Perhaps these numbers are not unfamiliar to you: One out of every ten people has a stomach ailment to some degree. One out of every six suffer from inability to conceive. The number of asthmatic children has grown by nearly four percentage points in the last ten years. In the next century, cancer will be the number one cause of death.

These facts are just the tip of the iceberg. Many office workers get headaches by afternoon. Many businessmen scurrying for orders have stomach pains. Working women often feel heart palpitations or lack of energy. Children get diarrhea when examination time rolls around. . . .

Even a hero fears illness. Once at the hospital, many people do every kind of test there is, but still can't find the cause of their ailment. The doctors call this a "psychosomatic illness" brought on psychologically-- another disease of civilization! The rate of increase of this type of psychosomatic illness, which is brought on by pressure, is by no means behind that of other illnesses. Everywhere you look, be it friends, family, or coworkers, there will be a large group of fellow-sufferers--about one in five strong.

It is not only that some traditional illnesses are increasing, there are also new illnesses like chronic exhaustion complex, fear or intense panic among children, and so on.

People at the end of the twentieth century can enjoy all manner of modern civilization-- in what we eat, how we dress, the places we live, and how we get around. Who would have thought that illnesses and their causes would also be in transformation.

Because of progress in medical technology, and the spread of an understanding of hygiene, a number of epidemic diseases caused by bacteria or microbes have gradually disappeared. Past diseases such as intestinal infections or pneumonia, with high death rates or high incidence, have gradually passed from the stage. Although some bacteriological illnesses have not been overcome, their place has been taken by "all kinds of illnesses introduced by the spread of chemicals and materials with urbanization and industrialization," notes Lan Chung-fu, director of the Institute of Public Health of the Yangming Hospital. This is the greatest threat from modern illnesses.

Historically speaking, when the industrial revolution began in 18th century Europe, a number of diseases brought by industry appeared, in particular in those on the front lines of handling raw materials--factory workers. From the discovery of virulent bladder excrescence in dye factories in Germany and Switzerland in the 19th century to the discovery of high rates of lung cancer in asbestos factories and Parkinson's disease in manganese steel factories in Britain and the United States, the continual appearance of these occupational diseases has been a serious shock to the medical community.

With factories producing the materials for occupationally related diseases, because there has been a lack of protective measures in the productive process, or residences and factories are not segregated, the number of areas and individuals affected has spread beyond the factory itself. Two examples are the black foot disease brought about by arsenic pollution in drinking water in southwestern coastal Taiwan in the 1970's and a loss of calcium in the bones, brought on by chemicals in rice two years ago. These types of diseases have mostly occurred in industrial advanced nations.

However, up to now, the environmental diseases brought on by pollution have by and large only remained incremental. Dangerous materials infiltrate our bodies in tiny amounts through more refined ways in processed products, or through the air, soil, or water, gradually becoming threats to our health.

The classic example is pulmonary disease which is clearly related to the air pollution brought by industry.

According to a survey of the National Taiwan University Hospital (NTUH) Department of Pediatrics, the rate of asthma among children was about 1.3% in the 1970's. In the 1980's it rose dramatically to 5%. And the rate is twice as high in heavily industrialized or urbanized areas like Taipei or Kao-hsiung than in places like Pingtung, which has kept its rural character.

This not only applies to asthma. "All pulmonary diseases have increased greatly," says Hsieh Kue-hsiung, doctor of pediatrics at NTUH. He says that on a typical afternoon he will see one or two hundred recurrent patients with pulmonary problems.

It has long been proven that there is a direct relationship between the rise in pulmonary disease and the large amount of dust, sulfur dioxide, carbon monoxide, and other chemicals produced by cars and factories. Taiwan is simply following in the footsteps of the advanced nations.

In London in 1952, more than 4,000 people suddenly died as a result of breathing difficulties brought on by factories burning coal and oil producing sulfur dioxide which invaded the lung cells and reduced the ability of the lung vesicles to deal with dust. Since that time the diseases caused by sulfur dioxide have come to be called "London Smog" type. In 1959 "Los Angeles Smog" appeared in the US. This was primarily caused by carbon monoxide emissions from automobiles. After the effects of sunlight, for more than 200 days per year for four consecutive years, many residents suffered eye problems because of some invisible irritant.

Every summer, when Taipei weather gets stultifying, it is hard for pollution left by cars and motorcycles to disperse. The environmental protection administration will issue warnings to old people and children to stay indoors as much as possible, because according to statistics they are twice as likely as others to get pulmonary infections.

And it is not only disease triggering factors in the larger environment which have penetrated everywhere because of changes in lifestyle. Think for a minute: What's different about our lives today? Composite materials have largely replaced natural ones in our clothes; soap has been displaced by body lotion; our foods are packed with additives, colorings, or preservatives to add taste or convenience; fertilizer increases agricultural production and pesticides wipe out insects. The materials for our homes and workplaces have changed from wood and stone to concrete, aluminum, asbestos, plastic, and paint. Copiers, office machines, and microwaves which emit radiant rays or electromagnetic waves have become efficient ways to handle tasks at home or office. And the vast amount of vehicles one can see on the main roads indicates that the consumption of petroleum is several tens of times greater than in the past.

For example, there are allergic diseases like nasal catarrh, atopic eczema, and urticaria, whose origins are similar to asthma. The increase in the number of sufferers and the lowering of age at which the diseases appear are related to the facilities in a modern home. Our living space is narrow and closed. Air circulation is poor, and there are carpets, mattresses, and wallpaper--all hotbeds for allergic triggers. Thus one kind of tiny but invisible insect which can trigger allergic responses has gone from 100 per gram of dust in old wooden style houses to 1000 per gram today.

Since 1981, when cancer jumped to the top of the list of leading killers of Chinese, it has maintained this "exalted position" until today. Improvements in medical diagnosis and the decline of virulent epidemic diseases are all factors in the rise of cancer to the top spot. Nevertheless, "the main reason is industrialization and the increase in carcinogens in our daily lives," points out NTUH pathologist Li Feng.

Although the basic cause of cancer has still not been discovered, it was pointed out in the US after large scale research was undertaken in the 1980's into the reasons behind cancer deaths that there is an 80% correlation between the occurrence of cancer and the environment. Besides smoking, the environment includes food additives, chemical fertilizers, industrial raw materials, chemical products, and environmental pollution.

After "packaging" these materials are turned into all kinds of products. For example, for a long time sarsaparilla drink included an additive that the department of health recently discovered is a carcinogen and announced that its use is no longer approved. In the past, a medicine commonly used to treat headaches could easily penetrate the skin and lead to brain hemorrhages and cancer. Then there is hair dye, which has already been proven to lead to blindness and bladder cancer; bleach, which stings the eyes, throat, and lungs, and leads to headaches, exhaustion, and breathing problems; correction fluid which includes carcinogens, and so on. These types of things are all around us.

At present, the number of chemicals and materials in the larger environment in creases at a rate of about 400 per year. Ac cording to US statistics, there are currently more than 20,000 kinds of chemicals in common use, of which nearly 6,000 are being tested for or have been proven to be health hazards.

Naturally it would be panic-mongering to suggest that all of these are dangerous to humans, because many of them have an insignificant impact on the human body. For some it is simply a matter of keeping the volume below a certain "permissible amount." Thus most advanced countries have stipulated methods of controlling chemical products, estimating their danger, the paths by which they are released, and the proper dosages, and setting the scope for their use and permissible amounts within a safe range.

Nevertheless, some doctors are still skeptical about these "permissible amounts" and argue that these have already become a "protective shield" for chemical products. "We've got a permissible level of this, and a permissible level of that, but in the end how much can people's bodies take?" asks Li Feng. Today, many people can't figure out why they would get cancer, but in fact they've already planted the seeds of it in their daily lives.

Thirty years ago, the American geneticist and biologist Rachel Carson issued a warning about the effects of chemicals on mankind in her famous book Silent Spring: "If you want living things to adapt to these chemicals, it will take an extended period of time, not just a matter of years in a single life, but several generations. But laboratories are continually manufacturing new chemicals, and people and animals must continually adapt. This far exceeds the rate of adaptability of mankind." The facts have borne out her vision.

"The destructiveness of manmade composites is slow, but fatal," says Li Feng. It is only after many products have reached the market and spread broadly that it is discovered that they can lead to cancer, infertility, or birth defects.

In terms of the danger of birth defects or lowered fertility, over the past few decades, the more advanced the country, the more serious the threat. Taking the US, where technology and medical care are most advanced, the rate of birth defects has stayed steady at 2%, with no way to effectively bring it down. Recently mainland China, which primarily burns coal for energy, also undertook a survey of birth defects. They discovered that because the pollution from coal-burning is relatively higher in the summer, the rate of children with birth defects is higher than that in the winter. In the Taiwan area, rate of deaths from inborn defects has continually been among the top fifteen causes of death. According to last year's census, the rate of birth defects is 1.7%.

Fetus deformities are caused by both genetic and nongenetic factors. In some cases, the reasons could be anticipated by the family quite early. But the medical community has discovered that in most cases there is no forewarning. Many mothers take no medications or X-rays during pregnancy, nor do they have any particular health problems. Yet the relationship between fetus deformities and pollution still awaits in-depth research. However, a number of pollutants which have come with industrial development have already been certified as factors raising the rate of birth defects. "Their impact on the genetic pool is an even greater challenge facing the future of mankind," points out Professor Lin Jen-hun of the Department of Biochemistry at NTUH.

Soong Yung-kuei, is director of OBGYN at Chang Geng hospital, and has done research on the relationship between the environment and infertility. He points out that one of the factors in the increase of the inability to conceive is lead or mercury in male sperm.

At the turn of the twentieth century, Western scientists began keeping records of the amounts of lead, mercury, and other chemicals which the human body is unable to expel or use which accumulate in the body. They discovered that the amount of lead in the air has on average increased more than 1,000 times over the pre-industrial revolution era, and increased ten times over in the human body.

Wang Jung-teh, a professor in the Graduate School of Public Health at National Taiwan University, did a study seven years ago of the amount of lead in new born children at the Municipal Hospital for Women and Children. The study discovered that the amount of lead in children of parents whose work had no relationship with lead still was as high as seven or eight milligrams. The medical community has long known that if the amount of lead in a newborn exceeds ten milligrams, this will affect intellectual development. An excess of lead in the mother's body can also lead to miscarriage, dead births, or infant mortality.

Someone once made the conclusion that the collapse of the Roman Empire was due in part to lead poisoning. This is because they applied a layer of lead of the relatively more obviously dangerous copper in their kitchen utensils. And indeed it has already been shown that there was an extremely high level of lead in Roman nobility.

Perhaps this problem can never be fully understood, but it might help us understand why the advanced countries are rushing to replace leaded gasoline with unleaded gas.

Just as the poisons produced in factories have led to occupational illnesses, industrial civilization has also brought "office building diseases" to office workers and white collar workers.

Today's cities are filled with glass encased office buildings. The windows are sealed shut and everything depends on the air conditioning circulation and filtering. Research has been conducted in the US on illnesses related to urban skyscrapers. It has been discovered that workers in offices without fresh air often have headaches, nausea, irregular glandular activity. Last year the ROC Environmental Protection Administration (EPA) invited scholars to undertake a survey of Taipei office buildings. Preliminary results show that the air quality control equipment in buildings in Taiwan is poor, so that many nine-to-fivers have headaches or inability to concentrate by the afternoon.

Besides this, people who work at their desks stay in a position with waists bent and heads lowered, creating chronic backache and sideache. The work of computer data entry has led to many cases of chronic muscular and skeletal system problems.

Signs advertising weight reduction are everywhere; health clubs are all the rage; and the popularity of vegetarian and coarsely prepared food indicates the rise of a "back to nature" attitude. This is because economic prosperity brought by industrial prosperity has led to luxuriant lives and long-term extravagant consumption of foods which are too rich and have too high a fat content, leading to overburdening the body's organs, generating in turn obesity, high blood pressure, and diabetes.

It has been known since the beginning of the century that industrial civilization does not merely bring physical illness. Dr. Lee Ming-bin of the NTUH Department of Psychiatry points out that several factors unique to industrialization and urbanization-- crowding, traffic, air and noise pollution, and even the knowledge explosion--are all sources of pressure for modern people, and all create psychological and physical maladies.

What kind of impact does the noise emanating from hectic traffic, airports, and neighboring factories have on people's health? "Don't assume that 'Well, it can't cause cancer' is an answer," explains Chen Yung- jen, director of the Office of Statistics at the EPA and a Ph.D. in public health. A noisy environment causes people to be unable to concentrate, raises blood pressure, raises the pulse rate, and reduces glandular secretions.

That the pressure and tension brought by the rapid pace of modern life affect our psychological and physical condition is a broad problem which should not be ignored. Yeh Ying-kun, former director of the Taipei Municipal Psychological Center, did a study in 1989 of psychological illnesses in the Taiwan area over the past thirty years. He discovered that though the incidence of schizophrenia has not changed, there has been an increase in psychosomatic disorders arising from interpersonal relations, confusion, fear and behavioral irregularities, leading to backaches, diarrhea, headaches, and so on.

However, there is no definitive conclusion about the relationship between these illnesses and the pollution and pressure brought on by modern civilization. One major reason is that these diseases--ulcers, high blood pressure, heart and arterial disease, and so on--are not acute illnesses brought on by a single cause, as many past epidemic diseases were, but are chronic illnesses brought on by numerous factors, so it is relatively hard to clarify cause and effect relationships.

Also, why is it that some people get ill and others don't under similar living environments? "Illnesses will clearly have different effects according to different living styles and physical condition of different people," Lin Jen-hun explains. For some people their ability to cope with pollutants is relatively high. Some people can smoke for a whole lifetime, but because there are fewer other pollutants in their environment, they can live to be 100. Some people eat a lot of fruit and vegetables, which assists in expelling many of the harmful products the body absorbs every day. There are many reasons why the relationship between the disease and the triggering factors is complex and hard to comprehend.

However, one can be certain that "there are certainly a great number of factors today which can lead to illness," say Lan Chung-fu. As a result, people's immunity is lowered. Thus pollutants are likely to increase the rate of sickness among old people, children, or those in poor physical condition.

For example, in an agricultural society where the air is clean, perhaps asthma and other allergic type illnesses will never be "activated" for a whole lifetime. Currently, fifty percent of the cases of allergic asthma have genetic factors behind them, but no genetic factors can be found in the other 50%. "Perhaps this is because the body's organs are continually harmed in this kind of environment, and ultimately develop allergic illnesses from a nonallergic condition," believes Hsieh Kue-hsiung.

The US federal government has done a survey of the contribution of health care to diseases, and discovered that medical technology is the most costly but has the least contribution to reducing disease, but that improvements in people's life styles and environment is the least expensive but most contributing item.

Thus it is not necessarily true that modern people become ill more easily, if only modern people will expend a little more effort to prevent illness triggering factors in their environment than their ancestors had to. For the present, this is a price that people must pay for industrial civilization.

Recently the EPA has been promoting the view of "common sense about danger." The hope is that one cannot but recognize the potential problems that come along with the convenience, efficiency, and enjoyment of modern products, and thus generate more recognition of and get more attention paid to the factors in life that can lead to disease, thus minimizing the threat to one's health. For example, heart disease can result from consumption beyond nutritional needs, so that one must reduce the amount of fatty foods, and so on.

Although these are only methods to treat the symptoms, how to maintain the benefits of industrialization while minimizing the disadvantages is too vast and too complex a problem. It is hard to change the larger environment, so one can only rely on oneself to treat the symptoms. Unfortunately, that's the best that can be hoped for at this stage in terms of reducing the diseases of civilization.

[Picture Caption]

The Progress of civilization hasn't reduced the incidence of disease for modern people. The photo shows a small child receiving treatment for asthma.

(Above) Because of the deterioration in air quality, infection by breathing has already become a nightmare for people today. (photo by Diago Chiu) (Below) Carpets and sheepskin rugs are two hothouses for allergic triggering factors.

Watch out, you clean hair freaks--regular blow-drying, washing, stylin g and perming can lead to hair loss.

Chemical compounds are an inescapable and useful part of daily life, including things like and cleaning fluid. But excessive use can aggravate problems like baldness or rashes.

Environmental illnesses appear first on those in the front lines: workers. Steel workers have to be especially careful of their eyes on the job. (photo by Diago chiu)

Pollutants entering the rivers and streams destroy the aquatic ecology and directly and indirectly threaten our health.

In traffic-clogged cities, how much dangerous matter is floating around in the air? And how much psychological stress comes along with the crowding?

(Above) An inability to conceive children is commonly seen as misfortune; a greater proportion of people may suffer this problem now than in the past.

(Below) Healthy babies are how mankind extends itself, but advanced industrial nations are unable to lower the number of children born with birth defects despite upgrading in health care and hygiene.

Pressures of work can affect moods, which can indirectly lead to physical illnesses. Psychosomatic illnesses are a common sight in modern societies.

"Diseases of civilization" are ordinarily chronic illnesses caused by multiple factors, and cannot be easily eradicated. For some the power of religion can help stabilize the spirit and ameliorate the illness.

The Progress of civilization hasn't reduced the incidence of disease for modern people. The photo shows a small child receiving treatment for asthma.

（Above） Because of the deterioration in air quality, infection by breathing has already become a nightmare for people today. （photo by Diago Chiu）

（Below） Carpets and sheepskin rugs are two hothouses for allergic triggering factors.

Watch out, you clean hair freaks--regular blow-drying, washing, stylin g and perming can lead to hair loss.

Chemical compounds are an inescapable and useful part of daily life, including things like and cleaning fluid. But excessive use can aggravate problems like baldness or rashes.

Environmental illnesses appear first on those in the front lines: workers. Steel workers have to be especially careful of their eyes on the job. （photo by Diago chiu）

Pollutants entering the rivers and streams destroy the aquatic ecology and directly and indirectly threaten our health.

In traffic-clogged cities, how much dangerous matter is floating around in the air? And how much psychological stress comes along with the crowding?

（Above） An inability to conceive children is commonly seen as misfortune; a greater proportion of people may suffer this problem now than in the past.

（Below） Healthy babies are how mankind extends itself, but advanced industrial nations are unable to lower the number of children born with birth defects despite upgrading in health care and hygiene.

Pressures of work can affect moods, which can indirectly lead to physical illnesses. Psychosomatic illnesses are a common sight in modern societies.

"Diseases of civilization" are ordinarily chronic illnesses caused by multiple factors, and cannot be easily eradicated. For some the power of religion can help stabilize the spirit and ameliorate the illness.