From Smithsonian Institution's Lemelson Center for Innovation and Invention's forthcoming book featuring Davis as an environmental innovator alongside Amory Lovins and others.  MIT Press, 2002
 

Profile of Innovation: Devra Lee Davis
 
 

The sooty gray skies and coal-paved alleys of Donora, Pennsylvania, are among the earliest memories of Dr. Devra Lee Davis, a leading epidemiologist who is now director of the Program in Health, Environment and Development at the World Resources Institute in Washington, D.C. But the path from Donora, a steel- and zinc-mill town that was the site of the first "killer smog" in the United States, to her pioneering studies of environmental risk factors for cancer and other chronic diseases was not a direct one.

Davis was born in 1946, when her parents were stationed at a military base in Virginia, but most of her childhood was spent in Donora, south of Pittsburgh in the Monongahela Valley, where her grandparents had settled when they emigrated from Eastern Europe. Her grandfather earned a living by scavenging and reselling good bits of steel from the slag heaps of the mills. Her father, after working as a chemist and machinist in the mills and serving in the Army, expanded the family business to resales of office and industrial equipment. Feeling that, as Jews, they owed a debt to the United States for defeating Hitler, her father remained an officer in the Army Reserve for thirty years. During the Korean War, he was called up as a drill sergeant, and the family lived for a while at Army bases in Indiana and Texas. With hindsight, Davis is glad that at least a few of her early years were spent away from the polluted air of Donora.

As a child, however, she took Donora's gray skies, dazzling sunsets, and sulfuric air for granted. She and her three siblings had fun sliding down the town's slippery, barren hills. Nor did she find her grandmother Pearl's heart disease at all unusual. "I only realized that not all blue-haired grandmothers stayed in bed tethered to oxygen tanks when I met someone else's granny who actually walked around," she recalls. Many years later, all of Pearl's five children, including Davis's mother, developed heart problems.

When Davis was two, Donora suddenly made national headlines. In October 1948, a smog of coal and coke fumes, mixed with toxic fluoride and cadmium gases from the mills, became trapped in the valley by an atmospheric inversion. It hung there for nearly a week, so dark and thick that cars could not navigate the streets even with headlights on in daytime. A third of the town's residents fell ill within a few days, and the death rate for that month was fifty people more than average, twenty of those "extra" deaths occurring in the first four days of smog. The event was never fully investigated, although a few chemists and physicians believed that the fluoride and cadmium gases from the zinc mill were connected with those deaths. "The idea that air pollution played any role in when and how many people die had never been imagined," Davis explains. Nonetheless, the incident in Donora, along with similar lethal smogs in Belgium in 1930 and England in 1952, raised public and professional concern about air pollution. Donora's killer smog ultimately contributed to passage of the federal Clean Air Act of 1956. It may also have contributed to Davis's family heart problems. Fluoride gas leaves no traces on the lungs, but directly weakens the heart.

That early experience with pollution did not inspire her to pursue a career in public health. Rather, her passionate interests were in science, religion, and music. One of the fundamental precepts of Judaism is to study the Torah, the five books of the Old Testament. As a child, Davis loved to hear the stories of the rabbis. Her devotion to Torah study carried over into other areas of learning as well, and has remained central to her life. She also spent hours each day playing the cello, eventually becoming first chair of the Pennsylvania High School State Orchestra. But it was science, and questions about the realms of science and religion, that led her to pursue higher education.

Although no one in Davis's working-class family had a college education (her mother had dropped out to get married), she was recruited by the University of Chicago when she was fourteen. Her parents would not let her go away to college at that age, but Davis, already tall and mature, felt more comfortable on a college campus than with high school peers. Her family had moved to Pittsburgh, and she began taking classes at the University of Pittsburgh while still in high school. Her most exciting course was graduate-level statistics. "The teacher was wonderful, " she says. "I was like a sponge!" (She still has strong feelings about statistics, always conscious of the people behind the numbers. She sometimes describes statistical data as "human beings with the tears removed.")

As a teenager, she was also involved in the civil rights movement, serving as a local organizer for marches in Selma, Alabama, and Washington, D.C. Although she was not aware of it at the time, she found out many years later that her father had been active in integrating the armed forces.

After graduation from high school, Davis enrolled as a junior at the University of Pittsburgh. She majored in sociology with a minor in biology, and gained additional science training by working in the labs and typing dissertations. She graduated in three years with a B.S. in physiological psychology and an M.A. in sociology. A Danforth fellowship -- one of the first given to a female student -- allowed her to pursue a doctorate at the University of Chicago.

Davis completed requirements for a Ph.D. in science studies (an interdisciplinary program in the history of culture) in two years. She passed her exam two years later, in 1972, after a brief marriage and divorce. By that time, she was already an assistant professor of sociology and director of interdisciplinary studies at Queens College of the City University of New York. There she continued her social activism in the antiwar movement and met another young faculty activist, an economist named Richard D. Morgenstern, who was studying the disparity in salaries paid to male and female academics. They married in 1975 and had two children, a son, Aaron, born in 1976, and a daughter, Lea, born in 1979. In the years that followed, Davis and Morgenstern often found their work dovetailing, as both were drawn into the world of environmental policy.

To have more time for her children while they were very young, Davis left teaching and accepted three postdoctoral fellowships between 1971 and 1982. The first was in neurology and neurotoxicology and included a study of acupuncture. The second was in neurotoxicology and toxicology with Larry Ng of the National Institutes of Health and resulted in their book Strategies for Public Health: Promoting Health and Preventing Disease , published in 1981. Davis had by then moved to Washington, D.C., to work as an advisor to the Environmental Protection Agency. Her husband was also at EPA, as chief economist, running major environmental programs. Davis's third fellowship was with Abraham Lilienfeld, a renowned epidemiologist at Johns Hopkins University. It was Lilienfeld who awakened her interest in epidemiology and propelled her toward a career that from its inception pitted her against established authorities in cancer research, most notably Sir Richard Doll.

Doll, a physician at Oxford University, had worked with A. Bradford Hill in the 1950s to prove the link between smoking and lung cancer. In 1981, Doll published another treatise on the causes of cancer, this time with Richard Peto, which dismissed data on rising rates of cancer in people over the age of sixty-four as being an "artifact" of better diagnosis. Lilienfeld disagreed with those findings, and Davis assisted him in researching and writing an article challenging Doll's conclusions. Lilienfeld died, suddenly, just before the article was published. Davis was left, a postdoctoral fellow in her early thirties, to carry on the debate. "Can you imagine the chutzpah of it?" she asks.

Davis had an opportunity to meet with Doll at the International Agency for the Treatment of Cancer. She admired his pioneering work and felt very flattered that he would give her so much attention. During the meeting he proceeded to explain why she was wrong, seeking to convince her of her errors. After that meeting, she spent nearly two years checking, point by point, what he had said, going directly to official death and population records to compute the rates of cancer among older people from specified and unspecified causes. If Doll were right and the overall rate of cancer was not increasing, better diagnoses would mean that increases in cases of specified cancers would be offset by a decline in the number of cancers from unspecified causes. But the evidence seemed to contradict Doll's conclusions. Statistics indicated an increase in all kinds of cancer, both specified and unspecified. Davis's determination to find answers was intensified by news of her own father's bone cancer, multiple myeloma, which had been diagnosed in 1979 when he was fifty-three years old.

In 1983, after getting a master's in public health from Johns Hopkins and working at the Environmental Law Institute, she was recruited by the National Academy of Sciences to direct the Board on Environmental Studies and Toxicology. There she headed a large staff and coordinated the work of hundreds of experts throughout the country in studies such as the one that led to the ban on smoking on most domestic airline flights. When her father died in 1986, she decided she needed to do more on the issue of cancer in the older population, this time comparing evidence from a number of industrialized countries. She wrote to Alice Whittemore, a highly respected professor of epidemiology at Stanford University, who told Davis that the work she proposed was very important and had to be done.

Davis then requested a leave from the New York Academy of Sciences and was given instead an sixteen-month sabbatical. Colleagues -- particularly David Hoel, director of the National Institute of Environmental Health Sciences -- helped her contact authorities in Germany, France, Italy, Sweden, Denmark, and Great Britain. Davis spent two months visiting those countries, taking her nine-year-old daughter with her and lugging an early-generation laptop computer, with which she "vacuumed up" data from computerized government records. David Hoel obtained statistics from Japan. Returning to the United States, Davis divided up the data among an international team of epidemiologists who proceeded to analyze it. Their findings were presented at a workshop at the Collegium Ramazzini in Italy in 1989 and published in both the British medical journal Lancet and the Annals of the New York Academy of Sciences in 1990.

Basically, the report presented strong evidence that incidence of many forms of cancer was increasing in all the countries studied, particularly among people over fifty-five, and that brain cancer was increasing in those under forty-five. Davis and Hoel concluded that the rise was too great and too widespread to be simply an artifact of improved diagnoses. They urged further research on possible causes of these cancers and emphasized the need for prevention.

The publication brought her greater attention and gained her more critics. Doll and others dismissed Davis's work. They said she was seeking publicity. By generating new hypotheses and raising issues about possible causes of cancer, she made many people uncomfortable. But she had her supporters as well. Vilma Hunt, an Australian-born epidemiologist who had done important work a few decades earlier, advised Davis that she would be taken more seriously when she was older. In 1992, after an article appeared in the New York Times Magazine discussing the controvery about Davis's research, Hunt wrote a letter to the editor stating:

...Davis's professional experience had a unique impact on the very small group of female scientists from earlier generations. We read familiar words to describe Davis and her work -- "out for publicity," "she's not that reliable," "unoriginal," "wrong." They were such devastating words for us thirty or forty years ago. They seem so trite and inconsequential today, now that we know what those words really mean.Other supporters applauded Davis for finding new ways of synthesizing information and interpreting data. Gradually, as concerns about the environment, public health, and global changes became more widespread, her once-radical ideas filtered into the mainstream. By now, even Doll has published papers reporting unexplained increases in certain cancers.

Davis, an expert skier, likens the experience of coping with attacks from colleagues to knowing how to take a fall. "You have to learn to fall, and relax in your fall, and get back up again. I think that applies to professional life as well, because one always learns from it. If you are putting things out there that people aren't going to like to hear, you have to be prepared for the fact that not everybody's going to be happy." She notes that she has had many fruitful critical exchanges with people with whom she doesn't always agree, but from whom she always learns something.

When her sabbatical concluded, Davis returned to the National Academy of Sciences as a scholar in residence. At the Collegium Ramazzini workshop in 1989, Davis had founded the International Breast Cancer Prevention Collaborative Research Group. One day in 1992 she received a phone call from New York Congresswoman Bella Abzug, whom she had never met, telling Davis to appear at City Hall to testify on breast cancer at a special hearing. Women of Long Island had been developing breast cancer at a high rate. Those

who lived there more than forty years developed four times more breast cancer than those who'd lived there fewer than four years. A study conducted by the Centers for Disease Control concluded that these statistics could be explained by the standard risk factors, but Long Island women's organizations had mobilized to demand better answers. Davis testified, and breast cancer became a major focus of her work, particularly after she joined the World Resources Institute, a nonprofit environmental research group, in 1989. At WRI, she studies links between the environment and health and examines effective public policy options. "Spurred by Bella's demands, my colleagues and I began to look again at what was known about breast cancer and to consider whether avoidable environmental agents could be involved, " Davis says.

In countless lectures and publications, on the WRI Web site (www.wri.org), and in a video titled Exposure, produced by a Canadian company, Davis has raised questions about possible links between cancer and chemicals in the environment. She explains that fewer than 10% of breast cancers develop from inherited genetic factors. Known risk factors, such as early menarche or late menopause, account for a relatively small portion of other breast cancers. In the World Resources 1998-99 report, she writes:

However, a growing and complex array of evidence suggests that the general external environment--including behavior, diet, and physical and chemical exposures--plays a major role in fostering breast cancer. . . Environmental exposures may damage genes directly or they may affect the overall production of growth-regulating hormones, such as estrogen, progesterone, and other such naturally produced substances. [p. 102]She suggests that hormone-mimicking substances, which she calls "xenoestrogens, " can be produced from some plastics, pesticides, fuels, and pharmaceuticals. Some xenoestrogens may be responsible for triggering breast cancer or sexual aberrations, such as a preponderance of female births or reproductive disturbances in men. There is growing evidence from laboratory experiments and studies of wildlife that supports this theory. Human evidence is more difficult to obtain, due to the complex nature of cancer, which is rarely due to one single cause, and the near impossibility of maintaining strict experimental controls with human subjects. Davis emphasizes that: the debate isn't whether the environment causes 5% of cancer or 10% of cancer, the debate is that whatever about cancer is due to the environment, we can do something about it. It's avoidable. It's controllable. Unlike so much of cancer, which comes from who you were born to, or what you'd eaten three decades ago, or whether or not you had children, the things in the environment are something you can change, the government can change, the private sector can change. And that is why we have to pay attention to these things. Because it's something that can be controlled.Davis was called to serve as senior advisor to Philip Lee, Assistant Secretary for Health, in 1993, and she also advised Surgeon General Joycelyn Elders on issues of epidemiology. She held several visiting professorships, and in 1994 she was appointed by President Clinton to the National Chemical Safety and Hazard Investigation Board. Davis has received many awards and honors for her work, including the Breast Cancer Awareness Award of the American Cancer Society and the designation of "Global Guru" by GLOBE, a European parliamentary and environmental organization.

While continuing her work on breast cancer, collaborating on research projects as well as a public awareness campaign called "Better Safe than Sorry," she is now also engaged in studies of urban air pollution and its effects on children. She says:

The air pollution angle evolved out of a concern about the obvious issue of climate change, and the fact that people can't relate to what's going to happen fifty years from now. ... I was concerned about this question of urban excess. Then I got to thinking about what creates air pollution. The big issue fifty years ago in Donora was the power plants and the factories. In the United States, that's pretty much been controlled, but the big issue now is cars in the city. . . . What we are doing to our health and to the planet by the use of cars now, and lack of use of public transport, is astonishing!Children, particularly in developing countries, are being exposed to heavily polluted air in unprecedented numbers. Their growing bodies are more susceptible to toxins than those of adults, particularly where children do not have adequate diets or medical care. A report issued by Davis's office concludes that investing in improved transport and energy technologies that reduce the use of fossil fuels could have an important positive impact on public health.

Davis believes that there will be support to move in this direction:

Resistance may come from some in industry, but not from all. I think there's generally a move now, as one of my colleagues, Wolfgang Sachs says, to make sure that we do the right things, and that we do things right. Those are two different things. . . .What are the most important things to do? Should we all be drinking designer water? I don't think so. I think we ought to get our water clean for everybody in the city. Should we all be buying organic produce? If you can afford it, I suppose it makes you feel better and it does taste better, but we ought to get the food supply cleaned up for everybody. Those are the kind of things we need to pay attention to.
 
 One of her aims is to generate greater public awareness about the issues that concern her. "When does innovation have an impact?" she muses. "It's a very interesting question to me. I think that the opportunity to share information is what distinguishes modern science from, if you will, ancient science." She is now writing a book about environmental risk factors in public health, intended to share information she has gathered with a wide popular audience.

Two near-death experiences -- one from an adverse reaction to a drug that should not have been on the market (and which she later worked to get off the market) and the other from multiple bee stings -- have deepened her religious feelings and intensified her commitment to her work. She used to insist that there was no real connection between her childhood in Donora and her crusade against environmental toxins. Now she is more reflective, saying, "I think some things happen for a reason, and sometimes, if we're lucky, we figure it out."

Davis's office at WRI overflows with publications, papers, and family photos. There are snapshots of ski trips with her daughter, a student at Oberlin College, class of 2002; a portrait of her son in uniform as a lance corporal in the in U.S. Marine Corps; and pictures of Davis mountain climbing with her husband, who is now a senior economist and chief negotiator on global climate issues at the U.S. State Department. Among her books is a volume by Rashi, an eleventh-century French rabbi and scholar famous for his commentaries on the Torah and the Talmud, the collection of rabbinical writings essential to Judaic studies. Davis often draws on stories from the Talmud to communicate her ideas. One that she tells is about a group of farmers and workers who are complaining to a rabbi that they have been given too much to do. "We can't complete it. We'll never get the work done," they protest. "How can you possibly expect us to do this?" The rabbi says, "Look, it's not for you to finish the task. But you must begin it."

"That story really applies to the work we're trying to do now, " Davis observes. "It's a very complex task. It involves rethinking how our lives are organized and how we can do things better, more efficiently. How can we de-materialize, do more with less, be smarter? Those are the challenges. We won't finish it. But we need to start." After a pause, she adds, "Sometimes people face a task that looks hopeless. But I think, being a Jew, that we always have hope. That's the lesson of the Bible, isn't it?"

Martha Davidson EDITED DRAFT

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8/15/99

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