Following the Mediterranean coastline driving west out of Marseille about 30km, one reaches the beginning of one of France’s largest industrial regions. The Fos-sur-mer/Etang de Berre area is home to almost 430 installations, including: chemical plants, oil refineries, natural gas facilities, and steel production. The Fos-Lavera-Berre chemical park, for example, prides itself in being the largest in southern Europe, producing 40% of all French-produced ethylene and 60% of butadiene not to mention the adjacent oil port, one of the biggest in the world, which supports a local network of refineries. This impressive assemblage of industry belches out tons of toxic air pollutants, causing an eerie yellow-brown veil over the region and the sunsets to be other-worldly, particularly when the mistral winds are still.

The region also has incredible beauty. It extends for more than 50km from the airport at Vitrolles past the picturesque Etang be Berre lagoon to the wetlands of the Camargue, western Europe’s largest river delta and home to over 400 species of birds. The inland industrial region extends northward to the Crau, an expansive alluvial fan and important pasture lands for sheep and cattle since ancient times. The area is also home to about 400,000 people living in 30 towns throughout the vast hybrid landscape. What lies beneath this mixture of beauty and dread—the sacred and the profane—is a sense of underlying unease and apprehension about the impact of pollution on human health. It is an awkward mélange of wanting to know, of not wanting to know, of suspecting knowing, but feeling disempowered or afraid to act.

Understanding this public malaise requires understanding the calculus of environmental power in the region: namely who has authority over the land, the air, and the water. In 1965 a law was passed demarcating the coastal part of this region as the Autonomous Port of Marseille now called the Grand Maritime Port of Marseille (GPMM), the largest port in France. Its reach encompasses, not only the actual port of Marseille, but includes the ports and adjacent land extending through Fos-sur-mer all the way to the mouth of the Rhône, including the town of Port-St-Louis. The GPMM designation has had a significant impact on the towns of this region as the law effectively removed all decision-making authority from the citizens and their elected officials and transferred it to the state—specifically the public-private partnership that comprises the GPMM.

In the last 12 years, the two largest controversies over the siting of new hazardous facilities in the region happened in the port town of Fos-sur-mer: 1) the siting of a large Gaz de France LNG terminal on the Fos public beach (opened 2005) and, 2) an incinerator designed to burn all the garbage of Marseille, the second largest city in France (opened 2010). These were hugely unpopular projects in the eyes of the Fos and other nearby residents and served to catalyze the environmental community. On the face of it, the controversies were more about power (or lack thereof) and environmental degradation than about human health. However, the debates did prompt residents to ask questions that were present but not previously vocalized: what were the combination emissions from all the local polluting facilities doing to their health?

To situate the environmental health quest in an illuminating framework, it is helpful to know something about the recently growing research field, the sociology of ignorance, which is also called, the social construction of non-knowledge. Ignorance, is not what is not studied or a byproduct of science—ignorance is actively produced and is shaped by the social, scientific, and political institutions themselves. The study of non-knowledge, therefore, is a view into the values and cultural biases at work in scientific knowledge practices. The ways in which non-knowledge can be actively constructed are many, but in the case of environmental health data, there are two common forms. The first is the production of vast amounts of uninterpreted data presented as an impenetrable wall of numbers, basically insuring the publics’ dependence on state experts. Or conversely, the over-aggregation of data that can be used to either, show nothing (i.e. “no effect”), or to argue for continued expert studies until something can be known.

Following are some examples in the case of Fos. In the case of the incinerator siting controversy, the local associations fighting the project were given volumes of technical data about the proposed installation. It was an overwhelming amount of information and it was difficult for the citizens to ascertain exactly what the environmental and health impacts were. Alternatively, data over-aggregation is the norm in the various French agencies and associations tasked with collecting and monitoring health statistics. From cancer to asthma, health statistics are revealed to the public covering such large geographic areas, that it is impossible for a town to know if their health is adversely impacted by their adjacency to polluting industries.

Ignorance is also actively produced through institutional norms, pressures, rules, and logics.1 Disciplinary cultures have preferences for doing health science certain ways and not others. This can reinforce non-knowledge, but it can also thwart non-traditional ways of doing science to insure that the knowledge remains unknown. One example of the institutional shaping of knowledge gaps is the recent study conducted by the Agence Régionale de Santé (ARS). These scientists were committed to, and had the support of, local environmental activists in trying to answer the industrial zone residents’ questions regarding illness in their neighborhoods. The study tracked hospital admittance as the measure to assess the rate of cancer, asthma, and cardiac illness. To understand the prevalence of asthma or the incidence of cancer in a town, hospital admittance is not the best measure because a hospital stay is typically for the most extreme asthma attack or advanced stages of certain cancers. Hospital admission numbers, however, were the data that the ARS scientists could more easily obtain given the fact that public health data on these kinds of illnesses were not readily available. Thus ease of acquisition and cost considerations circumscribed the study that was possible.

In the end, the study showed no higher rates of hospital admission for either asthma or most cancers for residents living in the industrial region. The citizens were unhappy with the study as their primary questions remained unanswered: what are the rates of incidence of illness of those living closest to industry? The scientists explained that they regretted they could not answer the right questions. They explained that the availability of data was the problem. For example, while 13 regions in France have a cancer registry, this region does not. Additionally, while elevated rates of pediatric cancer would be an important indicator of environmental health impacts, this data is only maintained, in aggregate, at the larger regional level. And finally, the state-funded scientists were unable to study auto-immune and related diseases, such as diabetes type 1, as there is no classification for such diseases in the numerous data collection institutions in France. Even though many medical professionals believe these kinds of illness are environmentally triggered, state data collection is more focused on illnesses with large economic impact, thus auto-immune and related disease incidence rates remain unknown. These collection and classification norms form organisationally determined domains of unrealized knowledge, and this non-knowledge flows from one government domain to another and eventually reaches the public whose basic questions continue to be unanswered.

In the case of the residents of Fos, there is yet another kind of non-knowledge produced. This could be called “subverting the question” or non-answering though the rubric of risk. The citizens have questions such as: how prevalent is the respiratory illnesses and cancer in their town, or what is the health impact of the large variety of toxins in their air? Instead of attempting to answer these questions in a way that includes, and hopefully, satisfies the residents, the state funds numerous technical risk studies. Pollution exposure is then categorized by such terms as: exposure baselines, threshold values, emission profiles, and biomarker persistence. “The local people found these studies very strange”, according to one public health official, “and did not know why they were conducted.” Another spokesperson for a local mayor concurred and added, “many residents say that the right things were not studied as there were no studies begun from a human perspective, not just calculating risk using threshold values as people will not trust these studies—because they say they are certainly sick.”

The shape of knowledge absence as it intersects with the spatial and political geography of west Provence can be mapped onto specific historical, social, and organisational contexts.2 From the absolute power of the GPMM to the back office of a state bureaucrat determining health classification categories, the topography of ignorance takes complex and consequential shapes. In the case of the Fos/Etang residents, it may require thinking outside of the box—using new health study methods not yet recognized by state experts. It may be time for not only the people’s questions to be at the center of a study, but for the people themselves to be asked: what is your health status? This kind of lay science which uses local voices and their health responses as data might finally be able to answer the questions that two decades of state studies have yet to address.

References
 Frickel, Scott, “Not Here and Everywhere: The Non-Production of Scientific Knowledge,” in Kleinman, D. and Moore, K., eds., Routledge Handbook of Science, Technology and Society, London: Routledge/Taylor and Francis Press, 2014..
 Frickel, Scott, “Absenses: Methodological Note about Nothing, in Particular,” Social Epistemology, Vol. 28: 1, pp. 86–95, 2014. .