Minamata Disease and The Photography of W Eugene Smith

1. Minamata Disease and The Photography of W Eugene Smith Martin Donohoe http://www.publichealthandsocialjustice.org

2. Outline • Introduction • Mercury and Methylmercury as pollutants • Minamata Disease • W Eugene Smith – bio and photos • Minamata Convention

3. 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

4. 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)

5. 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

6. 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

7. 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

8. 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

9. 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

10. Mercury • Other sources: • Deforestation and runoff • Industrial boilers • Tooth fillings • Car batteries • Cosmetics

11. Mercury • Long biological half-life - 1-3 years in humans • Regulation inadequate • Allows “cap and trade”

12. 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)

13. Minamata Bay • Southern Japan • Shiranui Sea • Fishing village • Villagers: fisherman/Chisso Corporation employees and their families

16. 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)

18. 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

19. 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

21. 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

22. 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)

23. 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

24. 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

25. 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 

26. 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

31. 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)

34. 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

36. 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

37. 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

38. 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

39. 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

40. 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

41. 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

42. 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

43. Minamata Disease Memorial

44. 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

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