The Los Angeles Times says the FDA is considering reducing the amount of fluoride in water “because most people are now getting large quantities of the protective agent from other sources, including toothpaste, mouthwashes, prescription supplements and fluoride applied by dental professionals. As a consequence, some children’s teeth are becoming mottled because of overexposure to fluoride.” Wags have remarked that this represents a partial vindication of the fears of General Jack D. Ripper, who complained of its effects on his precious bodily fluids in Dr. Strangelove. The L.A. Times gives a nod to the “crazies”:
Despite the objections of a few crazies who have claimed that fluoridation represents a plot by the government to control their minds, the addition of fluoride to water beginning in the 1940s has been recognized as one of the great public health measures of the 20th century, markedly reducing cavities, especially in children.
But the community of “crazies,” if you can call them that, goes far beyond General Ripper. Wikipedia traces the history of the anti-vaccination movement. Early attempts to vaccinate the population were denounced as a “diabolical operation” by some clergymen. In the 19th century, the objections to vaccination started up again. In a book titled Bodily Matters, Nadja Durbach argued that vaccinations were resisted in part because populations were reluctant to surrender their bodies to the public health bureaucracy.
From its inception in 1853 until its demise in 1907, the compulsory smallpox vaccine was fiercely resisted, largely by members of the working class who interpreted it as an infringement of their rights as citizens and a violation of their children’s bodies. Nadja Durbach contends that the anti-vaccination movement is historically significant not only because it was arguably the largest medical resistance campaign ever mounted in Europe but also because it clearly articulated pervasive anxieties regarding the integrity of the body and the role of the modern state.
Recently, the anti-vaccine movement received an impetus from a study by Dr. Andrew Wakefield, whose findings were published in the Lancet, showing that the mumps, measles and rubella vaccine caused autism. Unfortunately for Dr. Wakefield, his study has been attacked as a fraud. Many of his co-authors have retracted and it has been alleged that he received money from a group of lawyers to stir up liability suits against vaccine manufacturers.
Though the fictional Jack D. Ripper was portrayed as being paranoid about fluoride, many other people are worried about what may or may not be in the air they breathe or the water they drink. Controversy still swirls around Chromium 6, the substance Erin Brockovich alleged was causing high rates of cancer in Hinkley, California. Nobody thinks Chromium 6 is beneficial, but the degree of its harmfulness is still debated:
Scientific and legal debate has raged over the risk posed by hexavalent chromium in drinking water since the 1990s, when Erin Brockovich, then an obscure legal file clerk, unearthed evidence that the substance had leached into Hinkley’s ground water. Residents sued, and in 1996, PG&E paid a $333 million settlement to about 600 people who blamed exposure to chromium 6 for high rates of cancer and other diseases.
While many researchers say that hexavalent chromium is an inhalation carcinogen, some have claimed that the risks are negligible when the substance is ingested. But in 2009, National Toxicology Program (NTP) scientists reported that their research “clearly demonstrates” that the compound is a carcinogen in drinking water.
The American Chemistry Council counters that the rats in the NTP study were subjected to unreasonably high chromium exposures. It’s sponsoring additional research.
It has now been found to be leaking out of containment tanks. How much should be spent to corral it? The Bologna Center recently published a paper on the management of unquantifiable risks, that is, risks whose probabilities we cannot estimate. It describes the cost of “doing something,” even in the face of not really understanding what it will do, as a “secondary risk.” It is the cost of dodging the bullet that may, or may not, be there.
Cass Sunstein argues that a related problem is that the world is permeated with certain risks on all sides. Since nothing is ever completely risk-free, Sunstein explores the notion of “substitute risks.” Substitute risks are secondary risks that are incurred while attempting to avoid primary risks. Sometimes, the secondary risks are even greater than the primary risks. This is the “out of the pan and into the fire” problem.
To illustrate this scenario, Sunstein recalls a train crash that occurred in Hatfield, UK in 2000. After the crash, which injured dozens and killed several passengers, fully a third of British rail travelers started using the highway instead of taking the train. The problem was that driving in the UK is more than ten times as dangerous as riding the train. In the first thirty days following the train crash, it was estimated that five additional deaths from automobile accidents could be attributed to the additional drivers on the road. That figure, Sunstein notes, was “nearly equal the total number of deaths from train accidents in the previous thirty years.”
Companies and public officials eager to avoid the liability from an unquantifiable risk may incur huge secondary costs because they have to “do something.” They will describe this as erring on the side of caution. In reality, the risks are not completely avoided and in some cases they are merely exchanged. Can you risk polluting your precious bodily fluids? Can you risk not to?