Minamata Disease and The Photography of W Eugene Smith

Martin Donohoehttp://www.publichealthandsocialjustice.org

Outline

• Introduction• Mercury and Methylmercury as

pollutants• Minamata Disease• W Eugene Smith – bio and photos• Minamata Convention

Mercury

• Mercury ore (cinnabar) used as pigment since Neolithic era

• Ancient Romans, Chinese used as rouge makeup

• Pigment mixed with wax for document seals in Middle Ages

Mercury

• Syphilis Treatment- 15th Century onward- abandoned 1940 for penicillin

• Recognized as cause of disease in 19th Century (Hunter-Russell Syndrome)- chemists, hatters (matted fur together with mercuric nitrate to make felt hats)

Mercury

• Added by US government to industrial alcohol during Prohibition to make it more lethal and discourage moonshine production (1926-1933)–Led to more than 10,000 deaths

Mercury

• Half from volcanic eruptions and other geological processes

• Released into air by coal combustion, industrial processes, mining, and waste disposal– 4500 tons/yr

• Travels throughout atmosphere and settles in oceans and waterways

• Bacteria convert it to toxic methyl-mercury

Mercury

• Travels up food chain via fish–Warmer temperatures increase

metabolic rate and ability of fish to accumulate–Avoid top predators (tuna, shark,

swordfish)–1/3 of US exposure to methylmercury

from canned tuna

Gold MiningGold = Cyanide + Mercury

• Mercury used to capture gold particles as an amalgam

• Gold leached from ore using cyanide–Cyanide paralyzes cellular respiration

• At least 18 tons of mine waste created to obtain the gold for a single 3 oz., 18k ring

Gold Mining and Mercury

• Contaminated groundwater often sits in large toxic lakes held in place by tenuous dams

• Release of cyanide and mercury into local waterways kills fish, harms fish-eating animals, and poisons drinking water

Mercury

• Other sources:–Deforestation and runoff–Industrial boilers–Tooth fillings–Car batteries–Cosmetics

Mercury

• Long biological half-life- 1-3 years in humans

• Regulation inadequate– Allows “cap and trade”

Mercury

• 16% of women of childbearing age exceed the EPA’s “safe” mercury level

• Freshwater fish mercury levels too high for pregnant women to eat in 43 states

• Mercury dental amalgams pose health risks to pregnant women, unborn babies, and children (FDA Black Box Warning added 2009)

Minamata Bay

• Southern Japan• Shiranui Sea• Fishing village• Villagers: fisherman/Chisso Corporation

employees and their families

Chisso Corporation

• Established 1918• Produced acetaldehyde for plastics, drugs,

perfumes, photography• Mercury (Hg) catalyst• Byproduct = methylmercury, dumped into bay

(150 tons over 4 decades)• Dumped over 60 deadly poisons, including

vinyl chloride (cause of liver cancer)

Chronology of Chisso's Environmental Pollution

• 1925 - local fishing cooperative compensated for decreased catch

• 1950s - bizarre behavioral changes observed in birds, marine fish, land vertebrates; oysters vanish

• 1950s / 1960s - reports in Japanese medical journals about human cases

Chronology of Chisso's Environmental Pollution

• 1956 - cause (MeHg) of Minamata Disease elucidated

• 1958-60 - reports in English medical journals• 1959-69 - Dr. Hosokawa's experiments– Cat #400– Other studies

• 1959 cyclator added– Removed Hg, but not MeHg

Chronology of Chisso's Environmental Pollution

• 1965 - fishing banned in Minamata Bay after similar events noted in Niigata, Japan

• 1968 - all acetaldehyde-producing plants ceased operating

• 1970 - Japan Water Pollution Control Act– Allowed no detectable Hg or MeHg in waste water

Chronology of Chisso's Environmental Pollution

• 1997 – Minamata Bay declared free of mercury

• 2004 – Japanese Supreme Court rules government shares responsibility for epidemic (government slow to react, cut off research funding in 1962)

Minamata Disease

• 3,000 official cases in Minamata Bay (almost 1800 dead)–Tens of thousands of unofficial cases–Number of victims may be as high as

100,000• Social stigma / Poor health care

Mercury: S/S, Dx, and Rx

• S/S: neuropsychiatric symptoms, excessive salivation/inflammation of gums, rash, nephropathy– Linked to autism

• Dx: mercury levels in air, blood, urine (>100 mcg/l in blood and/or urine = toxic)

• Rx: chelation with BAL, penicillamine, DMPS, DMSA

Minamata Disease:Signs and Symptoms

• Acute / Chronic Poisoning:– numbness, slurred speech, ataxia, unsteady gait,

deafness, poor vision, dysphagia, hypersalivation, confusion, drowsiness/stupor to irritability/restlessness; chronic liver disease, liver cancer, hypertension, autoimmune disorders

– death within a few months if severe

• Rx EDTA – only partially effective

Minamata Disease:Signs and Symptoms

• Congenital: high dose → infertility; medium dose → spontaneous abortions; low dose → congenital disease (including anencephaly and spina bifida)

• S/S: poor physical growth, mental retardation, impaired speech/chewing/swallowing, muscle tone abnormalities, involuntary movements, constricted visual fields

- EDTA not effective

Civil suit vs. Chisso (1969-73)

• Plaintiffs initially awarded $66,000 for deceased victims, $59,000 - $66,000 for survivors• Precedent - Niigata suit versus Showa Denko– $3.4 million paid out the first night, $80 million

paid out by 1975• As of 2014, most victims have received financial

compensation ($160,000 - $180,000; $26000 for those with lesser disabilities)

Civil suit vs. Chisso (1969-73)

• Dr. Hosokawa key witness (from deathbed)–Identity - company employee vs.

impartial physician with obligation to patients–Loyalty - company vs. to public

Reasons for Delayed Recognition and Action

• Science slow, unfunded/underfunded, corrupt

• Dissemination of knowledge slow• Social stigma of disease, fear of

contagion• Pressure from fisheries cooperative,

Chisso employees

Reasons for Delayed Recognition and Action

• Lack of local/world awareness of health effects of pollution

• Strong government-business links in Japan, employee loyalty strong

Decreasing Causes and Limiting Consequences of Mercury Pollution

• Phase out coal burning power plants• Hospitals phasing out mercury

thermometers• Stop buying gold (e.g., wedding rings)• Make healthy seafood purchases• Screen and treat when appropriate• Avoid tainted cosmetics

Minamata Convention

• 2013: Over 140 countries (including U.S.) agreed on a set of legally binding measures to curb mercury pollution–As of 4/7/14, 97 countries have signed

and one (U.S.) has ratified–Takes effect 90 days after 50 nations

ratify

Minamata Convention

• Best emission-control technologies requred for new power plants, boilers and smelters

• Compact fluorescent lightbulbs containing over 5 mg Hg banned by 2020

• Primary mercury mining banned (old mines get 15 yrs to close down)

• Allows use of mercury in artisanal and small scale gold mining; encourages nations to phase out use altogether

Minamata Convention

• Exempts dental fillings, but encourages alternatives

• Vaccines with thimerosol (ethylmercury) exempt (very few, trace amounts)

• Bans Hg-containing batteries by 2020 (button-cell batteries exempt)

• Bans switches and relays with Hg by 2020

Minamata Convention

• Limits Hg in soaps and some cosmetics• Bans Hg in medical devices by 2020• Exempts religious and traditional uses of

Hg• Bans use in certain types of

manufacturing

Minamata Disease Memorial

W Eugene Smith

• Born 1918, Wichita, KS• Local news photographer at age 15• Turned down scholarship to Notre Dame

to study photography at NY Institute of Photography

• Worked for Newsweek, then Life, then Magnum

W Eugene Smith

• Married to Aileen Smith, photojournalist• Minamata: Final Assignment• Beaten by Chisso employees• Died 1978

Role of the Media in Promoting Awareness of Environmental Health Issues

• Books– Henrik Ibsen’s Enemy of the People– Upton Sinclair's The Jungle– Rachel Carson's Silent Spring

• Photography– W. Eugene and Aileen Smith's Minamata photoessay– Jacob Riis, Dorothea Lange, Sebastiao Salgado, James

Nachtwey, others• Film, TV

Contact Info, References

Martin Donohoemartindonohoe@phsj.org

This slide show and others available at http://www.publichealthandsocialjustice.org

http://www.phsj.org