Dan Fagin's Toms River: A True Story of Science and Salvation, which won the nonfiction Pulitzer Prize this year, is a frustrating but familiar story. A dye plant moves into a small New Jersey town and, over decades, it pours its toxic byproducts into the river, ocean, and air. The contamination from that and other hazardous waste dumps ended up in the groundwater and didn't get much attention until local citizens and scientists documented a cancer cluster among the children in the area. After a years-long investigation, the town became one of the first places where environmental toxins were statistically linked to a higher incidence of cancer (it's still only one of two residential cancer clusters ever formally confirmed in the U.S.) But Fagin shows how the story of Toms Rivers has roots that go so much farther – all the way back to ancient Rome, where physicians first started worrying about environmental health; to the industrial revolution, when capitalism linked arms with chemistry; and into the modern era, defined in part by the advent of environmental regulation.

Toms River offers a thoroughly researched history and deeply personal tale of the confluences that lead to a cancer-stricken community. It also describes the effective, available tools that could prevent the next cancer corridor. Men's Journal spoke with Dan Fagin about pollution, the Pulitzer, and the problem with uncertainty.

What drew you to Toms River, New Jersey seven years ago?
I used to work for Newsday and I was their environmental reporter for years. It was obvious to me from speaking to my readers that patterns of illness and especially of cancer are a great concern to many people. They think that there are causes in the environment and wanted to know how they can reduce the risk, so I wrote a lot about that.

But I didn't feel that I was giving people the information that they wanted, which was how we really understand the relationship between the environment and chronic disease, especially cancer. There's a huge lag time between the initial triggers – the patterns of mutations – and getting a noticeable tumor. It can be five, 10, 15 years, easily. It turns out that epidemiology, the study of patterns of diseases, is the best tool that we have. So while I was writing these stories I heard about what was happening at Toms River. I had made a trip down there and was fascinated with the drama that unfolded. There was this really interesting science being done as a result of this citizen pressure.

Who is the hero of this book?
There are many people in this book who did things that were extraordinarily brave, going way beyond what could normally be expected from them. One person – if I had to name one person – is Linda Gillick, who lead the citizen uprising at Toms River. She certainly wasn't the only one who made things better at Toms River, but she played a crucial role, turning her private tragedy [her son was diagnosed with cancer at three-and-a-half months] into a public crusade. She and other families retained or developed their sense of community-mindedness when they could have done exactly the opposite. It would have been completely understandable for them to retreat into their pain and grief.

So much environmental advocacy seems to require a concerned citizen to take charge and shift the public debate.
There seems to be two archetypes of people in Toms River. One is epitomized by Linda – someone who has gone through a very traumatic personal experience and they are determined to find out why. They want the broader community to grapple with what has happened. These people do wonderful things; they change the world. They're not always right, by the way. Science sometimes gives them answers that they don't want to hear but the point is that their passion leverages knowledge.

The other archetype that I identified is the outsider scientist. They're people who see something around them that doesn't look right to them and they reject the prevailing scientific consensus at the time and say, 'That is not a good explanation for the evidence that I see.' As a result they're often ostracized and my book is filled with examples of people like that. Take the story of Dr. Wilhelm Hueper [one of the first doctors to link industrial toxins to cancer]. He was a classic outsider who didn't get along with anyone and yet he was frustrated and angry because the prevailing view did not fit the evidence that he saw, he was determined to bring his point of view forward. People like that change the world through science.

And both of them – the community activist and these scientific iconoclasts – can be very difficult people. But that's what it takes to swim against the tide. Maybe that's what it takes to change the world.

In over 30 years, nonfiction Pulitzer winners have only tangentially related to environmental journalism. Does it say anything about the state of environmental reporting?
There is a lot of great environmental journalism being done, right now. The difficulty is funding it and getting it to reach a large audience. I don't think the world discriminates against environmental reporters. I think the problem is deeper than that and that it's really difficult to do much deeply reported journalism at all. I'm happy that the book won this recognition but I don't labor under the illusion that many other people could not have done the same, maybe on different scales, but just didn't have the advantages that I have. Working at a place like NYU, and being a professor, you get the time and some resources to do this kind of work.

What do you hope this prize does for the legacy of Toms River, New Jersey? 
I'm thrilled about this award for many reasons including on behalf of the people of Toms River who very much want their story to be remembered – at least many of them do. They want to it to be a cautionary tale and perhaps this prize will let that happen. The people of Toms River eventually rose to the challenges and opportunities of citizenship, of getting involved in what was happening around them. Good science was done and eventually risk was reduced in Toms River.

And outside of Toms River?
I hope that regulators and politicians can see that epidemiology is powerful stuff. That when good science is done based on patters of illness and exposures, we can learn a lot. So why aren't we doing more of that? We spend at least $80 billion a year on U.S. intelligence agencies, and a very large share of that goes to data analysis. They are combing through vast amounts of data looking for patterns that may help identify people out there who might want to hurt us. Well, the budget of the Environmental Protection Agency is about $8 billion, and that doesn't make sense to me. I'm not saying that what the National Security Agency does is not important it is, but why aren't we using these tools of big data on environmental health, too? Especially when we know that cancer is just the beginning, that there's a whole host of diseases that in which environmental factors play a whole role.

In the book, you say one legacy of Toms River is that it solidified government opposition to future Toms River-style investigations. Do you still stand by that?
Yes, but I don't think governments are right to oppose such investigations. There are lots of reasons why public officials and the agencies they control don't want to do these investigations. They're expensive, they scare people, they can make important players in the community look bad, and they don't deliver absolute certainty. My point is, do them anyway! Everything we know about the history of epidemiology the history that I traced throughout this whole book is that we can learn a lot doing these studies. One out of a hundred times we might find something that's worth further investigation but even so, it's totally worth it.

How should experts grapple with uncertainty?
When scientists are really, really confident that they got something right, they will call it a theory, right? A theory is a really strong statement in science, but it still by definition leaves room for the possibility that something better will come along later. Good scientists are already comfortable with the idea of uncertainty. The real problem is when capitalism sides with uncertainty. It becomes a weapon in the hands of people who want to take advantage of that uncertainty to pursue their own agendas. I'm not just talking corporations, but advocacy groups too. They capitalize on uncertainties to spin information in whatever way reflects the policy agenda that they're pushing for. Science holds out a wonderful model for dealing with uncertainty. The problem is when we leave the science realm because uncertainty becomes a weapon. 

[Toms River: A Story of Science and Salvation, $23]