5. Conclusion And Recommendations: Reducing risks from chemical exposures
It is clear, we are exposed to and take into our bodies an incredible number of chemicals that are known or possible carcinogens. Biomonitoring data shows that exposures to a many cancer-causing chemicals are not limited to special populations such as industrial workers but are present in everyday life. Biomonitoring studies are incredibly valuable for accurately measuring and tracking human exposure to chemicals. This inventory of carcinogens is important for research aimed at uncovering the links between chemicals and disease and also for policy makers to understand the risks that exist among people. In fact, scientists at the reputable Silent Spring Institute in Massachusetts conducted a full study to identify potential biomarkers that may cause breast cancer for those very reasons.15 Detection of carcinogens in the human body is only part of the story. Thanks in large part to anti-smoking smoking campaigns, the incidence of lung cancer and some other cancers have begun to decline or level off. But 45 years after passage of the National Cancer Act, we have not seen the declines hoped for. Rates of liver, kidney and many childhood cancers continue to rise. Based not only on detections, but measured concentrations, at least a portion of the chemical carcinogens found in the majority of Americans are likely contributing to meaningful increases in cancer risk. Genetics and bad luck play a big part in who gets cancer but chemical exposures also play a major role. The ubiquity of chemicals in modern life means we cannot eliminate exposure, but we have some control through our consumer choices, along with factors such as diet and exercise. The 2010 Surgeon General’s report on tobacco concluded that quitting smoking at any age can drastically reduce a smoker’s risk of cancer – by up to 50 percent in just five to 10 years.16 The risks from most other chemical carcinogens are very small in comparison, but it is an important reminder that reducing exposures can have real health benefits. Scientists are rethinking how chemicals contribute to cancer, recognizing that chemicals can cause cancer through overlapping biological pathways. Advancing this idea will require a far more robust appraisal for how we determine toxicity and much tougher chemical regulations. Federal law fails to provide the EPA and FDA with the tools needed to ban or even limit carcinogens in everyday products. Regulations on chemicals in cleaners, cosmetics, food and other consumer products should all be strengthened to require expedited review of the most dangerous substances, to ensure they meet the tough “reasonable certainty of no harm” standard, to provide extra protection for vulnerable populations like children, and to ensure that that EPA and FDA have enough data and resources to do the job. Federal law should also preserve a role for state regulators, who have served as the only cop on the chemical beat for decades, and should not permit industry-financed “safe lists” of substances that get a free pass from regulation. Consumers should have the right to know the chemicals used in their products, including chemicals used in fragrance and flavors. More research is also needed investigating the role of chemical exposures and the environment on the development of cancer. In his final State of the Union speech, President Obama announced the creation of a National Cancer Moonshot Initiative to find a cure for cancer in our lifetime. The goal is to break down barriers stifling scientific research, foster scientific collaborations and fund promising and novel research. But the focus is on funding to advance treatment and research in genetics and molecular biology, largely ignoring environmental causes of the disease and prevention. Almost all of the scientists selected for the Blue Ribbon Panel to advise the initiative are entirely clinically focused. Improved treatments and better understanding of the genetics and molecular biology of cancer are crucial in the battle to defeat this disease. But, as the findings of this report make clear, our environment plays a critical role as well. Advances in treatment have improved survival by nearly 20 percent in the last 20 years. More promising treatments, such as immunotherapies, are on the horizon. But cancer is hundreds of diseases, not one, each with distinct etiologies. We are not searching for a single cure. Moreover, the costs of developing cancer, even if successfully treated, can be staggering. In addition to the tremendous physical and emotional toll, cancer treatments can result in a substantial financial burden. Financial stress, including increased rates of bankruptcy, can lead to poor survival and other adverse health outcomes among cancer patients.17 The only concrete agenda related to prevention outlined in President Obama’s Moonshot Initiative is for screening and vaccination. Understanding the environmental causes of cancer are also necessary to prevent and defeat this disease. The World Health Organization estimates that as much as 19 percent of cancers are due to environmental exposures.18 We have seen the success of smoking cessation efforts—reducing the rate of lung cancer by more than 25 percent in the last 25 years. The incredible number of human carcinogens detected in this report demonstrates the burden of environment on human health. It is imperative the Moonshot include federal funding for the investigation of the environmental causes of cancer and the development of prevention initiatives in that arena.