teeth from Strontium-90 due to atmospheric testing of nuclear weapons, PSR now wants to prevent cancer due to pesticide residues. They call for ``action now'' in the absence of data to prove the innocence of the chemical suspects, although there is still no evidence that a crime has occurred.

On the other hand, William Hazeltine, PhD, of the American Mosquito Control Association testified that the amendments fail to provide a rapid procedure to approve pesticides needed to protect public health. He also noted that the Act would impede the use of biological control agents. It would require registration, labels, and accepted directions for use for every barrel of mosquito fish moved from one pond to another. Furthermore, Hazeltine stated, placing biological control agents under the EPA's pesticide registration authority would mean that ``any private property would be at risk of inspection by the EPA if it had mosquito fish on it due to purely natural causes, in addition to any that were purposely planted for mosquito control.''

The War on Drugs and Disinfectants

Not crack cocaine, but antimicrobials and other life-saving pharmaceuticals (along with pesticides, plastics, paper, pipes, etc.) are the targets of the anti-chlorine crusaders. Industry has an ``addiction to chlorine,'' according to Greenpeace director Barbara Dudley. Indeed, the chlorine industry accounts for about $100 billion of the US economy, and 370,000 jobs.

The attack on chlorine started with the paper industry. EPA's proposed rules on effluents would cost US paper manufacturers $3 billion in capital costs and hundreds of millions of dollars annually in increased operating costs.

``Next, we'll go after plastic and solvents,'' said Joe Thornton of Greenpeace (Science 261:152-154, 7/9/93).

Next, there's much more: 98% of US drinking water is chlorinated, and 85% of all pharmaceuticals require chlorine chemistry (EPA Watch 2/15/94). EPA Administrator Carol Browner has announced that she will ask Congress to authorize her agency to develop a strategy to ``prohibit, reduce or substitute for the [use] of chlorine'' over the next three years (CEI Update, May, 1994).

First, the EPA targets ``point sources.'' Next, they look for ``non-point sources'' such as your home or farm. The Chlorine Zero Discharge Act introduced by Congressman Richardson (D-NM) would mean that water disinfected with chlorine could not lawfully be drained into storm sewers from fire hoses, street cleaners, or lawn sprinklers (ECO, PO Box 191, Hollow Rock, TN 38342, 4/30/94).

Greenpeace invokes a ``public health emergency'' due to dioxin, a byproduct of chlorine chemistry. This devilish compound is no longer called ``the most potent carcinogen known to man'' due to negative evidence, but it might stunt fetal growth and suppress hormones. It is present at a level of 5 parts per trillion in the fatty tissue of the average American, a decrease from 18 ppt in 1976 (EPA Watch 5/31/94).

Microbes, No Threshold, and the One-Particle Hypothesis

Ironically, EPA assumptions about carcinogens (see May issue) actually do apply to some pathogenic microorganisms. Since they have a doubling time rather than a half life, they can be lethal even with an inoculum of one or a few organisms. And urgent action is needed. The potential for disaster is real; the evidence undisputable. If we wait for a raging epidemic, it will be too late to rebuild our public health infrastructure.