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. 2003 Feb 22;326(7386):452.

When Smoke Ran Like Water: Tales of Environmental Deception and the Battle Against Pollution

Bert Brunekreef 1
PMCID: PMC1125339

graphic file with name smoke.f1.jpgWhen Smoke Ran Like Water: Tales of Environmental Deception and the Battle Against Pollution by Devra Davis. The Perseus Press, £14.99, pp 316. www.theperseuspress.com. ISBN 1 903985 50 1. Rating: ★★

This book begins by describing the air pollution disasters that occurred in Donora, Pennsylvania, in 1948 and in London in 1952, along with accounts of the health effects of more current conditions. Then follows a look at scientific uncertainties in the environmental health field, and how commercial interests sometimes exploit these to postpone or derail environmental regulations. There are chapters on breast cancer and male reproductive health in relation to environmental factors, and a look at environmental health problems in developing countries and the possible health consequences of global change. The author finishes with a call to arms, urging the reader to stand up to injustice and economic pressure in the battle for a clean and healthy environment.

When Smoke Ran Like Water is at its best when describing how commercial interests have harassed well known environmental health scientists in attempts to downplay the seriousness of, say, the effects of environmental lead on the IQ of children. Such pressures are not unusual and most environmental health scientists will recognise some of their own experiences in these sections. However, the book comes close to blaming much of the lack of knowledge and uncertainty in our field on such pressures, creating an “us or them” atmosphere that leaves little room for nuance or exception.

The chapters on “subject matter” I found less convincing. When she writes about air pollution—the subject I am most familiar with—Devra Davis, who teaches at Carnegie Mellon University in Pittsburgh, makes an alarming number of errors. She describes inversion layers as cold air on top of warm air (it's the other way round), says that particles between 2.5 and 10 micrometres are removed in the upper airways (they penetrate into the thorax), and claims that the 1930 fog disaster in the Meuse Valley hit the city of Liège (it stayed out of it—many more people would have died if it hadn't). Also, effect estimates are often misquoted by an order of magnitude. The list goes on. In a field that attracts criticism from industry and environmentalists alike, we need a little more rigour.

It is a pity that the author repeatedly, in support of central arguments, refers to sources such as television documentaries and reports by non-governmental organisations, and then claims that because of the pressures mentioned earlier, “these findings are unlikely to ever appear in the scientific literature.” Solid research papers published in the best peer reviewed journals are the field's best defence (“bullet-proof vests”) against the guns that are being hired by various interest groups. Dr Davis hasn't organised her defences properly.

My feeling at the end was that Dr Davis is largely preaching to the converted. This book will not succeed in convincing more sceptical readers that serious environmental health problems still exist. More rigorous environmental epidemiology is needed to analyse such problems in support of appropriate public health measures.


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