Cancer is an environmental problem
“In my experience, the attitude of most clinicians and cancer researchers is that the environmental causes of cancer are not very important. It was certainly my attitude. This is how Margaret Kripke, physician and cancer researcher, began her presentation
at the Cancer and Environment Forum in March. The forum, co-hosted by several major cancer research centers in the United States, was intended to educate practicing clinicians about daily exposures that can increase a person’s likelihood of developing cancer. “My perspective on this topic changed dramatically when I was a member of the president’s panel on cancer,” said Kripke, who served on the panel in 2010. That year, the committee produced its first-ever report on the environmental causes of cancer. Kripke continued, “What I learned from this exercise was absolutely shocking to me.
This 2010 report found that environmental exposures play a bigger role in cancer formation than clinicians once believed, and that these cancer risks are especially dangerous for children. Since, researchers tightened their estimate: 70% at 90% of cancer development is driven by non-genetic environmental factors. These may be factors such as smoking or diet, but, as Kripke and his colleagues focus on them, also factors such as air quality and repetitive exposure to chemicals used on workplaces and at home.
In February of this year, President Joe Biden announcement the relaunch of Cancer Moonshot, a fundraising initiative he originally led when he was Vice President of 2016. The stimulus aims to garner congressional support around the goal of halving the U.S. cancer death rate over the next 25 years. The role of environmental risk factors is recognized in this effort: the relaunch included the formation of an advisory committee “Cancer Cabinet,” which includes representatives from agencies such as the Environmental Protection Agency and the Food and Drug Administration. In his March State of the Union address, Biden acknowledged the likely role toxic smoke from military burning stoves played in his own son’s cancer and announced a Department of Veterans Affairs. to reign streamlining access to medical care for veterans with cancers that research has linked to these pits.
But in the President’s proposal 2023 budget, no funds were allocated to the National Institute of Environmental Health Sciences (NIEHS), the leading agency in research on environmental cancer risks, responsible for breakthroughs in toxicology research methods. Its parent agency, the National Institutes of Health, which houses 27 other institutes and centers, including the NIEHS, received only an aggregate amount of $275 million increase in discretionary funding in the proposed budget. Ruthann Rudel of the Silent Spring Institute, a breast cancer research center that receives funding from the NIEHS, says money for research into the environmental causes of cancer is sorely needed. The studies are complex, requiring large samples of participants, followed for years at a time, to understand the consequences of exposure.
A difficulty in carrying out this research is that basic information about potential carcinogens is lacking. Kripke, who sits on the board of the Silent Spring Institute, attributes this lack of information to under-regulation of the industries that produce these chemicals in the first place. “In this country, we operate on what is called the reactionary principle of chemical production,” says Kripke. “If it causes harm, we regulate it or take it off the market. »
But proving wrong in the absence of regulation can be an uphill battle. This is the challenge facing the community in East Oakland, California. Late last year, Communities for a Better Environment (CBE), an environmental justice group, sued a local facility, AB&I Foundry, plus its emission of hexavalent chromium, a known carcinogen. Although residents spoke of the high rates of health problems in their community, the lawsuit against the smelter was only possible after a local air quality district passed to reign which required the district to assess all health risks posed by the entire facility, rather than just regulated parties. This assessment revealed that the greatest risk of cancer AB&I Foundry product was hexavalent chromium pollution released into the atmosphere. Machines that produced hexavalent chromium were exempt from permits at the time of installation, and therefore its pollution had never been officially tracked.
So far, the only carcinogenic pollution being officially guarded foundry was lead. Esther Goolsby, a CBE organizer, says that although she worked at the foundry, she was unaware of what she and other workers were exposed to until she joined CBE. “And knowing, only when I was growing up, what was there, and thinking about how that affects my kids growing up, and then the whole community that was there. And there are two primaries and a library. So thinking about how long this lasts – and we’ve only just taken action.
The district air quality assessment would have been the first step in a multi-year process to bring all of AB together&I Foundry operations in regulation. Tyler Earl, a lawyer for CBE, said the organization was pushing for the foundry to install abatement technology on machines to reduce its pollution. Instead, in March of this year, AB&I Foundry announced that it would move all of its operations to Texas. CBE did not interpret this as a victory: Goolsby’s response was, “In Texas, they’ll just go to another community and put toxins there. A B&I Foundry cited increasing regulatory standards for its move. Earl said the decision “highlighted the importance of a just transition for workers at facilities like this where communities – especially black and brown people who surround industrial facilities – have paid the price for corporate profits.
Historically, environmental cancer risks were studied in unionized industrial settings, Rudel says, which often had centralized health care, detailed employment records and worker advocates, all of whom favored collaboration with research teams. But last year, the Bureau of Labor Statistics reported that only about one in ten American workers belonged to a union, an all-time high.
Worker organization, in whatever form, still plays a vital role in the success and continuation of public health research. For example, Rudel co-directs the Women Workers Biomonitoring Collaborative, a research collaboration that studies occupational cancer risks for female firefighters, nurses and office workers. She credits the existence of the collaboration to employee advocacy groups who were the first to sound the alarm about cancer similarities among co-workers. “But for many situations where people are exposed, including at work,” warns Rudel, “we don’t have it, and we never will. And so, we will never be able to study what happened to these exposures.
Deysi Flores, organizer of the nonprofit Make the Road New York (MRNY), co-directs the Safe and Just Cleaners Research Partnership, which produces research on the health risks posed to household cleaners by cleaning products . Flores says where the organization’s studies struggle to find funding is for all the associated programs and workplace advocacy that keep workers engaged in the study. When organizing participants for Safe and Just Cleaners, in a profession often paid on the black market, MRNY took on the challenge of connecting undocumented participants to preventive health care, so that they could then even participate in research.
After this organizing experience, MRNY made universal health care coverage in New York a political priority. Flores says, “What we see in the communities we represent is that the most vulnerable workers are day laborers, those who don’t have the most ideal worker protections. This means we need to do a better job of including these workers in these workplace safety regulatory processes.