TESTIMONY OF NACHMAN BRAUTBAR, M.D.
TUESDAY, DECEMBER 9, 1997
Los Angeles, CA

Honorable Senator Boxer, members, ladies and gentlemen, it is an honor to testify in front of the United States Senate Environment and Public Works Committee. My name is Dr. Brautbar, a medical doctor from Los Angeles, and a 23 year resident and citizen of California. I am testifying today as a physician and scientist. I have no political agenda and have not received any compensation, from either the opponent or proponent, to be here today.

I practice medicine, treat and diagnose patients, and teach at the University of Southern California School of Medicine and hold the title of Professor of Clinical Medicine, and former Associate Professor of Pharmacology. I am a member of the National Society of Toxicology, American College of Toxicology, and have published over 160 scientific medical papers in medicine, toxicology and pharmacology. My resume is attached to your package as Exhibit "A".

In the last 5 years I have studied the health effect of MTBE in gasoline on patients, and personally examined over 350 patients with MTBE health related problems from drinking water contaminated with MTBE and gasoline. The patients I have seen and examined have been exposed to MTBE and gasoline in the drinking water, due to contamination from leaking gasoline tanks. Those 350 patients who did not know that they were exposed to MTBE in gasoline developed skin rashes, sinus congestion, severe headaches, loss of memory, shortness of breath, asthma, diarrhea and abnormal white blood cell life span. These symptoms which started in 1992 were verified by review of medical records, examination and laboratory testing. Before these patients were exposed to MTBE and gasoline in drinking water none of them experienced any of these symptoms and findings. Removing these patients from MTBE and gasoline contaminated water resulted in some improvement and in some, complete reversal of these pathological and disabling findings.

In addition to the objective studies and physical examination documenting the validity of those complaints, I have conducted studies of the blood cells in these patients. These tests showed that the life span of the white blood cells of MTBE in gasoline exposed patients was reduced significantly, indicating serious harmful effects of MTBE in gasoline in linewith the position of leading physicians and scientists worldwide, that MTBE in gasoline is harmful to humans (Exhibit "B"). My studies have been published in scientific peer reviewed journals, preprints of these manuscripts are attached here as Exhibits "C" and "D".

MTBE causes cancers in many organs and tissues in significant numbers of experimental animals and these cancers are identical to those exposures by the same doses as has been described for other carcinogens such vinyl chloride and benzene which are known human carcinogens. My opinion is supported by the general agreement among experts in chemical carcinogens, that a substance which causes cancer in significant numbers of experimental animals in well documented assays, poses a presumptive carcinogenic risk to some humans even in the absence of confirmatory experimental data in humans. Even though there is no recognized method as yet for establishing the existence of a threshold for a carcinogen in human populations, these principles, which are accepted by scientific and medical experts throughout the world, have served for many years and are still serving as the basis for some public health and policy and regulatory action on carcinogens. Specifically, the International Agency for Research on Cancer (IARC) of the world health organization in its supplement 7 of the monograph, 1987, page 22, indicates that the information compiled from the first 41 volumes of IARC, shows that of the 44 agents for which there is sufficient or limited evidence of carcinogenicity to humans, all 37 have been tested adequately in experimentally produced cancer in at least one animal species...-in the absence of adequate data on humans it is biologically plausible and prudent to regard agents for which there is sufficient evidence of carcinogencity in experimental animals as if they presented a carcinogenic risk to humans. (Exhibit "E" attached)

The permissible water levels for benzene and vinyl chloride, which are carcinogenic, has been reduced extensively to levels of 0.7 for benzene and 0.5 for vinyl chloride micrograms per liter in California, and 1 micrograms per liter for benzene and 2 micrograms per liter for vinyl chloride in North Carolina. In February of 1996 the U.S. EPA conducted an inter agency assessment of potential health risks associated with oxygenated gasoline, which was concerned mainly with MTBE. Using the EPA's own data from that meeting, table 5, my colleague Dr. Mehlman has calculated the exposure level for MTBE. Based on the lymphoma and leukemia data from the EPA's table 5, the upper bound limit cancer risk is 4 x 103 milligrams per kilograms per day which means in simple language that this level of exposure to MTBE 4 individuals per 1,000 may develop cancer. This is an extremely high risk and such an exposure is not justified. Specifically, the State of North Carolina classifies water suitable for drinking to mean "the quality of water which does not contain substances in concentrations which either singularly or in combination isingested into human body, may cause death, disease, behavioral abnormalities, congenital defects, genetic mutations will result in incremental lifetime cancer risk in excess of 1 per 1 million." Thus, based on North Carolina's definition and the maximum risk of cancer of 1 per 1 million, the reported oral potency in risk for leukemia and lymphoma of 4 per 1 million violates these provisions.

The substantial weight of evidence clearly indicates that MTBE is carcinogenic. This is reported by several studies where MTBE was shown to cause cancer in 2 different species of experimental animals. The medical scientists are further clear that pregnant women, young children, people on medications, and sensitive individuals are at even greater risk for developing cancers. Thus the levels of exposure for these individuals may be extremely high.

The permissible exposure levels of contaminants in drinking water for possible or probable human carcinogens are set extremely low, sometimes even as low as for a known human carcinogen. Accordingly, I am of the opinion that in order to reduce or prevent unnecessary risk of individuals developing cancers the drinking water standard should be no greater than that for benzene (<0.7 ppb).

For a susceptible individual, there may be a hundred times greater risk for contracting and dying from cancer. The hundred times greater susceptibility factor is based on an analogy to MTBE in gasoline. Cross sensitivity of MTBE in gasoline is 100 times greater than MTBE alone and causes a tremendous variety of acute illnesses including neurological, allergic and respiratory in humans. This indicates strong synergistic interaction with other chemicals as in the case of, for instance, asbestos and smoking causing lung cancer. The smoking factor increases the risk of asbestos related cancer by a factor of multiplied 60 to 80.

This issue of synergistic effects, meaning exposure to MTBE alone may not be as carcinogenic and as toxic as exposure to MTBE and gasoline due to multiplying the risk factor by a factor of 100. The synergistic effect may occur out of joint or separate exposure to single compounds, as well as one of exposure to mixture of potentially carcinogenic compounds, that is exactly what is happening with MTBE and gasoline that penetrates the drinking water from corroded tanks such as in the case of Wilmington, North Carolina, such as in the case of Santa Monica, California, and such as in the case of Glenwood, California. It is the issue of the synergistic effect of MTBE and gasoline contaminating the drinking water and consumed by unknowing citizens, children, pregnant women, elderly and patients with chronic diseases on a daily basis. This synergistic effect is described nicely and summarized on Exhibit "F".

My office receives many phone calls daily from patients who are sick and have been exposed to MTBE and are seeking medical help. This problem is not unique to the citizens of California. Patients in Alaska, Maine, New Jersey, North Carolina, Pennsylvania, Michigan and others have been presenting with these same problems as a result of exposure to MTBE in gasoline. Indeed, the State of Alaska has banned the used of MTBE in gasoline as a result (Exhibit "G").

History is a good predictor and teacher of the future. Throughout my 30 years as a physician, I have seen patients who suffered lung disease and lung cancer from cigarette smoking, but was told by the cigarette companies that cigarette smoking is safe, the rest today is indeed history.

Indeed our great State of California under the leadership of the Honorable Senator Mountjoy is, in my opinion, following in the footsteps of Alaska. Most recently Chevron, the States largest refiner, announced that the company is asking the State air resource board to allow it to make gasoline without MTBE, saying in a statement that MTBE and similar chemicals do little to reduce smog and is a threat to water supplies. Seven wells in Santa Monica have been shut because of MTBE contamination and water experts fear that MTBE will cloud all wells in years to come. Chevron's K.C. Bishop was quoted to say that when customers are concerned Chevron is concerned. I believe that the writing is on the wall, scientific data and medical studies are clear, concise, and the public, as well as manufacturers such as Chevron are realizing that exposing the public to MTBE in gasoline is a dangerous and is uncalled for.