More companies are investing in renewable energy to power their operations and offset their carbon emissions...Getty Images
EBay at its very core pioneered the circular economy — of finding new homes for treasures that might otherwise have ended up at the dump. “Avoiding items going into a landfill is very important to our customers,” says Steve Priest, CFO of eBay. “Driving the circular economy is part of everything we do.” But finding new shelves for Beanie Babies is just a small component in eBay’s sustainability efforts, which prioritize slashing greenhouse gas emissions.
In eBay’s case, these are mostly tied to electricity used to power vast data centers. Since 2017 eBay has cut its carbon emissions by 29% to 88,000 tons per year. The e-commerce giant became carbon neutral this year, and is aiming to achieve a 100% renewable electricity supply for all its offices and data centers by 2025.
This goal might actually be attainable in the next few years as eBay’s biggest clean energy projects yet come online. The White Mesa Wind Project in Texas (a joint venture with Apple, Sprint and Samsung) began operating this year, producing 75 peak megawatts for the four companies, enough to power 20,000 homes.
Meanwhile the Ventress Solar Project in Louisiana, a virtual purchase power agreement between eBay, McDonalds and BP’s Lightsource division, will generate 345 MW. “We collaborate with our tech peers when some sustainability issues come up, where banding together makes more sense,” says eBay’s chief sustainability officer Renee Morin.
Such efforts have earned eBay the no. 11 spot on our inaugural Forbes Green Growth 50 list. Using emissions data from Sustainalytics and financial data from FactSet Research Systems, we honed in on U.S. companies with market caps greater than $5 billion, that started with more than 100,000 tons of carbon dioxide equivalent emissions in 2017, and have since successfully reduced their emissions while simultaneously growing profitability (as measured by an absolute increase in net income or operating income from 2017-2020).
Going in, we figured these criteria would produce a list of more than 100 companies. But green growth is harder than it looks — both Weyerhaeuser and Edison International, ranking no. 21 and no. 10 on our list, grew earnings less than 2% since 2017.
Is there a connection between cutting carbon emissions and boosting earnings? eBay’s Priest thinks we’ve reached the point where companies that don’t care about green will find it nearly impossible to deliver growth. “Customers want to be associated with corporations that take their environmental responsibilities very seriously. Those that do will continue to drive loyalty from their customer base.”
This is a strategic emphasis echoed by Stephan Tanda, CEO of Aptar, which took the no. 1 spot on the Green Growth 50. Aptar makes myriad drug delivery systems and dispensing products for consumer goods, especially foods and cosmetics. “We look at everything we do through a sustainability lens.” Most of Aptar’s facilities in Europe are already certified landfill free. By the end of the year Aptar is looking to achieve “80% disposal avoidance.”
It’s a business that involves reconciling contradictions — most of their products are plastic, which he says actually has a pretty low carbon footprint relative to alternative containers. A new Aptar product is a “monomaterial” lotion pump with no metal parts, entirely recyclable.
Consumer demand for such new products is arguably more impactful than the kind of government policy circus on display at the recent COP26 meetings in Glasgow, Scotland.
“Governments don’t impact what we do that much. Consumers and patients and customers demand what we do,” says Tanda. They will pay for the carbon transition because it is what they want. Listening to the consumers is how Tanda aims to “future proof our business.”
That approach has worked for electricity giant AES, which landed no. 15 on the Green Growth 50 list after reducing emissions by 22%, replacing coal-fired power plants with wind, solar and batteries — “a winning combination that can decarbonize 90% of the grid,” says Chris Shelton, president of AES Next. Because the costs of renewables kept going down, they were able to shift customers over under a “green, blend and extend” program.
AES also operates a kind of inhouse venture capital operation. Its Fluence utility-scale battery joint venture with Siemens recently went public and now sports a $6 billion market cap — the company behind some of the biggest battery installations in the world.
There used to be a large group of companies “in denial” about mitigating greenhouse gas emissions. “That group is vanishing fast,” with companies moving over to the “bargaining” group, where they want to know the minimum they have to do to get by and keep activists off their back — that’s the insight of Chris Romer, cofounder of Project Canary, which installs laser-based sensors at industrial sites to monitor methane leakages.
The landmark ESG moment, he says, was last year’s ExxonMobil annual meeting, where shareholders voted in more green-friendly board members. There’s no going back. Romer says manufacturers can already earn multiples of their monitoring and certification costs by selling “green” products at a premium.
Even on the Green Growth 50, some companies are less enthusiastic than others. Nicotine giant Altria for example, positioned at no. 35 on our list, seems to be doing just enough, having cut emissions by 10% in the studied time period. But according to its most recent sustainability report, Altria’s renewable energy use is just 2.3% of its total, a surprisingly meager ratio.
Altria also demonstrates how hard it can be to stick to a well intentioned program. The company was making great strides toward reducing the amount of waste it was sending to the landfill. In 2018 it nearly hit its 21 million pounds goal. But 2019 wrecked the trend, when Altria delivered 87 million tons to landfill — mostly rubble from a headquarters renovation. Their next challenge: reducing litter from cigarette butts.
Stronger performers included Eli Lilly, which ranked eighth on our list after the pharmaceutical company swapped out old light bulbs for LEDs at three plants, saving 330 mwh per year. And Bristol Myers Squibb, which heats its Munich, Germany office building with 100% geothermal energy, found itself at no. 13. Church & Dwight, parent company of Arm & Hammer, has meanwhile placed third on the list, having achieved its goals of no more PVC in packaging, and offsets carbon emissions by planting millions of trees in the Mississippi River Valley.
CREDIT: PETER AND MARIA HOEY -Plant-based meats claim to offer the sensory experience of real meat at a fraction of the environmental cost. Are they really as green as they say?
Marketed to meat lovers, plant-based burgers like Impossible and Beyond claim to taste like the real thing and to have far lighter environmental footprints. Here’s what the numbers have to say.
If you’re an environmentally aware meat-eater, you probably carry at least a little guilt to the dinner table. The meat on our plates comes at a significant environmental cost through deforestation, greenhouse gas emissions, and air and water pollution — an uncomfortable reality, given the world’s urgent need to deal with climate change.
That’s a big reason there’s such a buzz today around a newcomer to supermarket shelves and burger-joint menus: products that look like real meat but are made entirely without animal ingredients. Unlike the bean- or grain-based veggie burgers of past decades, these “plant-based meats,” the best known of which are Impossible Burger and Beyond Meat, are marketed heavily toward traditional meat-eaters. They claim to replicate the taste and texture of real ground meat at a fraction of the environmental cost.
If these newfangled meat alternatives can fill a large part of our demand for meat — and if they’re as green as they claim, which is not easy to verify independently — they might offer carnivores a way to reduce the environmental impact of their dining choices without giving up their favorite recipes.
That could be a game-changer, some think. “People have been educated a long time on the harms of animal agriculture, yet the percentage of vegans and vegetarians generally remains low,” says Elliot Swartz, a scientist with the Good Food Institute, an international nonprofit organization that supports the development of alternatives to meat. “Rather than forcing people to make behavior changes, we think it will be more effective to substitute products into their diets where they don’t have to make a behavior switch.”
There’s no question that today’s meat industry is bad for the planet. Livestock account for about 15 percent of global greenhouse gas emissions both directly (from methane burped out by cattle and other grazing animals and released by manure from feedlots and pig and chicken barns) and indirectly (largely from fossil fuels used to grow feed crops). Indeed, if the globe’s cattle were a country, their greenhouse gas emissions alone would rank second in the world, trailing only China.
Worse yet, the United Nations projects that global demand for meat will swell by 15 percent by 2031 as the world’s increasing — and increasingly affluent — population seeks more meat on their plates. That means more methane emissions and expansion of pastureland and cropland into formerly forested areas such as the Amazon — deforestation that threatens biodiversity and contributes further to emissions.
Not all kinds of meat animals contribute equally to the problem, however. Grazing animals such as cattle, sheep and goats have a far larger greenhouse gas footprint than non-grazers such as pigs and chickens. In large part that’s because only the former burp methane, which happens as gut microbes digest the cellulose in grasses and other forage.
Pigs and chickens are also much more efficient at converting feed into edible flesh: Chickens need less than two pounds of feed, and pigs need roughly three to five pounds, to put on a pound of body weight. (The rest goes to the energy costs of daily life: circulating blood, moving around, keeping warm, fighting germs and the like.) Compare that to the six to 10 pounds of feed per pound of cow.
As a result, the greenhouse gas emissions of beef cattle per pound of meat are more than six times those of pigs and nearly nine times those of chicken. (Paradoxically, grass-fed cattle — often thought of as a greener alternative to feedlot beef — are actually bigger climate sinners, because grass-fed animals mature more slowly and thus spend more months burping methane.)
Building fake meat
Plant-based meats aim to improve on that dismal environmental performance. Stanford University biochemist Pat Brown, for example, founded Impossible Foods after asking himself what single step he could take to make the biggest difference environmentally. His answer: Replace meat.
To do that, Impossible and its competitors basically deconstruct meat into its component parts, then build an equivalent product from plant-based ingredients. The manufacturers start with plant protein — mostly soy for Impossible, pea for Beyond, and potato, oat or equivalent proteins for others — and add carefully selected ingredients to simulate meat-like qualities. Most include coconut oil for its resemblance to the mouthfeel of animal fats, and yeast extract or other flavorings to add meaty flavors. Impossible even adds a plant-derived version of heme, a protein found in animal blood, to yield an even more meat-like appearance and flavor.
All this requires significant processing, notes William Aimutis, a food protein chemist at North Carolina State University, who wrote about plant-based proteins in the 2022 Annual Review of Food Science and Technology. Soybeans, for example, are typically first milled into flour, and then the oils are removed. The proteins are isolated and concentrated, then pasteurized and spray-dried to yield the relatively pure protein for the final formulation. Every step consumes energy, which raises the question: With all this processing, are these meat alternatives really greener than what they seek to replace?
To answer that question, environmental scientists conduct what’s known as a life cycle analysis. This involves taking each ingredient in the final product — soy protein, coconut oil, heme and so forth — and tracing it back to its origin, logging all the environmental costs involved. In the case of soy protein, for example, the life cycle analysis would include the fossil fuels, water and land needed to grow the soybeans, including fossil fuel emissions from the fertilizer, pesticides and transportation to the processing plant. Then it would add the energy and water consumed in milling, defatting, protein extraction and drying.
Similar calculations would apply to all the other ingredients, and to the final process of assembly and packaging. Put it all together, and you end up with an estimate of the total environmental footprint of the product.
Unfortunately, not all those numbers are readily available. For many products, especially unique ones like the new generation of plant-based meats, product details are secrets closely held by the companies involved. “They will know how much energy they use and where they get their fat and protein from, but they will not disclose that to the general public,” says Ricardo San Martin, a chemical engineer who codirects the Alternative Meats Lab at the University of California, Berkeley. As a result, most life cycle analyses of plant-based meat products have been commissioned by the companies themselves, including both Beyond and Impossible. Outsiders have little way of independently verifying them.
Even so, those analyses suggest that plant-based meats offer clear environmental advantages over their animal-based equivalents. Impossible’s burger, for example, causes just 11 percent of the greenhouse gas emissions that would come from an equivalent amount of beef burger, according to a study the company commissioned from the sustainability consulting firm Quantis. Beyond’s life cycle analysis, conducted by researchers at the University of Michigan, found their burger’s greenhouse gas emissions were 10 percent of those of real beef.
Indeed, when independent researchers at Johns Hopkins University decided to get the best estimates they could by combing through the published literature, they found that in the 11 life cycle analyses they turned up, the average greenhouse gas footprint from plant-based meats was just 7 percent of beef for an equivalent amount of protein. The plant-based products were also more climate-friendly than pork or chicken — although less strikingly so, with greenhouse gas emissions just 37 percent and 57 percent, respectively, of those for the actual meats.
Similarly, the Hopkins team found that producing plant-based meats used less water: 23 percent that of beef, 11 percent that of pork and 24 percent that of chicken for the same amount of protein. There were big savings, too, for land, with the plant-based products using 2 percent that of beef, 18 percent that of pork and 23 percent that of chicken for a given amount of protein. The saving of land is important because, if plant-based meats end up claiming a significant market share, the surplus land could be allowed to revert to forest or other natural vegetation; these store carbon dioxide from the atmosphere and contribute to biodiversity conservation. Other studies show that plant-based milks offer similar environmental benefits over cow’s milk (see Box).
A caution on cultivation methods
Of course, how green plant-based meats actually are depends on the farming practices that underlie them. (The same is true for meat itself — the greenhouse gas emissions generated by a pound of beef can vary more than tenfold from the most efficient producers to the least.) Plant-based ingredients such as palm oil grown in plantations that used to be rainforest, or heavily irrigated crops grown in arid regions, cause much more damage than more sustainably raised crops. And cultivation of soybeans, an important ingredient for some plant-based meats, is a major contributor to Amazon deforestation.
However, for most ingredients it seems likely that even poorly produced plant-based meats are better, environmentally, than meat from well-raised livestock. Plant-based meats need much less soy than would be fed to actual livestock, notes Matin Qaim, an agricultural economist at the University of Bonn, Germany, who wrote about meat and sustainability in the 2022 Annual Review of Resource Economics. “The reason we’re seeing deforestation in the Amazon,” he explains, “is because the demand for food and feed is growing. When we move away from meat and more toward plant-based diets, we need less area in total, and the soybeans don’t necessarily have to grow in the Amazon.”
But green as they are, plant-based meats have a few hurdles to clear before they can hope to replace meat. For one thing, plant-based meats currently cost an average of 43 percent more than the products they hope to replace, according to the Good Food Institute. That helps to explain why plant-based meats account for less than 1 percent of meat sales in the US. Advocates are optimistic that the price will come down as the market develops, but it hasn’t happened yet. And achieving those economies of scale will take a lot of work: Even growing to a mere 6 percent of the market will require a $27 billion investment in new facilities, says Swartz.
Steak hasn’t yet been well done
In addition, all of today’s plant-based meats seek to replace ground-meat products like burgers and chicken nuggets. Whole-muscle meats like steak or chicken breast have a more complex, fibrous structure that the alt-meat companies have not yet managed to mimic outside the lab.
Part of the problem is that most plant proteins are globular in shape, while real muscle proteins tend to form long fibers. To form a textured meat-like product, scientists essentially have to turn golf balls into string, says David Julian McClements, a food scientist at the University of Massachusetts, Amherst, and an editor of the Annual Review of Food Science and Technology. There are ways to do that, often involving high-pressure extrusion or other complex technology, but so far no one has a whole-muscle product ready for market. (A fungal product, sold for decades in some countries as Quorn, is naturally fibrous, but its sales have never taken off in the US. Other companies are also working on meat substitutes based on fungal proteins.)
McClements is experimenting with another approach to make plant-based bacon: creating separate plant-based analogs of muscle and fat, then 3D-printing the distinctive marbling of the bacon. “I think we’ve got all the elements to put it together,” he says.
Some critics also note that a shift toward plant-based meat may reinforce the industrialization of global food systems in an undesirable way. Most alternative meat products are formulated in factories, and their demand for plant proteins and other ingredients favors Big Agriculture, with its well-documented problems of monoculture, pesticide use, soil erosion and water pollution from fertilizer runoff. Plant-based meats will reduce the impact of these unsustainable farming practices, but they won’t eliminate them unless current farming practices change substantially.
Of course, all the to-do about alternative meats overlooks another dietary option, one with the lowest environmental footprint of all: Simply eat less meat and more beans, grains and vegetables. The additional processing involved in plant-based meats means that they generate 4.6 times more greenhouse gas than beans, and seven times more than peas, per unit of protein, according to the Hopkins researchers. Even traditional, minimally processed plant protein such as tofu beats plant-based meats when it comes to greenhouse gas. Moreover, most people in wealthy countries eat far more protein than they need, so they can simply cut back on their protein consumption without seeking out a replacement.
But that option may not appeal to the meat-eating majority today, which makes alternative meats a useful stopgap. “Would I prefer that people were eating beans and grains and tofu, and lots of fruits and vegetables? Yes,” says Bonnie Liebman, director of nutrition at the Center for Science in the Public Interest, an advocacy organization supporting healthy eating.
“But there are a lot of people who enjoy the taste of meat and are probably not going to be won over by tofu. If you can win them over with Beyond Meat, and that helps reduce climate change, I’m all for it.”
Sharon calls herself a universal reactor. In the 1990s, she became allergic to the world, to the mould colonising her home and the paint coating her kitchen walls, but also deodorants, soaps and anything containing plastic. Public spaces rife with artificial fragrances were unbearable. Scented disinfectants and air fresheners in hospitals made visiting doctors torture. The pervasiveness of perfumes and colognes barred her from in-person social gatherings.
Even stepping into her own back garden was complicated by the whiff of pesticides and her neighbour’s laundry detergent sailing through the air. When modern medicine failed to identify the cause of Sharon’s illness, exiting society felt like her only solution. She started asking her husband to strip and shower every time he came home. Grandchildren greeted her through a window. When we met for the first time, Sharon had been housebound for more than six years.
When I started medical school, the formaldehyde-based solutions used to embalm the cadavers in the human anatomy labs would cause my nose to burn and my eyes to well up – representing the mild, mundane end of a chemical sensitivity spectrum. The other extreme of the spectrum is an environmental intolerance of unknown cause (referred to as idiopathic by doctors) or, as it is commonly known, multiple chemical sensitivity (MCS).
An official definition of MCS does not exist because the condition is not recognised as a distinct medical entity by the World Health Organization or the American Medical Association, although it has been recognised as a disability in countries such as Germany and Canada.
Disagreement over the validity of the disease is partially due to the lack of a distinct set of signs and symptoms, or an accepted cause. When Sharon reacts, she experiences symptoms from seemingly every organ system, from brain fog to chest pain, diarrhoea, muscle aches, depression and odd rashes. There are many different triggers for MCS, sometimes extending beyond chemicals to food and even electromagnetic fields. Consistent physical findings and reproducible lab results have not been found and, as a result, people such as Sharon not only endure severe, chronic illness but also scrutiny over whether their condition is “real”.
The first reported case of MCS was published in the Journal of Laboratory and Clinical Medicine in 1952 by the American allergist Theron Randolph. Although he claimed to have previously encountered 40 cases, Randolph chose to focus on the story of one woman, 41-year-old Nora Barnes. She had arrived at Randolph’s office at Northwestern University in Illinois with a diverse and bizarre array of symptoms.
A former cosmetics salesperson, she represented an “extreme case”. She was always tired, her arms and legs were swollen, and headaches and intermittent blackouts ruined her ability to work. A doctor had previously diagnosed her with hypochondria, but Barnes was desperate for a “real” diagnosis.
Randolph noted that the drive into Chicago from Michigan had worsened her symptoms, which spontaneously resolved when she checked into her room on the 23rd floor of a hotel where, Randolph reasoned, she was far away from the noxious motor exhaust filling the streets. In fact, in his report Randolph listed 30 substances that Barnes reacted to when touched (nylon, nail polish), ingested (aspirin, food dye), inhaled (perfume, the “burning of pine in fireplace”) and injected (the synthetic opiate meperidine, and Benadryl).
He posited that Barnes and his 40 other patients were sensitive to petroleum products in ways that defied the classic clinical picture of allergies. That is, rather than an adverse immune response, such as hives or a rash where the body is reacting to a particular antigen, patients with chemical sensitivities were displaying an intolerance. Randolph theorised that, just as people who are lactose-intolerant experience abdominal pain, diarrhoea and gas because of undigested lactose creating excess fluid in their gastrointestinal tract, his patients were vulnerable to toxicity at relatively low concentrations of certain chemicals that they were unable to metabolise.
He even suggested that chemical sensitivity research was being suppressed by “the ubiquitous distribution of petroleum and wood products”. MCS, he believed, was not only a matter of scientific exploration, but also of deep-seated corporate interest. Randolph concludes his report with his recommended treatment: avoidance of exposure.
In that one-page abstract, Randolph cut the ribbon on the completely novel but quickly controversial field of environmental medicine. Nowadays, we hardly question the ties between the environment and wellbeing. The danger of secondhand smoke, the realities of climate change and the endemic nature of respiratory maladies such as asthma are common knowledge. The issue was that Randolph’s patients lacked abnormal test results (specifically, diagnostic levels of immunoglobulin E, a blood marker that is elevated during an immune response). Whatever afflicted them were not conventional allergies, so conventional allergists resisted Randolph’s hypotheses.
Randolph was in the dark. Why was MCS only now rearing its head? He also asked another, more radical question: why did this seem to be a distinctly American phenomenon? After all, the only other mention of chemical sensitivities in medical literature was in the US neurologist George Miller Beard’s 1880 textbook A Practical Treatise on Nervous Exhaustion (Neurasthenia).
Beard argued that sensitivity to foods containing alcohol or caffeine was associated with neurasthenia, a now-defunct term used to describe the exhaustion of the nervous system propagated by the US’s frenetic culture of productivity. Like Beard, Randolph saw chemical sensitivities as a disease of modernity, and conceived the origin as wear-and-tear as opposed to overload.
Randolph proposed that Americans, propelled by the post-second world war boom, had encountered synthetic chemicals more and more in their workplaces and homes, at concentrations considered acceptable for most people. Chronic exposure to these subtoxic dosages, in conjunction with genetic predispositions, strained the body and made patients vulnerable. On the back of this theory, Randolph developed a new branch of medicine and, with colleagues, founded the Society for Clinical Ecology, now known as the American Academy of Environmental Medicine.
As his professional reputation teetered, his popularity soared and patients flocked to his care. Despite this growth in interest, researchers never identified blood markers in MCS patients, and trials found that people with MCS couldn’t differentiate between triggers and placebos. By 2001, a review in the Journal of Internal Medicine found MCS virtually nonexistent outside western industrialised countries, despite the globalisation of chemical use, suggesting that the phenomenon was culturally bound.
MCS subsequently became a diagnosis of exclusion, a leftover label used after every other possibility was eliminated. The empirical uncertainty came to a head in 2021, when Quebec’s public health agency, the INSPQ, published an 840-page report that reviewed more than 4,000 articles in the scientific literature, concluding that MCS is an anxiety disorder.
In medicine, psychiatric disorders are not intrinsically inferior; serious mental illness is, after all, the product of neurological dysfunction. But the MCS patients I spoke to found the language offensive and irresponsible. Reducing what they felt in their eyes, throats, lungs and guts to anxiety was not acceptable at all.
As a woman I will call Judy told me: “I would tell doctors my symptoms, and then they’d run a complete blood count and tell me I looked fine, that it must be stress, so they’d shove a prescription for an antidepressant in my face and tell me to come back in a year.” In fact, because MCS is so stigmatising, such patients may never receive the level of specialised care they need.
In the wake of her “treatment”, Judy was frequently bedbound from crushing fatigue, and no one took her MCS seriously. “I think a lot of doctors fail to understand that we are intelligent,” she said. “A lot of us with chemical sensitivities spend a good amount of our time researching and reading scientific articles and papers. I probably spent more of my free time reading papers than most doctors.”
Judy grew up in Texas, where she developed irritable bowel syndrome and was told by doctors that she was stressed. Her 20s were spent in Washington state where she worked as a consultant before a major health crash left her bedbound for years (again, the doctors said she was stressed). Later, after moving to Massachusetts, a new paint job at her home gave her fatigue and diarrhoea.
She used to browse the local art museum every Saturday, but even fumes from the paintings irritated her symptoms. She visited every primary care doctor in her city, as well as gastroenterologists, cardiologists, neurologists, endocrinologists and even geneticists. Most of them reacted the same way: with a furrowed brow and an antidepressant prescription in hand. “Not one allopathic doctor has ever been able to help me,” Judy said.
Morton Teich is one of the few physicians who diagnoses and treats patients with MCS in New York. The entrance to his integrative medicine private practice is hidden away behind a side door in a grey-brick building on Park Avenue. As I entered the waiting room, the first thing to catch my eye was the monstrous mountain of folders and binders precariously hugging a wall, in lieu of an electronic medical record.
I half-expected Teich’s clinic to resemble the environmental isolation unit used by Randolph in the 1950s, with an airlocked entrance, blocked ventilation shafts and stainless-steel air-filtration devices, books and newspapers in sealed boxes, aluminium walls to prevent electromagnetic pollution, and water in glass bottles instead of a cooler. But there were none of the above. The clinic was like any other family medicine practice I had seen before; it was just very old. The physical examination rooms had brown linoleum floors and green metal chairs and tables. And there were no windows.
Although several of Teich’s patients were chemically sensitive, MCS was rarely the central focus of visits. When he introduced me, as a student writing about MCS, to his first patient of the day, a petrol-intolerant woman whose appointment was over the phone because she was housebound, she admitted to never having heard of the condition. “You have to remember,” Teich told me, “that MCS is a symptom. It’s just one aspect of my patients’ problems. My goal is to get a good history and find the underlying cause.” Later, when I asked him whether he had observed any patterns suggesting an organic cause of MCS, he responded: “Mould. Almost always.”
Many people with MCS I encountered online also cited mould as a probable cause. Sharon told me about her first episode in 1998, when she experienced chest pain after discovering black mould festering in her family’s trailer home. A cardiac examination had produced no remarkable results, and Sharon’s primary care physician declared that she was having a panic attack related to the stress of a recent miscarriage. Sharon recognised that this contributed to her sudden health decline, but also found that her symptoms resolved only once she began sleeping away from home.
She found recognition in medical books such as Toxic (2016) by Neil Nathan, a retired family physician who argued that bodily sensitivities were the product of a hyper-reactive nervous system and a vigilant immune system that fired up in reaction to toxicities, much as Randolph had said. The conditions that Nathan describes are not supported by academic medicine as causes of MCS: mould toxicity and chronic Lyme disease are subject to the same critique.
Sharon went to see William Rea, a former surgeon (and Teich’s best friend). Rea diagnosed her with MCS secondary to mould toxicity. “Mould is everywhere,” Teich told me. “Not just indoors. Mould grows on leaves. That’s why people without seasonal allergies can become chemically sensitive during autumn.” When trees shed their leaves, he told me, mould spores fly into the air. He suspected that American mould is not American at all, but an invasive species that rode wind currents over the Pacific from China. He mentioned in passing that his wife recently died from ovarian cancer. Her disease, he speculated, also had its roots in mould.
In fact, Teich commonly treats patients with nystatin, an antifungal medication used to treat candida yeast infections, which often infect the mouth, skin and vagina. “I have an 80% success rate,” he told me. I was dubious that such a cheap and commonplace drug was able to cure an illness as debilitating as MCS, but I could not sneer at his track record. Every patient I met while shadowing Teich was comfortably in recovery, with smiles and jokes, miles apart from the people I met in online support groups who seemed to be permanently in the throes of their illness.
However, Teich was not practising medicine as I was taught it. This was a man who believed that the recombinant MMR vaccine could trigger “acute autism” – traditionally an anti-science point of view. When one of his patients, a charismatic bookworm I’ll call Mark, arrived at an appointment with severe, purple swelling up to his knees and a clear case of stasis dermatitis (irritation of the skin caused by varicose veins), Teich reflexively blamed mould and wrote a prescription for nystatin instead of urging Mark to see a cardiologist.
When I asked how a fungal infection in Mark’s toes could cause such a bad rash on his legs, he responded: “We have candida everywhere, and its toxins are released into the blood and travel to every part of the body. The thing is, most people don’t notice until it’s too late.” Moulds and fungi are easy scapegoats for inexplicable illnesses because they are so ubiquitous in our indoor and outdoor environments. A great deal of concern over mould toxicity (or, to use the technical term, mycotoxicosis) stems from the concept of “sick-building syndrome”, in which visible black mould is thought to increase sensitivity and make people ill.
This was true of Mark, who could point to the demolition of an old building across the street from his apartment as a source of mould in the atmosphere. Yet in mainstream medicine, diseases caused by moulds are restricted to allergies, hypersensitivity pneumonitis (an immunologic reaction to an inhaled agent, usually organic, within the lungs) and infection.
Disseminated fungal infections occur almost exclusively in patients who are immunocompromised, hospitalised or have an invasive foreign body such as a catheter. Furthermore, if “clinical ecologists” such as Teich are correct that moulds such as candida can damage multiple organs, then it must be spreading through the bloodstream. But I have yet to encounter a patient with MCS who reported fever or other symptoms of sepsis (the traumatic, whole-body reaction to infection) as part of their experience.
Teich himself did not use blood cultures to verify his claims of “systemic candidiasis”, and instead looked to chronic fungal infection of the nails, common in the general population, as sufficient proof.
“I don’t need tests or blood work,” he told me. “I rarely ever order them. I can see with my eyes that he has mould, and that’s enough.” It was Teich’s common practice to ask his patients to remove their socks to reveal the inevitable ridges and splits on their big toenails, and that’s all he needed.
Through Teich, I met a couple who were both chemically sensitive but otherwise just regular people. The wife, an upper-middle-class white woman I will call Cindy, had a long history of allergies and irritable bowel syndrome. She became ill whenever she smelled fumes or fragrances, especially laundry detergent and citrus or floral scents. Teich put both her and her husband on nystatin, and their sensitivities lessened dramatically.
What struck me as different about her case, compared with other patients with MCS, was that Cindy was also on a course of antidepressants and cognitive behavioural therapy, the standard treatment for anxiety and depression. “It really helps to cope with all the stress that my illness causes. You learn to live despite everything,” she said.
In contemporary academic medicine, stress and anxiety cause MCS, but MCS can itself cause psychiatric symptoms. Teich later told me, unexpectedly, that he had no illusions about whether MCS is a partly psychiatric illness: “Stress affects the adrenals, and that makes MCS worse. The mind and the body are not separate. We have to treat the whole person.”
To understand this case, I also spoke to Donald Black, associate chief of staff for mental health at the Iowa City Veterans Administration Health Care. He co-authored a recent article on idiopathic environmental intolerance that took a uniform stance on MCS as a psychosomatic disorder. In 1988, when Black was a new faculty member at the University of Iowa, he interviewed a patient entering a drug trial for obsessive-compulsive disorder.
He asked the woman to list her medications, and watched as she started unloading strange supplements and a book about environmental illness from her bag. The woman had been seeing a psychiatrist in Iowa City – a colleague of Black’s – who had diagnosed her with systemic candidiasis. Black was flummoxed. If that diagnosis was true, then the woman would be very ill, not sitting calmly before him.
Besides, it was not up to a psychiatrist to treat a fungal infection. How did he make the diagnosis? Did he do a physical or run blood tests? No, the patient told him, the psychiatrist just said that her symptoms were compatible with candidiasis. These symptoms included chemical sensitivities. After advising the patient to discard her supplements and find a new psychiatrist, Black made some phone calls and discovered that, indeed, his colleague had fallen in with the clinical ecologists.
Black was intrigued by this amorphous condition that had garnered an endless number of names: environmentally induced illness, toxicant-induced loss of tolerance, chemical hypersensitivity disease, immune dysregulation syndrome, cerebral allergy, 20th-century disease, and mould toxicity. In 1990, he solicited the aid of a medical student to find 26 subjects who had been diagnosed by clinical ecologists with chemical sensitivities and to conduct an “emotional profile”.
Every participant in their study filled out a battery of questions that determined whether they satisfied any of the criteria for psychiatric disorders. Compared with the controls, the chemically sensitive subjects had 6.3 times higher lifetime prevalence of major depression, and 6.8 times higher lifetime prevalence of panic disorder or agoraphobia; 17% of the cases met the criteria for somatisation disorder (an extreme focus on physical symptoms – such as pain or fatigue – that causes major emotional distress and problems functioning).
In my own review of the literature, it was clear that the most compelling evidence for MCS came from case studies of large-scale “initiating events” such as the Gulf war (where soldiers were uniquely exposed to pesticides and pyridostigmine bromide pills to protect against nerve agents) or the terrorist attacks on the US of 11 September 2001 (when toxins from the falling towers caused cancers and respiratory ailments for years).
In both instances, a significant number of victims developed chemical intolerances compared with populations who were not exposed. From a national survey of veterans deployed in the Gulf war, researchers found that up to a third of respondents reported multi-symptom illnesses, including sensitivity to pesticides – twice the rate of veterans who had not deployed.
Given that Gulf war veterans experienced post-traumatic stress disorder at levels similar to those in other military conflicts, the findings have been used to breathe new life into Randolph’s idea of postindustrial toxicities leading to intolerance. The same has been said of the first responders and the World Trade Centre’s nearby residents, who developed pulmonary symptoms when exposed to “cigarette smoke, vehicle exhaust, cleaning solutions, perfume, or other airborne irritants” after 9/11, according to a team at Mount Sinai.
Black, who doubts a real disease, has no current clinical experience with MCS patients. (Apart from the papers he wrote more than 20 years ago, he had seen only a handful of MCS patients over the course of his career.) Despite this, he had not only written the article about MCS, but also a guide in a major online medical manual on how to approach MCS treatment as a psychiatric disease. When I asked him if there was a way for physicians to regain the trust of patients who have been bruised by the medical system, he simply replied:
“No.” For him, there would always be a subset of patients who are searching for answers or treatments that traditional medicine could not satisfy. Those were the people who saw clinical ecologists, or who left society altogether. In a time of limited resources, these were not the patients on which Black thought psychiatry needed to focus. It became clear to me why even the de facto leading professional on MCS had hardly any experience actually treating MCS.
In his 1990 paper, Black – then a young doctor – rightly observed that “traditional medical practitioners are probably insensitive to patients with vague complaints, and need to develop new approaches to keep them within the medical fold. The study subjects clearly believed that their clinical ecologists had something to offer them that others did not: sympathy, recognition of pain and suffering, a physical explanation for their suffering, and active participation in medical care.”I wondered if Black had given up on these “new approaches” because few CS patients wanted to see a psychiatrist in the first place.
Physicians on either side of the debate agreed that mental illness is a crucial part of treating MCS, with one I spoke to believing that stress causes MCS, and another believing that MCS causes stress. To reconcile the views, I interviewed another physician, Christine Oliver, a doctor of occupational medicine in Toronto, where she has served on the Ontario Task Force on Environmental Health. Oliver believes that both stances are probably valid and true. “No matter what side you’re on,” she told me, “there’s a growing consensus that this is a public health problem.”
Oliver represents a useful third position, one that takes the MCS illness experience seriously while sticking closely to medical science. As one of few “MCS-agnostic” physicians, she believes in a physiological cause for MCS that we cannot know and therefore cannot treat directly due to lack of research. Oliver agrees with Randolph’s original suggestion of avoiding exposures, although she understands that this approach has resulted in traumatising changes in patients’ abilities to function. For her, the priority for MCS patients is a practical one: finding appropriate housing.
Often unable to work and with a limited income, many of her patients occupy public housing or multi-family dwellings. The physician of an MCS patient must act like a social worker. Facilities such as hospitals, she feels, should be made more accessible by reducing scented cleaning products and soaps. Ultimately, finding a non-threatening space with digital access to healthcare providers and social support is the best way to allow the illness to run its course.
Whether organic or psychosomatic or something in between, MCS is a chronic illness. “One of the hardest things about being chronically ill,” wrote the American author Meghan O’Rourke in the New Yorker in 2013 about her battle against Lyme disease, “is that most people find what you’re going through incomprehensible – if they believe you are going through it. In your loneliness, your preoccupation with an enduring new reality, you want to be understood in a way that you can’t be.”
A language for chronic illness does not exist beyond symptomatology, because in the end symptoms are what debilitate “normal” human functioning. In chronic pain, analgesics can at least deaden a patient’s suffering. The same cannot be said for MCS symptoms, which are disorienting in their chaotic variety, inescapability and inexpressibility. There are few established avenues for patients to completely avoid triggering their MCS, and so they learn to orient their lives around mitigating symptoms instead, whether that is a change in diet or moving house, as Sharon did. MCS comes to define their existence.
As a housebound person, Sharon’s ability to build a different life was limited. Outside, the world was moving forward, yet Sharon never felt left behind. What allowed her to live with chronic illness was not medicine or therapy, but the internet. On a typical day, Sharon wakes up and prays in bed. She wolfs down handfuls of pills and listens to upbeat music on YouTube while preparing her meals for the day: blended meats and vegetables, for easier swallowing.
The rest of the day is spent on her laptop computer, checking email and Facebook, watching YouTube videos until her husband returns home in the evening. Then bed. This is how Sharon has lived for the past six years, and she does not expect anything different from the future. When I asked her if being homebound was lonely, I was taken aback at her reply: “No.”
In spite of not having met most of her 15 grandchildren (with two more on the way), Sharon keeps in daily contact with all of them. In fact, Sharon communicates with others on a nearly constant basis. “Some people are very much extroverts,” Sharon wrote. “I certainly am. But there are also people who need physical touch … and I can understand why they might need to see ‘real people’ then … but it’s very possible to be content with online friends. This is my life!”
The friendships that Sharon formed online with other housebound people with chronic illnesses were the longest-lasting and the most alive relationships she had ever known. She had never met her best friend of 20 years – their relationship existed completely through letters and emails, until two years ago, when the friend died. That “was very hard for me”, Sharon wrote.
The pandemic changed very little of Sharon’s life. If anything, Covid-19 improved her situation. Sharon’s local church live-streamed Sunday service, telehealth doctor appointments became the default, YouTube exploded in content, and staying indoors was normalised. Sharon saw her network steadily expand as more older adults became isolated in quarantine.
People within the online MCS community call themselves “canaries”, after the birds historically used as sentinels in coalmines to detect toxic levels of carbon monoxide. With a higher metabolism and respiratory rate, the small birds would theoretically perish before the less-sensitive human miners, providing a signal to escape. The question for people with MCS is: will anyone listen?
“Us canaries,” said a woman named Vera, who was bedbound from MCS for 15 years after a botched orthopaedic surgery, “we struggle and suffer in silence.” Now, in the information age, they have colonised the internet to find people like themselves. For our part, we must reimagine chronic illness – which will become drastically more common in the aftermath of the pandemic – where what matters to the patient is not only a scientific explanation and a cure, but also a way to continue living a meaningful life.
This calls into action the distinction between illness and disease that the psychiatrist and anthropologist Arthur Kleinman made in his 1988 book The Illness Narratives. Whereas a disease is an organic process within the body, illness is the lived experience of bodily processes. “Illness problems,” he writes, “are the principal difficulties that symptoms and disability create in our lives.”
By centring conversations about MCS on whether or not it is real, we alienate the people whose illnesses have deteriorated their ability to function at home and in the world. After all, the fundamental mistrust does not lie in the patient-physician relationship, but between patients and their bodies. Chronic illness is a corporeal betrayal, an all-out assault on the coherent self. Academic medicine cannot yet shed light on the physiological mechanisms that would explain MCS. But practitioners and the rest of society must still meet patients with empathy and acceptance, making space for their narratives, their lives, and their experience in the medical and wider world.
After two years of wrangling, false starts and disappointments, it finally happened: America has passed its first-ever climate legislation, moving the country closer to its goal of a decarbonized future and taking a significant step toward helping the planet avert the worst scenarios of climate catastrophe.
But it’s not a time to rest. We have always held power to account – on climate and every other major issue – from the fossil fuel companies responsible for heating the planet to the politicians representing their interests. The country responsible for the most greenhouse gas emissions in history has indicated it will change course; we will relentlessly report on what comes next, who will benefit and the remaining obstacles to progress.
With daily reporting and analysis on the climate emergency, we aim to ensure that even more people are made aware of the dangers – and opportunities – of this moment.
Plastic filled our lives during the pandemic, littering our world with N95 masks, take-out containers, and single-use grocery bags. While the world was fixated on the global health crisis, the plastic crisis only got worse. Plastic products like PPE and disposable packaging were marketed as tools in the fight against COVID-19.
In a new book, Plastic Unlimited, researcher Alice Mah says it didn’t have to be this way. (We published an excerpt of her book here.) She argues that plastic corporations knowingly pushed false claims about the benefits of plastic during the pandemic in order to increase sales. And as life returns to normal, she says it’s crucial for companies and consumers to dramatically cut down on plastic production.
In the years before the pandemic, consumers became increasingly worried about plastic, Mah says. In 2017 and 2018, stories about sea creatures dying from plastic pollution went viral, including a harrowing image of a turtle with a straw lodged up its nose. There was growing awareness about microplastics, tiny particles of plastic that end up in the food chain, harming our bodies. And given that the majority of disposable plastic ends up being incinerated, it also contributes to climate change. All of this led to a wave of activism that resulted in companies like Starbucks vowing to eliminate plastic straws and states like California and New York banning plastic bags.
This anti-plastic sentiment was so powerful that corporations took notice. “I noticed in my research with these petrochemical companies—these plastics companies—that there was a panic about how bad the public perception of plastics was and how they really needed to turn the narrative around,” Mah says. “I saw how they very rapidly organized to embrace a narrative around the circular economy and recyclability.”
In 2020, Greenpeace published a research brief saying that the plastics industry had manipulated the media with misleading claims that disposable plastic goods were more sanitary than reusable ones, exploiting anxiety about the pandemic to churn out more products. But by then, consumers already felt confident that plastic could keep them safer. “At the time of the pandemic, you saw a resurgence of single-use plastics,” Mah says. “There was amnesia about the turtles with the straws up their nose.”
Mah says that even she felt guilty about the volume of plastic that entered her home in the U.K. during the pandemic. And while it’s true that people in the U.K. and U.S. generate between 218 and 240 pounds of plastic a year, which is double the global average, it’s also true that consumers are trapped in a society where plastic is ubiquitous. It’s very hard to go to the grocery store and ask for your meat, cereal, or vegetables not to be packaged in plastic, for instance. “People are locked into supply chains and infrastructures, unable to simply opt out of plastic consumption,” she says.
So what’s the solution? Consumers can—and should— work to reduce their personal plastic consumption, but Mah argues that we need global, systemic solutions to get plastic out of our lives. The answer isn’t recycling, which comes with its own environmental costs; instead, we need to eliminate plastic as much as possible.
In some ways, it’s worth thinking about plastic along the same lines as climate change, she says. One possible answer is for the United Nations to create an agreement similar to the Paris Climate Accord, but for plastic. A version of such a treaty is currently being discussed by the UN Environment Assembly, but it would take years to negotiate the complex details.
Governments must also play a role, because plastic corporations are unlikely to voluntarily reduce their own production. Legislators can pass outright bans on single-use plastics, which India did this month, forbidding the use of 19 plastic items like cups, straws, and ice-cream sticks. Governments can also hold companies accountable for the full lifecycle of their products, forcing them to pay for any pollution created when the item is thrown out. The European Union and Canada require plastic producers to pay for waste collection and management.
Ultimately, however, curbing plastic will mean redesigning almost every aspect of our lives. We will need to rethink the systems of food, shopping, transportation, logistics, public health, construction, and many other industries in order to fully excise plastic. This will mean moving away from our addiction to disposable products, and shifting toward durable, reusable goods.
“Plastic has been seen as a miracle material that can be transformed into almost anything,” May says. “It is cheap, but if you calculate all the costs—the people who die of toxic exposure, the loss of clean water, the impact on our ecosystems—it’s not really that cheap. I don’t think the solution is to come up with some other magical material, but to learn how to live without it.”
Small landowners across the world have the potential to use their land in the fight against climate change while making money in the process — -but only if the carbon market lets them in.
To slow the destructive impacts of climate change, the world needsto reduce its net carbon emissions: according to the most recent report from the Intergovernmental Panel on Climate Change, emissions need to decline by 45% from 2010 levels by 2030 in order to limit global warming to 1.5 degrees Celsius. While technological solutions will play an important role in this process, nature also offers a powerful tool: trees.
Trees pull carbon dioxide out of the air and store it, creating ‘negative emissions’ that can help offset carbon released from energy production and other processes. To incentivize the use of forests for negative emissions landowners need a way to document and sell trees as carbon credits. For small and private landowners, turning trees into carbon credits and selling them on the market is a hurdle too big to overcome.
Carbon markets offer a way for anyone to pay for carbon removal as a way of reducing their environmental impact or total balance of carbon emissions. Carbon credits are purchased from forestry, solar, cookstove or any projects that help reduce the total amount of carbon in the atmosphere. In this way, they offer an incentive for landowners to keep their forests alive and healthy, rather than using them for timber, grazing, or other uses:
With a high enough price, helping forests grow can be more lucrative than cutting them down. The Afognak Forest Carbon Project, for example, is expected to earn millions of dollars over 30 years through better land management of the over 8,200 acres owned by the American Land Conservancy and the Rocky Mountain Elk Foundation in Alaska.
For small-scale landowners, however, the math doesn’t always work out. While it is estimated that over a third of all American forest land is owned by individuals, each property averages only 66 acres. This makes embarking on a forestry project a very different experience for small scale landowners versus those that command large swaths of forest. Highly specific knowledge and an upfront capital investment is required to sell carbon credits from a forest.
Landowners need to develop a plan for how they will increase carbon dioxide uptake on their properties. The most common examples are increased tree planting or improved land management. The fees for professional planners and feasibility assessments can be tens of thousands of dollars — -a sizable upfront cost for a small-scale landowner.
Many forestry projects turn to investors to help with such upfront costs, but small-scale landowners have a greater challenge. Projects with smaller returns may not have enough capital to cover assessment costs and still provide value to investors.
For example, projects with less than 1500 acres aren’t expected to recover the cost of fees to sell on California’s carbon market. Additionally, smaller plots of land have a higher risk of being wiped out by disease or natural disaster. As a result, investors may prefer to stick with larger forestry projects and reduce their chance of losing the carbon credits they purchased.
Disparate carbon market standards and verification systems are challenging.
Landowners need to be confident that their land management plans will net them sufficient earnings through the carbon market to undertake the project to begin with. Small landowners may not have the time or expertise to deal with credit systems that can vary by market, location, and time. What’s more, the carbon credit verification and trading process comes with even more fees, eating into already thin margins.
Even for large-scale landowners, navigating the carbon credit verification system can be a challenge. Different carbon markets have different standards for earning credits. For example, projects participating in the California Air Resource Board’s market need to keep their captured carbon sequestered for 100 years, while users of the American Carbon Registry need only do so for 40 years. Different markets can also trade at different prices.
Novel financing mechanisms, opportunities for automation and sharing best practice guides for forestry projects provide a way forward.
Easing the pathway into carbon markets for small landowners is key to making productive use of their vast and diverse acreage. Luckily, many means of lowering the barrier exist and are currently being explored. Different financing options, including by lumping several small forestry projects into one larger one, could help attract investors; several carbon markets allow for such aggregation, though with constraints.
Automating components of the land management planning and verification process, for example through the use of remote sensing and artificial intelligence, could bring costs down as well. Finally, ensuring that clear, accurate, and up-to-date guides to forestry projects are easily available to landowners would ensure that they are always making the most-informed decisions about their land.
While getting small landowners on board is crucial, it is important that the standards for carbon credits don’t degrade in the process. Financial incentives make forestry projects feasible but what matters for the planet is just how many tons of carbon dioxide end up back in trees, not how much money was made from them.
As a key proponent of forestry projects, Sādu is aware of the barriers to scaling these solutions. Some of Sādu’s Sustainability Partners prefer to allocate capital towards nurseries and employment training programs rather than applying for international certifications like Verra, REDD+ and Gold Standard. This is a clear signal that the current certification process is not a fit for all types of projects.
As climate change continues so will the need for ecosystem conservation and carbon sequestration. Additionally, initiatives like 1t.org and LEAF Coalition, which mobilize capital for nature-based solutions to climate change, will continue to create an increased demand for forestry projects. In order to meet this demand the incorporation of small scale forestry projects into verified carbon markets will be necessary.
Service providers of GIS and remote sensing tools like Pachama, Planet, and Natural Capital Exchange, who use satellite imagery to estimate the amount of carbon sequestered by forests, are quickly reducing the barriers to entry for projects of all sizes.
These solutions, in combination with community-based verification apps like Greenstand or Treedom, and algorithmically determined carbon price research by The Cambridge Centre for Carbon Credits (4C) will result in a more robust data set by which the value of forestry credits can be determined. If this data is applied to small forestry projects nature-based carbon credits will become easier to access for both consumers and producers.
Sādu is building a solution to leverage this newly available data for our app users. Our goal is to make it easy to understand the positive impact of investments into forestry projects of all sizes. Once achieved, increased transparency and improved market access will result in longer living forests and a more diverse group of investors benefiting from the growth of the carbon market.