Paul D. Blanc. How Everyday Products Make People Sick: Toxins at Home and in the Workplace Berkeley, CA: University of California Press; 2007

Abstract

In the modern free market economy, it is profit not health that determines what gets produced and consumed. With a few exceptions such as asbestos and tobacco, public health researchers have rarely studied corporate decisions as a social determinant of health, missing opportunities for primary prevention. In fact, in recent decades, in the United States and elsewhere, public oversight of the occupational and environmental health consequences of corporate practices has eroded, leaving a worrisome burden of old and emerging threats to health. In this book, Paul Blanc, a professor of medicine and an occupational and environmental medicine specialist at the University of California, San Francisco, presents case studies of several every day products that contribute to workplace and community health problems. Among the products he examines are super glue, chlorine bleach, cotton dust, and methyl manganese tricarbonyl (MMT), a gasoline additive. For each product, he describes its industrial history and the unfolding story of its adverse health consequences. His aim, he writes, is to show that “these threats predictably arise as the unintended by-products of the ways in which we make and use consumer goods and produce and transport basic commodities and industrial materials...” In a style that is both readable and quirky, Blanc combines epidemiological, toxicological, and clinical evidence with references to historical studies, literature, and television, creating an interdisciplinary framework for his observations. For example, he attributes the overuse of chlorine bleaches, in part, to the advertising industry’s obsessive focus on whiteness as a sign of cleanliness. In other case studies, he cites episodes from I Love Lucy and Seinfeld as well as Ibsen, Dickens, and Eliot, who described an unscrupulous banker who profited from selling a manganese-based dye. The case studies reveal several recurring themes. First, Blanc observes that “the lessons that pharmaceuticals, industrial materials and potentially toxic household consumer products have to teach us are not all that different from one another.” He shows that the industries in question use similar strategies to confront public health critics of their products or practices—obfuscation of the science, litigation to delay regulation, lobbying to modify legislation, and aggressive public relations advocating consumer choice and free speech. By recognizing that corporations and their allies follow the same playbook, public health officials and advocates may be able to move beyond the single product, single industry approach that now characterizes most efforts to strengthen public health protection. Second, Blanc shows that both in the 21st and in earlier centuries, harmful products move globally. Regulating a harmful product in one nation may not advance population health if producers simply move to another location with weaker rules. Developing the global alliances that can act across national borders is an important public health priority. Third, the book emphasizes the importance of vigilance. The case studies show that public health officials often believe that they have triumphed in removing a harmful product only to have it reemerge in another form, another place, or for another use, as recent debates about mercury illustrate. How Everyday Products Make People Sick plays an important role simply as a record of recent disputes for a new generation of public health professionals, lest they forget the lessons already learned. Readers of the Journal of Urban Health may have questions that this book does not address. What is the cumulative impact of these toxic exposures on the increasing proportion of the world’s population concentrated in cities? How do occupational, environmental and consumer exposures interact in urban areas, especially in the slums where work and living space are often the same? What role can the emerging movements that challenge corporate practices in the tobacco, energy, automobile, pharmaceutical, alcohol, and food industries play in reducing harmful health consequences? Those wanting answers can use Blanc’s volume to inform the research that will address the urban impact of the everyday products that make people sick.