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Washington, D.C.
The subcommittee met at 10 a.m., pursuant to recess, in room 4200,
Senate Office Building, Senator Edmund S. Muskie (chairman of the
subcommittee) presiding.

Present: Senators Muskie and Boggs. Senator MUSKIE. The committee will be in order. This morning we have three distinguished witnesses who will testify on specific air pollutants. Much of the testimony will concentrate on the problem of pollution traceable to lead. I think that no preliminaries are necessary before we begin this testimony but Senator Boggs would like to have just a moment.

Senator Boggs. Mr. Chairman and Surgeon General and other witnesses, I regret that I have two other committee meetings this morning, both executive sessions, right at this time. They are trying hard to get a quorum. So, I am going to ask to be excused. I express appreciation for your appearing here. I am very much interested in the testimony you will give. I will read it most carefully. I feel very badly that this is the type of situation that we have this morning but it happens. Because I recognize the urgency of the work this committee is doing and the importance of it, I hate to leave, Mr. Chairman, but I will just have to ask you to excuse me.

I will be back.

Senator MUSKIE. I understand one of the committee meetings you are attending is one having to do with congressional reorganization. Perhaps you can find a way for a Senator to be at three Senate committee meetings at the same time.

Senator Boggs. That is one of the things we are going to try to figure out.

Senator MUSKIE. Our first witness this morning is Dr. William H.
Stewart, Surgeon General of the United States. It is a pleasure
to welcome you.


Dr. STEWART. Mr. Chairman, it is indeed a pleasure to participate in these hearings on air pollution and other problems of environmental

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contamination. For the record, Mr. Chairman, I want to introduce my two colleagues who are with me this morning.

On my left is Dr. Richard A. Prindle, who has just recently been appointed Chief of the Bureau of State Services. In his new position Dr. Prindle is directly responsible for our programs in environmental occupational and community health. Dr. Prindle is a former Deputy Chief of the Division of Air Pollution and has been Chief of the Division of Public Health Methods.

On my right is Dr. Edward T. Blomquist, Assistant Chief of the Division of Air Pollution, who is concerned particularly with the Division's progress in their program of research on the health effects of air pollution. Dr. Blomquist was, for 10 years, Chief of the Public Health Service's tuberculosis program. He is here today on behalf of Mr. MacKenzie, the Chief of the Division of Air Pollution, who, as you know, is in Europe this week.

My primary purpose here today is to attempt to place in a meaningful perspective some of the problems of environmental heal with special attention to lead contamination. Dr. Prindle will testify on precisely how we plan to improve our knowledge and our control of chemical and radioactive environmental contamination.

It is a difficult task to protect the public health from low levels of environmental contamination which may adversely affect us in subtle ways. One of the reasons this is so, I believe, is that society tends to concentrate its primary resources on those problems which cause obvious injury or disability over very short periods of time.

Many people who would not fail to invest in the most modern and effective firefighting equipment for their communities, often feel no sense of urgency about needed improvements in their air pollution, water pollution, occupational health, or food protection programs. So far, we have failed, and I am speaking of the nation as a whole, to really organize our thoughts, our plans, and our resources in such a way as to insure that we do not, as Secretary Gardner has suggested, we should not, allow the forces of scientific, industrial, and urban growth to determine for us the nature of many of our health programs.

Since the inception of public health programs, approximately 100 years ago, the greatest benefits to health have come from environmental controls. These improvements have related primarily to the control of infectious diseases through improvements in sanitation, in the quality of drinking water and milk supplies, and through control of insects and other vectors of disease.

But only in the past few years have we noted a quickened national awareness of the fact that those problems of environmental contamination which are not related to infectious diseases are also very real and growing, and which deserve a far greater degree of attention than they have received heretofore.

This new awareness is occurring against a background of economic, public health, and medical history that has offered more than passive resistance to our painfully new realizations.

As Secretary Gardner pointed out, scientific achievement, industrial growth and technologic development are the hallmark of our era. Our pursuit of these goals has produced such high standards of nutrition, sanitation, housing, working conditions, and so forth, that we have been loathe to believe that our successes could in any way threaten the public health.

Now, however, the fact of environmental hazard is inescapably clear. We must, and we shall, strengthen our ability to cope with this threat.

The proposed reorganization of the Public Health Service, now before the Congress, would place into a new Bureau certain elements of both disease and environmental control. This arrangement will, I believe, enable us to understand and to influence more effectively those forces which create or contribute to the real and potential hazards of our environment.

I use the word "influence” advisedly, Mr. Chairman. The Public Health Service has never had, does not have, and in all likelihood will never have, the power to directly insure a completely safe, sane, and wholesome environment for all Americans.

We are convinced that many of the national health problems of our era, both physical and mental, can best be brought under control through modifications in the human environment. But we are by no means under the illusion that public health workers alone can modify it. The increasing prevalence in man's environment of radioactive, chemical, and physical hazards, as well as emotional and mental stresses, result from activities which are quite demonstrably worthwhile. We must understand, of course, that we do not need to choose between technological development on the one hand and a healthful environment on the other.

We need and should strive for both.

I feel confident that we can have both. But to achieve it we must avoid an attitude of undue complacency or, at the other end of the spectrum, an attitude of undue alarm or despair. Neither of these views, it seems to me, leads to constructive understanding and action.

Dr. Prindle will discuss some of the tentative plans and aspirations of the Public Health Service toward the objective of dealing more effectively with the challenge of environmental contamination. Before he does so, I shall enumerate some of the various contaminants which concern us and discuss in a bit more detail the problem of lead in the environment.

The modern environment is contaminated by many substances whose potential threat to public health has not been widely recognized or adequately studied and evaluated. These contaminants range from such familiar and widely used substances as lead and asbestos to such exotic materials as beryllium and vanadium. They reach the environment as a result of the manufacture, use, and disposal of the increasing quantities of goods and services as demanded by our affluent society.

The number of such contaminants is constantly increasing. And progress in science and technology often results in the creation and introduction into the environment-of wholly new classes of manmade compounds. A recent report on environmental pollution issued by the National Academy of Sciences-National Research Council said that “chemical poisons are being produced in new forms so fast that the toxicologists cannot keep up with them."

A great many examples can be cited to illustrate these trends in environmental contamination. For instance, the materials used as additives to gasoline now include not just the familiar lead antiknock compounds but also various detergents and deposit scavengers as well as nickel and boron compounds.

The use of fuel additives which are not consumed during combustion is an important contributor to environmental pollution.

The development and testing of rockets and missiles are another example of present-day trends affecting the nature and the scope of environmental contamination; these and other activities relating to weapons development involve the use, and often release into the environment, of potentially harmful materials.

The increasing use of pesticides is still another instructive example. These agricultural chemicals once consisted mainly of arsenic and lead-themselves hazardous—but now contain a far wider range of potentially toxic materials, the effects of which are often subtle and difficult to identify.

Of particular importance, because of its national scope, is a special problem inherent in the burning of materials discarded by a technologically advanced society. Some materials, of which some plastics are a notable example, produce highly toxic substances when they are burned. This adds a new and potentially very hazardous dimension to the air pollution problems which have traditionally been associated with open burning and incineration of refuse.

The public health hazards which may arise from these aspects of environmental contamination have not been adequately documented. I shall merely enumerate some of the substances which may produce significant adverse effects on human health at low concentrations.

In each instance, further investigation is needed to determine whether health is indeed threatened and what control measures may be necessary. Of special interest among such contarninants are the following: arsenic, asbestos, beryllium, cadmium, fluorides, mercury, and plastics.

I am prepared to submit for the record, if you desire, Mr. Chairman, a brief written discussion of each of these.

Senator MUSKIE. Yes; we will include that in the record following your remarks.

Dr. STEWART. With regard to some of them there is already a sizable fund of scientific information indicating that they constitute a public health hazard. In others, the use and disposal of the materials involved are increasing at a rate which, if long sustained, could result in substantial environmental contamination. The time to examine the possible consequences of such contamination is now.

In addition to the substances already mentioned, there are many others whose relatively wide use and known or suspected toxic properties place them in the category of potential environmental threats to health. Among the more notable examples of such materials are a number of metals, including chromium, manganese, nickel, titanium, and vanadium. These metals are widely used in alloys of which virtually all metal products are made—and in countless other products including ceramics, paints, and dyes.

They may reach the environment in various ways—as a result of mining, milling, smelting, and manufacturing activities and again, as a result of waste disposal and salvage operations. To one degree or another, available scientific evidence, mainly from occupational experience, indicates that prolonged exposure to such metals is harmful to human health.

In particular, exposure under occupational conditions has been associated with the occurrence of various chronic respiratory diseases, including in the case of chromium, an excessive incidence of lung cancer among chromate workers.

I should like to conclude, Mr. Chairman, with a discussion of lead as an environmental contaminant, not only because it is in itself significant, but because lead provides an excellent illustration of the complex ways in which environmental contaminants may threaten us.

A major share of the lead that most people receive from the environment is ingested with food, water, and beverages. An additional amount is inhaled with polluted air and some with tobacco smoke. For some individuals including workers in lead industries as well as such persons as auto mechanics, occupational exposure is still another factor in their total intake of lead.

To me, it seems axiomatic that we can make no valid judgment of the extent to which environmental lead contamination threatens human health without taking into consideration all of the ways in which lead may enter the human body. Our concern must be with the total human absorption of lead from all sources.

That environmental lead contamination may pose a hazard to health has been known since ancient times. Among environmental contaminants, lead and its physiological effects have received more study than almost any others. Nevertheless, we continue to obtain new informa

. tion concerning adverse effects of lead absorption and of the changing mechanisms of lead exposure.

To begin a needed reassessment of the problem, the Public Health Service held a symposium on environmental lead contamination in December 1965. The discussions that took place in that 3-day meeting served to underline the pressing need for a searching up-to-date look at the sources, extent, effects, and control of the lead problem.

To be sure, a sizable body of data on the effects of lead is already available from research in the field of occupational health. This research has provided a lucid understanding of clinical lead poisoningof the conditions under which it occurs and of the effects its produces. Lead poisoning is one of the best understood of all occupational diseases.

The occurrence of clinical lead poisoning among industrial workers is associated with prolonged exposure to relatively high concentrations of lead.

Senator MUSKIE. Dr. Stewart, what is clinical lead poisoning?
Dr. STEWART. It causes demonstrable disease, demonstrable injury.

Such exposure does not normally occur in the community environment. However, there is evidence suggesting that lower levels of

. exposure produce more subtle but potentially serious effects on human health.

The participants in our symposium cited evidence that relatively small amounts of lead in the body are associated with such effects as destruction of red blood cells, interference with liver and kidney function, and disturbances of enzyme activity.

All of these effects are nonspecific; that is, they may occur as a result of factors other than lead exposure. In the absence of better data than we now have, it is not possible to estimate the extent to which such

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