Abstract
In Exposed Science: Genes, the Environment, and the Politics of Population Health, Sara Shostak charts a major shift in the field of environmental health science, in which scientists turned from studying the health effects of exposures such as air and water pollution to focusing on gene-environment interactions. She describes this shift as the molecularization of environmental health sciences. Shostak shows how environmental health scientists watched in dismay throughout the 1990s as the human genome was being mapped, draining resources and prestige away from their field. In her telling, environmental health scientists turned to molecular and genomic methods at least in part because they had professional anxieties about the prestige and stature of their field, and they embraced genomic and molecular tools as a means of shoring up their jurisdictional authority. Her central argument is twofold: first, that scientists who drove the molecularization of environmental health sciences were motivated by what they perceived as the field’s structural and epistemic vulnerabilities; and second, that the shift to molecularization has had unintended consequences for what we know (and do not know) about the public health effects of environmental exposures.
Shostak anchors her inquiry in the National Institute of Environmental Health Sciences (NIEHS), the NIH institute that sponsors the lion’s share of environmental health research, but she also explores how their intramural research program coalesced with the efforts of scientists working in academic institutions and in regulatory agencies to drive changes in the broader field of environmental health science. Drawing on interviews with scientists and environmental health activists, as well as archival documents and participant observation, Shostak demonstrates that these scientists recognized that their research mission had become inextricably intertwined with the goals of public health promotion and disease prevention. As such, they knew that their findings needed to be useful to their regulatory partners but also had to be robust enough to withstand legal and technical critiques from their scientific peers and from polluting industries. Much of their professional anxiety stemmed from concern about the validity and utility of risk assessment, which assesses chemicals for their toxicity and impact on human health. Toxicologists hoped to exploit molecular and genomic technologies to advance the science of risk assessment, but also to increase their professional stature and to create new funding opportunities and markets for their research.
Shostak shows that these scientists who wanted to develop molecular and genomic tools for environmental health developed a consensus critique, a narrative they hoped would solve the professional challenges they faced. Their dissatisfaction with risk assessment centered on three problems: first, it involves extrapolating from animal studies to predict effects on human health; second, animal studies are slow and expensive to conduct, and as a result there are many chemicals in use today that have never been assessed for toxicity; and third, risk assessment is ill-suited for assessing risks to vulnerable subpopulations (e.g., children or the elderly). According to Shostak, these scientists argued that the development of molecular and genomic tools would improve the risk assessment enterprise: first, new approaches would “move beyond classical toxicology” (p. 58); second, toxicogenomic tools would be faster and cheaper than traditional risk assessment, allowing regulatory agencies to “clear the backlog” of unassessed chemicals; and third, it would broaden the range of applications for their findings, including the development of clinical interventions to protect human health in the event of an exposure. In this way, scientists hoped to promote new tools and methods without questioning the overall integrity of the risk assessment process.
In the three empirical chapters that are at the heart of the book, Shostak shows how this consensus critique led to the institutionalization of genomics in programs within NIEHS and in the field at large. These chapters are based upon previously published articles, but one of the pleasures of reading the book is seeing how Shostak has knitted these findings into a cohesive whole. She also skillfully integrates her interview data with historical evidence, tracing the contemporary dilemmas these scientists face to their disciplinary roots. For example, in Chapter Four, “Opening the Black Box of the Human Body,” she shows how the field of environmental epidemiology has developed the means for assessing environmental exposures and environmental effects at the molecular level by searching for evidence of mutagenesis. She sets these contemporary developments in the social history of the field, and shows how modern-day environmental epidemiology has been caught “betwixt and between” its roots in sanitation and industrial hygiene.
The overall effect of the consensus critique, Shostak argues, is that it allowed scientists the interpretive flexibility to create new tools, pursue new funding sources, and develop new markets for their research. While these developments may have increased their professional stature, it has, however, come at a price. Shostak shows that molecular and genomic tools have turned the scientific gaze radically inward, thus effacing the social, economic, and political conditions that place some communities at increased risk of exposure. The most compelling parts of the narrative are where Shostak brings the environmental justice activists into dialogue with the scientists. In Chapter Six, she interviews activists from communities that are burdened by toxic waste, who are skeptical that this new brand of science will help prevent illness before it takes root. By bringing these two constituencies into dialogue, Shostak helps us understand how new scientific methods can both provide legitimacy to a scientific field at the same time that it seems to drift further away from actual, on-the-ground relevance.
Shostak’s greatest contribution is in advancing STS approaches to studying changes in scientific practices. Following in the tradition of Pierre Bourdieu, STS scholars have examined how scientists police the boundaries of their disciplines and maintain jurisdictional authority over particular kinds of scientific knowledge production. For too long, however, this work has focused on “scientists talking to other scientists.” Shostak argues that we should broaden our analyses of scientific fields to consider what she terms an arena (p. 9). The notion of the arena is a potentially useful one, although at times it seems a bit slippery. Shostak fruitfully directs our attention to jurisdictional struggles at multiple levels: among scientists from different disciplines, among scientists embedded within different research agencies, and between regulatory agencies and the industries they regulate and the communities they protect. Because the boundaries between scientific agencies, regulatory agencies, and regulated industries can be especially porous, however, I would have appreciated a bit more clarity on how Shostak identified and characterized the different actors who inhabit a scientific arena. But this is a very minor point.
Overall, Shostak’s approach of studying the intramural and extramural initiatives of the NIEHS is an original and refreshing way to appreciate how what happens in the laboratory is affected not only by scholars in neighboring disciplines, but by a diverse set of external actors. Shostak ultimately concludes that the way environmental health scientists have embraced gene-environment interactions has had the paradoxical effect of drawing them away from studying environmental exposures as they are experienced in the real world, and has led to a radically decontextualized vision of human health. This has major implications for the future conduct of science and protection of public health.