Eat your vegetables. Exercise often. Drink but a little, and don't smoke at all. Follow these edicts, experts say, and you will probably be one of the lucky ones. Live right, they predict, and you will probably never hear the dreaded words "You've got cancer."

That is what public health experts say, anyway. If only it were true, writes Sandra Steingraber, an ecologist and poet. She substantially challenges the conventional wisdom in her powerful and poignant book Living Downstream: An Ecologist Looks at Cancer and the Environment. While she does not deny the evidence that smoking, poor diet, and other lifestyle choices increase cancer risk, she also considers the effects of the millions of tons of synthetic chemicals in our environment.

Thirty-five years after Rachel Carson first published her groundbreaking book Silent Spring, detailing the destruction caused by indiscriminate use of pesticides and synthetic chemicals, we are producing and releasing more of these chemicals than ever, writes Steingraber.

Why don't we hear more about the possible environmental causes of cancer, she asks, when proven or probable human carcinogens are so often detected in our food, air, and water? Why has the incidence of human cancer risen almost 50 percent in the United States since 1950, despite improved nutrition, diagnosis, and medical care? How much cancer is caused by synthetic chemicals, alone and in combination? Finally, and most importantly, what can we do to get out of this mess?

Steingraber, who was diagnosed with bladder cancer at the age of 21 yet survived it, indicts a variety of synthetic chemicals for causing cancer. She draws from a vast sweep of scientific studies and clearly explains subjects as diverse as the biology of cancer cells, the control of agricultural pests, the epidemiology of cancer clusters, and the circulation of groundwater. Her research is meticulous and well documented, her logic and prose clear.

The author begins and ends her story in the flat, fertile farmland of central Illinois where she was raised. She loves the land with its black soil and vast horizon while lamenting the vanished tall-grass prairie and the polluted, once fecund Illinois River. But central Illinois is every place, she argues, its industries and pollution typical, and its incidence of cancer rising. Steingraber shares a sober, clear-eyed view of what we know, and a passion to learn what we don't.

Steingraber, who received her doctorate in biology from the University of Michigan, tracks down a rogues' gallery of toxic chemicals and carefully assembles the damning evidence. The names are both familiar and foreign: dioxin, PCBs, and DDT; toxaphene, perchloroethylene, and atrazine. The chemicals we have made are now everywhere, she writes, and they have spread through a generation of us.

As she builds her case, Steingraber is careful, methodical, and relentless. She shows where the poisons are, using data from the federal Toxic Release Inventory, which reports on the levels of toxic chemicals released by industry into American communities. Using newly available information from state cancer registries, she learns how many people contract cancer in specific locales. When she assembles these data and dozens of public health studies, the pattern is clear: Areas with high cancer rates are, in general, more polluted.

Steingraber, who was recently appointed to serve on President Clinton's National Action Plan on Breast Cancer, describes one such cancer cluster in an industrial working-class community near Philadelphia. Even today, she writes, environmental causes of cancer are dismissed:

The author hits her targets hard but she reports fairly, documents her work thoroughly, and candidly admits what is not known. She draws from a variety of sources, but her narrative is strongest when it is most personal.

She poignantly describes the long, brutal battle of her friend Jeannie Marshall, a writer in her thirties, with a rare cancer of the spinal cord. She unflinchingly describes what happens after a cancer diagnosis, based on her own experience.

Living Downstream is not without faults. Clear as Steingraber's descriptions are, some illustrations would have helped. Readers unfamiliar with organic chemistry may be stymied by descriptions such as these: "DDT . . . consists of two hexagonal rings, each with one chlorine atom attached, yoked together by a single carbon atom from which dangles a chlorinated carbon tail." In addition, although her feelings are understandable, Steingraber sometimes wields her opinions like blunt instruments. Her narrative would have been stronger if she had let the facts, both personal and scientific, speak for themselves. The reality is powerful enough.

But the strengths of Living Downstream more than compensate for its stylistic weaknesses. The book educates, informs, and moves us, but more importantly, it gives a vision of what a better world would look like. Scientists, all too often silent, would be among those demanding funding to finally determine, after decades of widespread use, the health effects of the hundreds of common industrial chemicals. People would easily find out about the chemicals in their communities; right-to-know requirements would be improved and enforced. The precautionary principle would be the law of the land: new synthetic chemicals, like new drugs, would be guilty until proven innocent, so that innocent people and wildlife would not be unwittingly used as guinea pigs. And we would all have a more intimate, firsthand knowledge of our true relationship with the land, air, and water that supports us.

A generation after Rachel Carson first exposed to the public the silence that hid the devastation caused by manmade chemicals, this book continues her legacy. We need to break that silence, Steingraber writes, because cancer won't be defeated by blaming the victim and eating more vegetables. Cancer, she argues, is a human rights issue.

"From the right to know and the duty to inquire," Steingraber writes, "flows the obligation to act." This book is a good place to start.

Introduction to Silent Spring by Vice President Al Gore - introduction to the 1994 reprint of Rachel Carson's classic book, in which Carson, an ecologist and nature writer, first awakened the conscience of a nation to the indiscriminate abuses of pesticides and the threats to the natural world.

Silent Spring Institute - a nonprofit scientific research institute with projects and publications for understanding the relationships between the environment and women's health, including breast cancer.

Rachel Carson Homestead - nonprofit group preserving Carson's family home in Springdale, Pennsylvania. Also an international resource about her life and work, and designs and implements environmental education programs.

Toxic Release Inventory: Community Right-to-Know - Under "community right-to-know laws," U.S. residents can begin learning what toxic chemicals are being released into local environments, and by whom. This EPA page on the Toxic Release Inventory has background information and tips on getting TRI data.

ATSDR Science Corner - environmental health information available from the U.S. Agency for Toxic Substances and Disease Registry. The site has a wealth of information about toxic substances and environmental health. It provides links to the International Joint Commission, which monitors the environmental health of the Great Lakes ecosystem, and to the Global Environmental Information Locator Service, which distributes environmental data worldwide.

Envirofacts Warehouse Chemical References Index - curious about a particular chemical? Look here to find material safety data sheets and information on health risks and regulations.

Junk Science Home Page. - Web site by a group calling itself The Advancement of Sound Science Coalition (TASSC). The author(s) don the mantle of science to dismiss any environmental links to disease, as well as the existence of any environmental problems whatsoever. The site's producer, Steven Milloy, has also written a book called Science Without Sense: The Risky Business of Public Health Research Page, published by the conservative Cato Institute. Milloy claims that the U.S. public health establishment is engaged in scare tactics that ensure a successful scam of taxpayer money.

Environmental Working Group - group doing research on pesticide hazards and drinking water contamination. They also document what they say are industry misinformation campaigns on environmental issues. See their Web page on TASSC, which they say is a corporate front group run out of a Washington, D.C., public relations firm.