Have you ever noticed a black-and-white warning sign near the door of a winery tasting room or even just before you board an airplane? It reads: “Warning: Drinking distilled spirits, beer, coolers, wine and other alcoholic beverages may increase cancer risk, and, during pregnancy, can cause birth defects.” Have you wondered why this warning exists? Here’s the rest of the story.
In the beginning, there was Proposition 65, the cleverly named “Safe Drinking Water and Toxic Enforcement Act of 1986.” Who doesn’t want safe drinking water? It passed 63 percent to 37 percent. The statewide ballot in November 1986 contained no fewer than 24 propositions, 18 put on the ballot by the legislature and six by voter petition. The propositions included seven bond measures and six affecting tax provisions. All but two passed, including one declaring English to be the official language of California. Oddly, one that failed was a proposition declaring AIDS to be an infectious and communicable disease.
The ballot summary for Prop 65 was 82 words long, stating that persons doing business shall not expose individuals to chemicals causing cancer or reproductive toxicity without first giving a warning, and shall not discharge such chemicals into drinking water. The governor was required to publish a list of such chemicals.
The actual 1986 law, with some additions in 2003, is about 3,000 words long, with another 2,800 words in the California Code of Regulation on what constitutes “clear and reasonable warnings” under Prop 65.
The job of listing chemicals causing cancer or reproductive toxicity fell initially to the California Department of Health Services and then to the Office of Environmental Health Hazard Assessment (OEHHA), which was created along with Cal/EPA in 1991.
The mechanism for listing chemicals included opinions from “qualified experts,” which in the early days, meant the Scientific Advisory Panel (SAP). The governor-appointed members of SAP, which classified “ethyl alcohol in alcoholic beverages” as a reproductive toxicant in October 1987, primarily based on fetal alcohol syndrome research.
The more complicated issue for SAP was whether alcohol causes cancer. The International Agency for Research on Cancer (IARC) decided that alcoholic beverages are carcinogenic to humans. But there were decidedly different opinions when SAP met on April 22, 1988, to debate the issue. Seemingly, everyone at the meeting had “Dr.” in front of his or her name, and the detailed transcript of the meeting is almost 90 pages long. Reading it, I was amazed how scientists can disagree with one another without ever using the phrases “You’re full of it” or “What planet did you do research on?”
Three scientists stated flatly, “We do not believe that alcohol has been clearly shown to cause cancer in humans.” They cited a number of studies on research animals that seemed to show no connection. They cited some studies on humans that actually showed a lower incidence of some cancers in people who drank alcohol moderately versus those who didn’t drink at all. They used interesting phrases such as, “In some cases, ethanol reduced the oncogenicity of known carcinogens.” They debated whether or not the fact that human cells convert alcohol to acetaldehyde, which may be a carcinogen, makes alcohol a carcinogen.
In the end, the SAP decided to put alcoholic beverages on the cancer list. But it added an important qualifier, to wit “alcoholic beverages when associated with alcohol abuse.” That may be important to the wording of the warning, which does not say, as many other required warnings under Prop 65, that alcoholic beverages “are known to the state of California to cause cancer.” Instead, the warning uses the phrase “may increase cancer risk.”
Ethyl alcohol and alcoholic beverages were among the earliest chemicals “listed” under Prop 65. Was there a political agenda involved? I don’t know. Here are some other chemicals that were listed at the same time or later: aspirin during the last three months of pregnancy (1990), barbiturates (1992), chlordane (1988), carbon monoxide (1989), marijuana smoke (2009), dioxin (1988), environmental tobacco smoke (2006), nitrous oxide (2008), oral contraceptives “combined” or “sequential” (1989), cocaine (1989), vaporized unleaded gasoline (1988) and wood dust (2009).
The SAP has now been replaced by two separate committees of qualified experts: the Carcinogen Identification Committee and the Developmental and Reproductive Toxicant Identification Committee. The committees screen and prioritize chemicals based on objective criteria, and then the chemicals are studied extensively by OEHHA staff to produce reviews of available research. There are more than 800 chemicals on the list.
Who enforces the warning sign requirement for alcoholic beverages? Not OEHHA, whose job is to compile the list, to help businesses by developing “safe harbor” numbers for many listed chemicals, and to help government agencies with toxicological and medical information relevant to decisions involving public health. Instead, enforcement occurs by the attorney general, local district attorneys, the state Alcohol Beverage Control on a case-by-case basis, or private party lawsuits. The ABC thinks every alcohol licensee should display the warning sign, but Prop 65 itself exempts businesses with fewer than 10 employees.
How about the fiscal impact of Prop 65? The ballot estimate was that the measure would cost $500,000 in 1987 and perhaps more than $1 million per year in later years. Fast forward: OEHHA’s budget for 2011-2012 is $19.4 million, covering about 117 employees, many of whom are very highly educated. I need to add that people at OEHHA, especially Sam Delson, deputy director for external and legislative affairs, are among the most responsive government employees I’ve ever encountered. I asked questions and received immediate, comprehensive answers.
