#353: EPA: Dioxin Does Cause Cancer In Humans

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RACHEL'S HAZARDOUS WASTE NEWS #353
---September 2, 1993---
News and resources for environmental justice.
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Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org ==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com
========================Original Source========================

An explosion at a Hoffman-LaRoche chemical plant in Seveso, Italy, in 1976 sent a cloud of the herbicide 2,4,5-T over the surrounding countryside, contaminating several thousand people. Dioxin is created as an unwanted by-product during the manufacture of 2,4,5-T, so the Seveso population was exposed to dioxin. For years, optimists have been pointing to Seveso saying, "Dioxin doesn't cause cancer in humans--look at Seveso." Now a new study in the journal EPIDEMIOLOGY reveals that people exposed to dioxin during the Seveso explosion have begun to exhibit excessive numbers of cancers.[1]

Dr. Linda Birnbaum, director of environmental toxicology for U.S. EPA [Environmental Protection Agency], told the Associated Press that the new study "is one more nail in the coffin" for dioxin.[2] Birnbaum, who is coordinating EPA's multi-year "scientific reassessment" of dioxin said, "This, together with other studies, clearly supports that dioxin has the potential to cause cancer in people, just as it does in every animal it's been tested in. The weight of the evidence is becoming overwhelming," she told AP reporter Paul Raeburn.

The area around Seveso has been divided into three zones, called A, B and R. The small A zone was most heavily contaminated, but its 724 residents were evacuated. ("Heavy" contamination means that each square yard of land contained 13 to 494 micrograms of dioxin; a microgram is a millionth of a gram and there are 28 grams in an ounce.) The B zone was less heavily contaminated but its 4824 residents were not evacuated; zone B contained 43 micrograms of dioxin per square yard of soil, or less. The R zone was even less contaminated (average contamination being 4.3 micrograms per square yard), so its 31,647 residents were probably exposed to low levels. Another 181,579 people living beyond zone R serve as a control group living in "noncontaminated" areas.

The greatest cancer increase has occurred in zone B. In zone A the numbers are small and no significant cancer increases have occurred. In zone R one kind of cancer has increased: soft tissue sarcoma. Previous studies have linked dioxin exposure to soft tissue sarcoma in humans.

In zone B, among women there has been an observable increase in cancers of the gall bladder and biliary tract (the system that delivers bile from the liver to the small intestine), and in cancers related to the blood-forming system (multiple myeloma and myeloid leukemia).

Among men in zone B, there were observable increases in cancers of the blood-forming system, and in one kind of non-Hodgkin's lymphoma (a cancer of the lymph system called lymphoreticulosarcoma).

This new study only covers the period 1976 through 1986--10 years after the Seveso accident. Since most cancers take longer than 10 years to develop, the cancers reported in this study may represent only the earliest signs of more trouble to come.

This Seveso study is not the first to indicate that dioxin causes cancer in humans. [3-10,14,15] Swedish researchers in the late 1970s began reporting that exposure to phenoxy herbicides (2,4-D and 2,4,5-T) caused a 3-fold to 6-fold increase in the risk of soft tissue sarcomas and lymphomas. Phenoxy herbicides are contaminated with dioxin during manufacture.

Monsanto Corporation, a major manufacturer of phenoxy herbicides, in the late 1970s and early 1980s sponsored studies of workers that the company had exposed to dioxin, and these studies showed no increased cancer deaths among exposed workers. However, the Monsanto studies have been criticized by a report from the National Research Council, [11] which says Monsanto's studies were "plagued with errors in classification of exposed and unexposed groups, according to some reports, and hence have been biased toward a finding of no effect." A 1990 analysis of Monsanto workers, conducted by the National Institute for 

Occupational Safety and Health, reported a statistically-significant increase in soft tissue sarcomas. [12]

As part of its multi-year scientific reassessment of dioxin, EPA recently published a draft review of all scientific data linking dioxin to cancer and other health effects in humans. [13] The EPA's draft document concludes that four separate studies[8,9,14,15] of workers exposed to dioxin have revealed an "overall increased mortality from all malignancies combined." EPA speculates that dioxin's ability to mimic hormones gives dioxin the capacity to cause cancer in many different organs and bodily systems in humans. [13, pg. 7-7]

There seems to be little room left for doubt: As the EPA's "scientific reassessment team" told then-chief of EPA, William Reilly, January 27, 1992: "Dioxin does cause cancer in humans." (See RHWN #283.)

It therefore seems that EPA now has little choice but to declare dioxin a class A carcinogen, i.e., one known to cause cancer in humans. This would have far-reaching implications for public health policy. (A public hearing to discuss the new EPA document, and its implications, is scheduled for 9-to-5 September 7 and 8, 1993, at the Ritz-Carlton Hotel in Pentagon City, Arlington, Va. If you want to reserve time to speak, contact Helen Murray of Eastern Research Group: (617) 674-7374. The meeting will be full and space is limited, so we suggest you arrive by 8 a.m. if you want a seat.)

An editorial in the September issue of EPIDEMIOLOGY points out some of the public policy implications of the conclusion that dioxin causes cancer in humans. [16] The author of the editorial, Swedish dioxin researcher Olav Axelson, says that the "biological effects of TCDD [dioxin]" are "a first order public health concern." Axelson says "there seems to be an urgent and costly need to change or improve industrial and other processes so as not to produce dioxins (and the toxicologically similar chlorinated dibenzo-furans). For example, there is a need to restrict the use of chlorine in paper bleaching. Incineration of waste material at too low temperature should be avoided as well as the 'combustion' of organochlorine compounds in general," Axelson says.

Dioxin is produced by every municipal solid waste incinerator ever tested; it is produced by all hazardous waste incinerators, cement kilns and BIFs [boilers and industrial furnaces] that burn chlorinated wastes. It is produced by the manufacture of many pesticides (85% of which involve chlorine). It is produced by metal smelters, and paper mills, and probably by other common industrial processes. Although there is now little doubt that dioxin causes cancer in humans, translating that into public policies that genuinely protect public health will create a political firestorm. Once again, EPA chief Carol Browner faces a series of decisions that will define clearly and unmistakably which side she and Bill Clinton are on.

--Peter Montague, Ph.D.

===============

[1] Pier Alberto Bertazzi and others, "Cancer Incidence in a Population Accidentally Exposed to 2,3,7,8-Tetrachlorodibenzo-PARA-dioxin," EPIDEMIOLOGY Vol. 4 (September, 1993), pgs. 398-406.

[2] Paul Raeburn, "Dioxin Dangers," a story on the Associated Press news wire datelined New York, August 29, 1993.

[3] Lennart Hardell and others, "Case-control study: soft-tissue sarcomas and exposure to phenoxyacetic acids or chlorophenols," BRITISH JOURNAL OF CANCER Vol. 39 (1979), pgs. 711-717.

[4] Lennart Hardell and others, "Malignant lymphomas and exposure to chemicals, especially organic solvents, chlorophenols, and phenoxy acids: a case-control study," BRITISH JOURNAL OF CANCER Vol. 43 (1981), pgs. 169-176.

[5] Mikael Eriksson and others, "Soft tissue sarcomas and exposure to chemical substances: a case-referent study," BRITISH JOURNAL OF INDUSTRIAL MEDICINE Vol. 38 (1981), pgs. 27-33.

[6] Sheila Hoar and others, "Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma," JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Vol. 256 (1986), pgs. 1141-1147.

[7] Sheila Hoar Zahm and others, "A case-control study of non-Hodgkin's lymphoma and the herbicide 2,4-dichloro phenoxyacetic acid (2,4-D) in Eastern Nebraska," EPIDEMIOLOGY Vol. 1 (1990), pgs. 349-356.

[8] Marilyn Fingerhut and others, "Cancer Mortality in Workers Exposed to 2,3,7,8-tetrachloro-dibenzo-P-dioxin," NEW ENGLAND JOURNAL OF MEDICINE Vol. 324 (1991), pgs. 212-218.

[9] R. Saracci and others, "Cancer Mortality in Workers Exposed to Chlorophenoxy Herbicides and Chlorophenols," LANCET Vol. 338 (1991), pgs. 1027-1032.

[10] Pier Alberto Bertazzi and others, "Ten-year Mortality Study of the Population Involved in the Seveso Incident in 1976," AMERICAN JOURNAL OF EPIDEMIOLOGY Vol. 129 (1989), pgs. 1187-1200.

[11] Anthony B. Miller and others, ENVIRONMENTAL EPIDEMIOLOGY VOLUME 1 PUBLIC HEALTH AND HAZARDOUS WASTES (Washington, D.C.: National Academy Press, 1991), pg. 207.

[12] Marilyn A. Fingerhut and others, MORTALITY AMONG U.S. WORKERS EMPLOYED IN THE PRODUCTION OF CHEMICALS CONTAMINATED WITH 2,3,7,8-TETRACHLORODIBENZO-P-DIOXIN (TCDD) FINAL REPORT [PB91-125971] (Springfield, Va.: National Technical Information Service, 1991).

[13] David Bayliss, Marie Sweeney and others, CHAPTER 7. EPIDEMIOLOGY/HUMAN DATA [EPA/600/AP-92/001g; Revised June 1993; Workshop Review Draft] (Cincinnati, Ohio: U.S. Environmental Protection Agency, Center for Environmental Research Information, 1993). For a free copy while supplies last, phone EPA in Cincinnati: (513) 569-7562.

[14] A. Manz and others, "Cancer mortality among workers in chemical plant contaminated with dioxin," LANCET Vol. 338 (1991), pgs. 959-964.

[15] A. Zober and others, "Thirty-four-year mortality follow-up of BASF employees exposed to 2,3,7,8-TCDD after the 1953 accident," INTERNATIONAL ARCHIVES OF OCCUPATIONAL AND ENVIRONMENTAL HEALTH Vol. 62 (1990), pgs. 139-157.

[16] Olav Axelson, "Seveso: Disentangling the Dioxin Enigma?" EPIDEMIOLOGY Vol. 4 (September, 1993), pgs. 389-391.

Descriptor terms: explosions; accidents; spills; hoffman-laroche; seveso; italy; 2,4,5-t; herbicides; pesticides; studies; linda birnbaum; epa; dioxin; carcinogens; cancer; soil contamination; soft tissue sarcoma; sts; gall bladder cancer; biliary tract cancer; liver cancer; multiple myeloma; myeloid leukemia; hematopoeitic system cancers; blood; lymphomas; non-hodgkin's lymphomas; phenoxy herbicides; 2,4-d; monsanto; william gaffey; w r gaffey; judith zack; j a zack; occupational safety and health; nrc; national research council; niosh; marilyn fingerhut; chlorine; chlorinated solvents; incineration; cement kilns; bifs; boilers; industrial furnaces; carol browner; bill clinton;

#462: Killing Science

=======================Electronic Edition========================
RACHEL'S ENVIRONMENT & HEALTH WEEKLY #462
---October 5, 1995---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@rachel.clark.net
==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com
========================Original Source========================

Last week Congress permanently closed down its scientific research arm, the Office of Technology Assessment (OTA). Although we did not agree with the recommendations of every report that OTA produced during its 23 years of policy analysis, we know that the death of OTA will be an immeasurably great loss to the nation's ability to get the facts straight. The so-called conservatives in this Congress claim to favor public policies based on "good science," yet they are hacking away the infrastructure of laboratories and institutes that, for decades, has done the nation's scientific work. Next on the chopping block is the National Institute of Standards and Technology (NIST, formerly the National Bureau of Standards), which designs standardized testing and measurement protocols that are relied upon by scientists and engineers throughout the world. This Congress is moving us steadily back toward the dark ages.

On the chopping block as we go to press is the university-based program of basic research within the National Institute of Environmental Health Sciences (NIEHS), part of the National Institutes of Health (NIH). The NIEHS Superfund Basic Research Program, now in its ninth year, provides funding to 17 programs at 60 universities and institutions around the country, studying the human health effects of hazardous chemicals in the environment, especially those found at leaking waste dumps.

Congress has already reduced the appropriation for this program, which makes up barely 1% of the Superfund toxic waste cleanup effort. But now the House Subcommittee on Commerce, Trade and Hazardous Materials, chaired by Rep. Michael Oxley of Ohio's 4th District, is refusing to reauthorize the program entirely, thus killing it dead. Mr. Oxley's position is that Superfund money should only be used for cleanup, not for any "extraneous" uses like determining how clean our cleanups need to be, and why. Like other so-called "conservatives" who claim they want policies based on "good science," Mr. Oxley reveals his true intentions as he prevents any "good science" from being funded and carried out.

Looking at some of last year's research highlights produced by the Superfund research program, one can appreciate Mr. Oxley's fear of what good science will reveal: [1]

** Researchers determined the dose-response relationship for benzene down to doses as low as those received by ordinary people. Millions of Americans are exposed to small amounts of benzene when, for example, they pump their own gasoline. These benzene experiments strongly suggest that a cancer risk from benzene is present even at very low doses. With millions of people exposed to benzene every day, it seems important to know that benzene really does cause cancer.

** Other investigations demonstrated for the first time in laboratory animals that benzene exposure, which has been associated with leukemia and aplastic anemia in humans and animals, is also mutagenic; that is, it causes inheritable genetic changes which can affect the next generation, the next after that, and so on.

** Researchers showed that several biological markers (subtle observable changes in a person) can be used to detect probable chromium exposure in humans living near places where chromium wastes have been dumped. Researchers studied Jersey City, N.J., and surrounding Hudson County where corporate polluters dumped chromium wastes on the ground for decades. Such research should make it easier to sue corporate polluters for exposure to toxics.

** Researchers developed a test to detect a single molecule of a cancer-associated chromosomal rearrangement in the presence of DNA from a million normal human cells. This work offers the possibility of very sensitive detection of the ability of chemicals to cause chromosomal rearrangements as an indicator of their cancer-causing potential.

** Researchers are studying the neurological and immune-system effects of drinking water containing mercury compounds. Early results indicate that even a small dose of methyl-mercury, such as 5 ppm [parts per million] in drinking water, impairs neurological, endocrine (hormone), and immune-system functions in animals. This corresponds to a daily consumption of 0.3 milligrams per kilogram (mg/kg) of body weight which is smaller than the "safe" dose of 0.48 mg/kg body weight indicated by the World Health Organization. In other words, mercury is even more dangerous than formerly believed.

** A large epidemiologic study examined the respiratory disease hazards of susceptible individuals living near toxic waste sites and industrial facilities. Analysis of interim data has provided important information on the association between asthma status (active or inactive) and exposure to irritants --active asthmatics have been found to suffer an adverse effect on lung function resulting from irritant chemical exposure (after adjustment for smoking). Asthma is increasing each year in the U.S. population, and annual production of toxic chemicals is increasing as well. Could these two trends be related? It would be important to know.

** Researchers demonstrated a high degree of correspondence between laboratory and field-test results of immune-system toxicity in dogs exposed to industrial PCBs [polychlorinated biphenyls]. Not only have these studies clarified effects of PCBs on the immune system, but they have sparked a number of spin-off studies involving the thyroid, lymphocyte (white blood cell) development, and brain function. These studies help clarify how PCBs affect behavior, physiology, and response to infectious disease, in addition to environmentally-induced threats such as cancer. Efforts to date have provided a key step in validating laboratory immune-system toxicity observations with field studies of animal health.

** In a study comparing effects of perinatal (near the time of birth) vs. adult exposure to PCBs, researchers have found that toxic effects on the brain occur in completely opposite ways. In adults, ortho-PCBs reduce brain dopamine levels while dioxin-like coplanar-PCBs have no such effect. (Dopamine is an important natural chemical in the brain.) However, following perinatal exposure, dioxin-like PCBs elevate brain dopamine concentrations and alter the behavior of exposed female offspring while ortho-PCBs reduce brain dopamine concentrations. Thus, PCB exposures have opposite effects, depending on the age at exposure and the type of PCBs to which the organism is exposed. These results suggest that PCBs may not only directly affect nerve function, but may also alter steroid hormone function during a baby's development.

** Some of the most interesting and important Superfund research involves the role of estrogens and estrogen-like chemicals that seem to interfere with the reproductive system of fish, birds, and mammals, probably including humans. Estrogens are female sex hormones.

A study of sea gulls on Santa Barbara Island, not far from Los Angeles, in 1977 revealed bizarre gull behavior: female gulls were pairing up and sharing nests. In 1981, bird toxicologist Michael Fry published a study showing that, by injecting a small amount of DDT into bird eggs, he could produce hermaphroditic male birds --that is, male birds with the sex organs of both a male and a female. Fry's work met with skepticism back in 1981, but in the subsequent decade wildlife experts worldwide reported declining birth rates, hermaphroditic offspring, lowered sperm counts, and deformities of the testicles of fish, panthers, alligators, and other animals in polluted habitats. [2]Timothy Gross, a wildlife endocrinologist (hormone specialist) at the University of Florida in Gainesville, says, "If you look at people, the same pollutants are in our bodies. What is a safe level? We don't know. But I'd be a pretty naive scientist to conclude there couldn't be the same effects in humans." [3]

The possible effects of estrogen-like chemicals on humans are now thought to include prostate cancer and testicular cancer [4]in men, and perhaps breast cancer in women. [5] Prostate cancer has been steadily increasing in the U.S. in recent years, especially among older men; it strikes 244,000 men each year in the U.S., and kills about 40,000. Breast cancer strikes 183,000 American women each year and kills about 46,240. One out of every 8 women gets breast cancer, and one out of every 7 men gets prostate cancer. Because men with undeveloped testes, and castrated men, rarely develop prostate cancer, researchers began to suspect that sex hormones circulating in the blood might affect prostate cancer. "The evidence has since been stacking up to form an alarming picture that paints estrogen [female sex hormone] and testosterone [male sex hormone] as cancer culprits," says a recent issue of ENVIRONMENTAL HEALTH PERSPECTIVES, [4]published by the National Institute of Environmental Health Sciences [NIEHS], a staid scientific organization that does not use the word "alarming" lightly. Estrogens and estrogen-mimicking industrial chemicals in the environment have now been shown to alter testosterone levels in men. Thus the wildlife research supported by Superfund money has begun to pay off with a better understanding of major killer diseases. "We're relying on Superfund money for research," says wildlife-and-hormone specialist Timothy Gross at University of Florida. "And who knows what will happen to that? Congress now has a vendetta against lots of this environmental research," he says. [3]

Indeed, people calling themselves "conservatives" in Congress are determined to cut off the funding for this line of research. In their mind, the only good science is no science. Without federal funding, this research will cease because the private sector has no interest in showing how industrial discharges may be contributing to the nation's steadily-rising burden of cancer, diabetes, birth defects, endometriosis, and infertility.

Now a Congressman from Ohio is leading the charge to kill this important health research program. Mr. Oxley might change his mind if he received letters or phone calls from people in his district, who hold the power to end his political career. In addition, calls from outside his district might help, too. Mr. Oxley represents 11 counties (Allen, Auglaize, Crawford, Hancock, Hardin, Knox, Logan, Marion, Morrow, Richland and Wyandot), with the district's four most populous cities being Lima, Mansfield, Marion, and Findlay (Mr. Oxley's home town). His phone number in D.C. is: (202) 225-2676; fax: (202) 226-1160. Mail: 2233 Rayburn Building, Washington, D.C. 20515.

 --Peter Montague

===============

[1] Highlights of Superfund research can be found on the World Wide Web at http://www.niehs.nih.gov/sbrp/1994-hig.htm.

[2] Recent work on estrogen-like chemicals and wildlife appears in "Wildlife Development," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 103, Supplement 4 (May, 1995).

[3] Gross quoted in Amanda Spake, "Is the modern world giving us cancer?" HEALTH (October, 1995), pg. 55.

[4] Renee Twombly, "Assault on the Male," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 103, No. 9 (September, 1995), pgs. 802-805.

[5] Devra Lee Davis and H. Leon Bradlow, "Can Environmental Estrogens Cause Breast Cancer?" SCIENTIFIC AMERICAN Vol. 273, No. 4 (October, 1995), pgs. 166-172.

Descriptor terms: research funding; superfund; congress; science; ota; benzene; chromium; congressman michael oxley; cancer; mercury; asthma; hazardous wastes; pcbs; dogs; estrogens; hormones; immune system; nervous system; endocrine system; endocrine disruptors; wildlife; hermaphroditism; fish; gulls; birds; panthers; alligators; prostate cancer; testicular cancer; breast cancer; morbidity statistics; mortality statistics; testosterone; niehs

#003b: Common Weed Killer Now Linked To Cancer Deaths In New Study.

=======================Electronic Edition========================

RACHEL'S HAZARDOUS WASTE NEWS #3
---December 15, 1986---
News and resources for environmental justice.
------
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com
=======================Original Source========================

A new study by the National Cancer Institute and the University of Kansas has linked exposure to herbicides with non-Hodgkins lymphoma, lymphatic cancers besides Hodgkins disease. The study was based on the health histories of 948 male Kansas farmers who had cancer and an equal number of non- cancer victims for comparison.

The study points up 2,4-D as a cause of cancer; 2,4-D is found in many lawn-care products commonly used around suburban homes.

The study found that if farmers were exposed to herbicides 20 days a year or more, they were 600% more likely to contract lymphatic cancer than people who did not work with herbicides. The risk for farmers who came in actual contact, mixing or applying the chemicals, increased eightfold. Farmers who failed to use protective equipment such as gloves or masks while working with pesticides were 40% more likely to develop cancer than those who used protection.

The higher cancer risk was found to be particularly associated with 2,4-dichlorophenoxyacetic acid, or 2,4-D, a chemical compound used in a variety of herbicides. Agent Orange, the herbicide sprayed in Vietnam that is the focus of lawsuits filed by exposed veterans, contains 2,4-D and an established link between cancer and exposure to 2,4-D could have a profound effect on those lawsuits.

--Peter Montague, Ph.D.

Descriptor terms: lawsuits; ks; cancer; lymphatic cancer; herbicides; pesticides; nci; 2,4-d; 2,4- dichlorophenoxyacetic; agent orange; studies; national cancer institute; university of kansas;

#385: Cancer Dangers Increasing Sharply

=======================Electronic Edition========================
RACHEL'S HAZARDOUS WASTE NEWS #385
---April 14, 1994---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org
==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com =======================Original Source========================

A white male of the baby boom generation is about twice as likely to get cancer as his grandfather was, and a white female of the same age has about a 50% greater chance of getting cancer than her grandmother did, according to a study published in February in the JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION (JAMA). [1]

The new JAMA study is limited to white people. The historical data (1950-1989) we show in Table 1, below, are also limited to whites because data on non-whites from the 1950s and 1960s are considered unreliable. (Racial bias in the medical research community appears to explain the poor quality of historical cancer data for non-whites: until the 1970s, either the data were not collected at all or the data were not collected systematically enough to allow comparison with data for whites.)

The new JAMA study confirms for whites in the U.S. what previous studies had shown for many industrialized countries: that the incidence (occurrence) rate for many cancers is increasing steadily even though the death rate for some cancers has been falling. [2] Incidence rates and death rates are calculated per 100,000 persons in the population, and they are standardized to the age of the population in a selected year (1970 is often the year selected) so that the data can be reliably compared from one year to the next despite changes in the ages of the population. This means that the rising rates reported in JAMA and elsewhere are NOT caused by the population simply growing older.

As Table 1, from the National Cancer Institute, shows, there are two cancers (stomach and cervix) for which both incidence and deaths are diminishing as time passes. [3] These are the only really good news.
There are 8 cancers for which the death rate is diminishing even as the incidence rate is rising: colon/rectum, ovaries, larynx, testicles, bladder, lymph [Hodgkin's], childhood cancers, and leukemias [cancers of the blood-forming organs]. These 8 are the cancers that people are "learning to live with" through advances in surgery, chemotherapy and radiation therapy. Survivors are often disfigured and debilitated by life-saving treatments. (See RHWN #222.)

There are six cancers for which both the incidence rates and the death rates are rising: lung, skin, female breast, prostate, kidney, and non-Hodgkin's lymphomas. Many of these are major killers, as Table 1 shows. 

These six are unmitigated bad news.

It is common to "explain away" rising cancer rates by observing that the biggest increase is in lung cancer, and then to write off these deaths as inconsequential because many of them they are caused by tobacco, and are therefore, in some sense, self-inflicted. This view ignores compelling evidence that tobacco is as addictive as heroin and morphine, [4] and that tobacco corporations spend billions each year to get people hooked and keep them that way. This view also avoids asking: what is it about life in America that impels so many citizens to inflict an early, painful death upon themselves and upon those they live with?

The new JAMA study distinguishes cancers related to smoking (lung, mouth, larynx, and pharynx) and shows that non-tobacco-related cancers are also rising among Americans. [5] A white male born in the 1940s has twice the chance of getting a non-tobacco-related cancer, compared to his grandfather. Among women born in the 1940s, the chance of a non-tobacco-related cancer is 30% higher, compared to their grandmothers' chances.

The JAMA study concludes that cancer-causing hazards besides smoking have been introduced into the U.S. population in the past several decades, and into other industrialized countries as well. Better diagnosis explains some but not all of the increase, JAMA says, because the rise in cancers started before improved diagnostics became available.

Sweden has been maintaining proper cancer statistics longer than any other country in the world, and a recent study of Swedish people shows cancers rising among younger populations there, [6] just as in the U.S. This is important bad news. The recently-introduced causes of cancer in Sweden and the U.S. remain largely unidentified. Medical and industrial sources of radiation are certainly implicated, though often ignored; the JAMA study does not mention radiation. [7] The JAMA study suggests that something useful might be learned by studying farmers. Farmers smoke less and are more active than most people. They are also exposed to more engine exhausts, chemical solvents, pesticides, fuels, animal viruses, and sunlight than most people. Could these exposures be why farmers get more cancers than other people? (See RHWN #375.)
After 20 years of fruitless searching for a "cure" for cancer, the search now seems to be veering, slowly, toward a new goal: finding the PREVENTABLE causes of cancer, such as exposures to radiation and certain chemicals, and who knows what else. As Devra Lee Davis says, "Preventing only 20% of all cancers in the U.S. would spare more than 200,000 people and their families [each year] from this often disfiguring and disabling disease and would also spare society the burgeoning costs of treatment and care."

  --Peter Montague, Ph.D.


========================================================== TABLE 1 U.S. Cancer Incidence and Deaths in 1989, and the Percent Change in Age-Adjusted Rates of Incidence and Death per 100,000 U.S. Population, 1950-1989.

	-----ALL RACES-----		-----------------WHITES--------------------
Cancer type	Incidence in 1989	Deaths in 1989	Percent change in incidence, 1950-1989	Percent change in deaths, 1950-1989
-----------------------------------------------------------------------------------------------------------
stomach	20,000	14,185	-73.5	- 76.0
cervix	13,000	4,487	-76.0	- 73.9
colon/rectum	151,000	57,023	+10.0	-25.6
ovaries	20,000	12,256	+8.2	-0.2
larynx	12,300	3,727	+62.4	-10.1
testicles	5,700	392	+115.0	-66.4
bladder	47,100	10,121	+55.7	-35.6
Hodgkin's	7,400	1,721	+29.2	- 65.5
childhood cancers	6,600	1,768	+9.8	-61.1
leukemia	27,300	18,406	+7.8	- 2.1
lung	155,000	137,013	+263.8	+245.2
skin	27,000	6,161	+321.0	+152.4
breast (female)	142,000	42,836	+52.5	+4.7
prostate	103,000	30,519	+108.8	+14.8
kidney	23,100	9,638	+109.4	+28.0
non-Hodgkin's lymphoma	32,800	18,064	+158.6	+108.7
All types excluding lung	855,000	359,117	+29.9	-19.4
All types	1,010,000	496,130	+44.3	+3.2

=================
Source: Lynn A. Gloeckler Ries and others, editors, CANCER STATISTICS REVIEW 1973-1989 [National Institutes of Health Publication No. 92-2789] (Bethesda, MD: National Cancer Institute, 1992), Table I-3, pg. I.23. NIH says historical data for non-whites are not considered reliable spanning the period 1950-1989 so historical data are only given for whites.
===========================================================

[1] Devra Lee Davis and others, "Decreasing Cardiovascular Disease and Increasing Cancer Among Whites in the United States From 1973 Through 1987," JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Vol. 271, No. 6 (February 9, 1994), pgs. 431-437. And see David Brown, "Baby Boom Cancer Risk Up Sharply," WASHINGTON POST February 9, 1994, pgs. A1, A11. See also Tim Beardsley, "A War Not Won; Trends in Cancer Epidemiology," SCIENTIFIC AMERICAN Vol. 270 (January 1994), pgs. 130-138.

[2] David G. Hoel and others, "Trends in Cancer Mortality in 15 Industrialized Countries," JOURNAL OF THE NATIONAL CANCER INSTITUTE Vol. 84, No. 5 (March 4, 1992), pgs. 313-320.

[3] Lynn A. Gloeckler Ries and others, editors, CANCER STATISTICS REVIEW 1973-1989 [National Institutes of Health Publication No. 92-2789] (Bethesda, Md.: National Cancer Institute, 1992), Table I-3, pg. I.23.

[4] See Susan Okie, "Smoking Addictive, Koop Confirms; New Warning Label, Health Efforts Urged," WASHINGTON POST May 17, 1988, pg. A1. Even tobacco health researchers funded by the tobacco industry describe tobacco as addictive; in a government survey of 179 industry-funded researchers, all but one described tobacco as "addictive." See "Tobacco researchers say smoking harms," SCIENCE NEWS Vol. 140 (July 27, 1991), pg. 59.

[5] An editorial in the same issue of JAMA notes that these four cancers do not represent an "entirely pure" category of tobacco-related cancers because some cancers of the bladder, kidney, pancreas, and possibly cervix and stomach, may also be caused by tobacco. See Anthony B. Miller, "How Do We Interpret the 'Bad News' About Cancer?" JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION Vol. 271, No. 6 (February 9, 1994), pg. 468. [6] Hans-Olov Adami and others, "Increasing cancer risk in younger birth cohorts in Sweden," LANCET Vol. 341, No. 8848 (March 27, 1993), pgs. 773-777.

[7] See, for example, John Gofman's unpublished paper linking female breast cancer to radiation: "Ionizing Radiation and Breast Cancer," presented February 22, 1994 at the annual meeting of the American Association for the Advancement of Science in San Francisco. Available from: Dr. John Gofman, Committee for Nuclear Responsibility, P.O. Box 11207, San Francisco, CA 94101.

Descriptor terms: cancer statistics; morbidity; mortality; american medical association; sweden; u.s.; us; radiation; farmers; agriculture; pesticides; solvents; sun; sunlight; uv; uvb; ultraviolet radiation; viruses; breast cancer; stomach cancer; cervix cancer; colon cancer; rectal cancer; testicular cancer; bladder cancer; Hodgkin's disease; non-Hodgkin's lymphoma; leukemia; childhood cancer; children; lung cancer; skin cancer; prostate cancer; kidney cancer;

#365: A New Era in Environmental Toxicology

=======================Electronic Edition======================== 

RACHEL'S HAZARDOUS WASTE NEWS #365
---November 25, 1993---
News and resources for environmental justice.
------ 
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403 
Fax (410) 263-8944; Internet: erf@igc.apc.org 
==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com =======================Original Source======================== 

The federal National Institute of Environmental Health Sciences (NIEHS), in Bethesda, Maryland, has published a new report describing the "developmental effects" of chemicals on humans and animals. 

"Developmental effects" are those that occur during the earliest time of life when the young are developing in the womb, or in the egg. [1] With the publication of this report, ideas and data developed by Dr. Theo Colborn and many of her colleagues [2] have entered the mainstream of the nation's scientific and medical thinking. A new era of environmental toxicology has begun. We believe that the work of Dr. Colborn and her colleagues will eventually be seen to be as important as the work of Rachel Carson, who woke the nation to the dangers of pesticides and atomic fallout in her book, SILENT SPRING, in 1962.

The Colborn report is peppered with medical language, and is therefore somewhat difficult for most readers to grasp. However, the ideas in the report are of such profound importance that everyone should own a copy, should read it themselves, and should urge their family doctor to read it. We will mail it free to anyone who sends a stamped, self-addressed envelope bearing 52 cents postage.

The new report describes a class of chemicals (35 common pesticides, and 10 common industrial chemicals) [3] and a kind of health damage from these chemicals that affects the offspring of exposed adults. The damage to the offspring often remains hidden until the young grow to maturity and even to middle age. The damage occurs in three key bodily systems: the reproductive system, the endocrine system, and the immune system. The report describes evidence gathered from three sources: wildlife, laboratory animals, and humans.

The report emphasizes interference with the endocrine system, which then causes damage to the reproductive and immune systems.

The endocrine system is made up of specialized cells, tissues, and organs that create and secrete (usually into the blood) chemicals called hormones, which then regulate other kinds of cells in the body. Particular hormones only affect particular cells that contain "receptors" for those hormones. A small amount of a hormone attaches to a "receptor" (a protein molecule) and the hormone-receptor pair then initiates a cascade of chemical changes, often with major and far-reaching consequences in remote parts of the body. In this way, hormones act as messengers, sending chemical signals that control the way the entire body grows, is organized, and behaves.

What Colborn and her colleagues have discovered, examined, and documented is that many chemicals in common use since World War II enter the bodies of humans, domestic animals, and wildlife, chiefly through contaminated food and water, and that these chemicals mimic hormones. The body mistakes them for natural hormones and reacts to them in ways that cause deep and permanent trouble, especially when exposure occurs during the critical period of development before, and immediately after, birth or hatching.

Endocrine-disrupting chemicals mimic hormones, but with one key difference. Natural hormones do their work as messenger (or as stimulant of a cascade of other effects), and then the body disassembles them and removes them from the blood stream. In contrast, when industrial chemicals and pesticides mimic hormones, they do not disappear quickly. They tend to remain in the body for very long periods, doing the work of hormones at times, and in ways, that are inappropriate and destructive.

The Colborn report begins with this summary:

"Large numbers and large quantities of endocrine-disrupting chemicals have been released into the environment since World War II. Many of these chemicals can disturb development of the endocrine system and of the organs that respond to endocrine signals in organisms indirectly exposed during prenatal and/or early postnatal life; effects of exposure during development are permanent and irreversible. The risk to the developing organism can also stem from direct exposure of the offspring after birth or hatching. In addition, transgenerational exposure [exposure of offspring] can result from the exposure of the mother to a chemical at any time throughout her life before producing offspring due to persistence of endocrine-disrupting chemicals in body fat, which is mobilized during egg laying or pregnancy and lactation [production of milk]."

The report focuses on one group of chemicals, called the STEROID HORMONES, which are produced by the mother's ovaries and adrenal glands, the placenta, and by the fetus's gonads and adrenal glands. Steroid hormones have been identified as playing a major role in regulating developmental processes in many bodily systems and tissues.

In humans, the development of the body's organs begins during the second month in the womb. From then on, the course of development is regulated by steroid hormones and other parts of the endocrine system.

Certain organs appear to be particularly vulnerable to developmental abnormalities when the mother is exposed to endocrine-disrupting chemicals. In female fetuses, the most vulnerable organs are: breasts, fallopian tubes, uterus, cervix, and vagina. In male fetuses, the critical organs are prostate, seminal vesicles [where sperm originates], epididymides [a reservoir for sperm], and testicles.

In both sexes, critical organs are the external genitals, the brain, skeleton, thyroid, liver, kidney and immune system because they are all targets for steroid hormone action.

Although the report begins by highlighting the role of "steroid hormones," much of the discussion centers on the particular hormone called estrogen because most industrial endocrine-disruptors mimic estrogen. (See RHWN #334, #343.)

Wildlife Evidence

The Colborn report offers a quick catalog of problems documented in wildlife: Exposure to endocrine-disrupting chemicals in the environment has been associated with abnormal thyroid function in birds and fish; decreased fertility in birds, fish, shellfish, and mammals; decreased hatching success in fish, birds, and turtles; demasculinization and feminization of male fish, birds, and gastropods [the group of animals that includes snails and slugs]; and, finally, altered immune system function in birds and mammals.

To illustrate wildlife problems caused by endocrine-disrupting chemicals, the Colborn report describes the plight of the bald eagle, also known as the American eagle because it is pictured on the coat of arms of the U.S. Bald eagles around the Great Lakes and in the Columbia River basin in Washington state are unable to reproduce successfully after they have fed on local fish for two years or longer. Their bodies contain up to 10 times as much DDT, PCBs and chlordane [all of which have been banned for about 20 years in the U.S.] as would allow them to reproduce successfully. Most of these chemicals are being transported into the U.S. via the atmosphere from other countries where their use has not been banned (and where some U.S.-connected firms continue to produce them). They are also extremely persistent. "PCBs will be around over geologic time," the Colborn report says, meaning thousands of years.

Human Evidence

The Colborn report spends considerable time discussing DES (diethylstilbestrol), the synthetic hormone that was given to a million American women by their physicians between 1960 and 1970 to prevent spontaneous abortions. DES is an endocrine-disrupter. Daughters of women who took DES suffer reproductive organ dysfunction, abnormal pregnancies, reduced fertility, immune system disorders, and periods of depression. As young adults, these women also suffer elevated rates of a rare vaginal cancer.

The report offers a very long list of problems caused in both female and male children of DES-exposed mothers. "DES-exposed humans thus serve as a model for exposure during early life to any estrogenic chemical, including pollutants in the environment that are estrogen agonists [mimickers or enhancers]." "It is now suspected that increases in the incidence of numerous pathologies [disease conditions] in men and women may be related to exposure to pesticides and other endocrine-disrupting chemicals that can mimic DES and are thus estrogen agonists [mimickers or enhancers]. The clinical and experimental findings with DES show that consideration must be given to the following facts:

1. an increase in breast and prostatic cancer in the United States occurred between 1969 and 1986;
2. a 400% increase in ectopic [tubal] pregnancies occurred in the United States between 1970 and 1987;
3. a doubling of the incidence of cryptorchidism [undescended testicles] occurred in the United Kingdom between 1970 and 1987; and
4. an approximate 50% decrease in sperm count worldwide over the last 50 years. These trends may be a reflection of the increase [of] estrogenic pollutants in the environment. For example, an association between reduced sperm motility [power of spontaneous movement] and PCBs in men with fertility problems has been reported...."

"Evidence already exists that a number of organochlorine chemicals (such as dioxin, PCB, and DDT) has reached concentrations in aquatic food sources that can lead to substantial functional deficits in animals that consume this food," the report says.

Furthermore, "Based on current breast milk concentrations nationwide, it is estimated that at least 5% and possibly more of the babies born in the United States are exposed to quantities of PCBs sufficient to cause neurological effects."

--Peter Montague, Ph.D.

=============

[1] Theo Colborn, Frederick S. vom Saal, and Ana M. Soto, "Developmental Effects of Endocrine-Disrupting Chemicals in Wildlife and Humans," ENVIRONMENTAL HEALTH PERSPECTIVES Vol. 101 No. 5 (October, 1993), pgs. 378-384.

[2] Theo Colborn and Coralie Clement, editors. CHEMICALLY-INDUCED ALTERATIONS IN SEXUAL AND FUNCTIONAL DEVELOPMENT: THE WILDLIFE/HUMAN CONNECTION. Princeton, N.J.: Princeton Scientific Publishing Co., 1992.

[3] The Colborn report lists the following endocrine-disrupting chemicals: 2,4,-D; 2,4,5-T; alachlor; amitrole; atrazine; metribuzin; nitrofen; trifluralin; benomyl; hexachlorobenzene; mancozeb; maneb; metiram-complex; tributyl tin; zinab; ziram; beta-HCH; carbaryl; chlordane; dicofol; dieldrin; DDT and metabolites; endosulfan; heptachlor and heptachlor epoxide; lindane (gamma-HCH); methomyl; methoxychlor; mirex; oxychlordane; parathion; synthetic pyrethroids; toxaphene; transnonachlor; aldicarb; DBCP; cadmium; dioxin (2,3,7,8-TCDD); lead; mercury; PBBs; PCBs; pentachlorophenol (PCP); penta-to nonylphenols; phthalates; styrenes.

Descriptor terms: niehs; national institute of environmental health sciences; developmental effects; theo colborn; theodora colborn; rachel carson; radiation; nuclear weapons; fallout; pesticides; endocrine system; immune system; reproductive system; hormones; wildlife; reports; studies; steroid hormones; estrogen; bald eagle; great lakes; columbia river; des; diethylstilbestrol; breast cancer; prostate cancer; cryptorchidism; undescended testicles; ectopic pregnancy; reduced sperm count; pcbs; polychlorinated biphenyls; breast milk; nervous system disorders; dioxin;

#398: the theories of Bruce Ames

=======================Electronic Edition========================
RACHEL'S HAZARDOUS WASTE NEWS #398
---July 14, 1994---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org ==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com =======================Original Source========================

The NEW YORK TIMES ran a long article July 5th explaining the theories of Bruce N. Ames, the controversial biochemist from Berkeley. [1] Ames's basic idea is that most of the poisons we ingest are natural toxins appearing in our food; from this, he concludes that money spent controlling industrial chemicals is largely wasted. The TIMES'S story occupied 87 column-inches and contained only one sentence that challenged Ames, thus suggesting that Ames's ideas are almost beyond question. [2] That is not the case. 

Here is an incomplete list of problems with the Ames hypothesis:

1) Production and use of synthetic pesticides (and other synthetic organic chemicals) emits large quantities of hazardous materials into the environment. Workers and neighbors at manufacturing and waste disposal facilities are exposed to toxins. THE NATIONAL CANCER INSTITUTE'S CANCER MAPS REVEAL CANCER CLUSTERS NEAR INDUSTRIAL FACILITIES. IT IS VERY UNLIKELY THAT SUCH CLUSTERS OCCUR BY RANDOM CHANCE. In the TIMES, Ames acknowledged this problem when he said, "Environmental pollutants are not an important cause of cancer. They account for a tiny percent of cancers in Americans but might be a problem in people like farm workers who apply pesticides if they are heavily exposed." Or in anyone else heavily exposed, he might have added.

2) Natural toxins and pesticides that occur in vegetation do not build up in the environment; nature has ways of reassimilating (decomposing) them. On the other hand, the concentration of synthetic (human-created) pesticides and other synthetic organic chemicals is increasing in the environment. Synthetic pesticides are now measurable in groundwater in many states, and the concentrations are growing as time passes. Many pesticides, and industrial poisons such as PCBs, are measurable in all the world's oceans, and even in the polar ice caps. There is compelling evidence that wildlife is being harmed (in some instances, driven to extinction) by this buildup of exotic chemicals throughout the global ecosystem. [3]

3) Ames presents himself as an expert on cancer, yet he makes sweeping generalizations that go far beyond his studies of cancer. In this, he has abandoned science and taken up politics. (Ames opposes government regulation on principle.) He says, for example, "We're shooting ourselves in the foot with environmental regulations that cost over 2 percent of the G.N.P., much of it to regulate trivia." Even if it were true that industrial chemicals cause only a small fraction of all cancers, cancer is not the only problem that we should consider when we examine the wisdom of dumping billions of pounds of pesticides and other industrial poisons into the environment each year. During the past decade, much new information has come to light indicating that many chemicals damage the nervous, immune and endocrine systems of wildlife (fish, birds, and mammals) and humans. According to these studies, one clear result is reproductive and developmental damage in the affected species, and an increased likelihood of succumbing to bacterial and viral infections as well as cancers. Ames ignores the non-cancer effects.

To cite but one example, the National Academy of Sciences acknowledged in a 1992 study, "In the general population, increasing numbers of people suffer from disorders of the immune system, such as allergies, asthma, and AIDS. The incidence of asthma has increased 58% since 1970, and it is well known that nitrogen dioxide and ozone, common air pollutants, interact with allergens to increase the frequency and severity of asthma attacks." [4] Ames ignores the evidence that pollution weakens the human immune system; he insists that we are wasting money curbing industrial discharges because industrial poisons do not cause many cancers, he says --as if cancer were the only problem created by industrial poisons. This is neither good science nor good public policy.

4) Chemical toxicity and exposures are poorly understood because current knowledge is based on:

(a) chemical tests that do not take into consideration children and the elderly, people who are already sick from something else, and populations that eat unusual quantities of one or more food items (e.g., native people who eat a lot of fish);

(b) chemical tests that omit the combined effects of multiple exposures because science has no affordable way of assessing combined and cumulative effects.

This is a point worth emphasizing because Ames makes sweeping generalizations based on data derived from testing one chemical at a time, as if combinations of chemicals don't occur in the real world.

A recent study focused on this problem. In June, three scientists from the National Institute for Occupational Safety and Health (NIOSH) in Cincinnati, Ohio announced an "inherent problem with the way workplace risks are characterized." [5] The "inherent problem" is that workers are usually exposed to many contaminants simultaneously, while "health standards are almost always designed to protect workers from a single exposure." In 25 percent of cases studied, the NIOSH researchers reported what they called an "alarming finding." They reported that, "when animals were exposed to several [chemical] agents at once, the animals (or their offspring) experienced a dramatically increased number of adverse health effects." "In fact," the NIOSH researchers said, "the reported health effects were many times greater than expected by simply adding the effects of each substance." (They also found, in 25% of cases, that combinations of chemicals produced FEWER effects than they would have expected.)

The NIOSH researchers reported that exposure of rats to the common plasticizer, di(2-ethylhexyl) phthalate (DEHP), produced prenatal death in 16 percent of the fetuses and congenital defects (birth defects) in 21 percent of the surviving fetuses. Exposure of rats to caffeine produced prenatal death in about 9 percent of fetuses and defects in 3 percent of the surviving fetuses. However, exposure to DEHP and caffeine simultaneously produced prenatal death in 80 percent of the fetuses and defects in 73 percent of the surviving fetuses.

The researchers point out that risk assessments should consider not only job-related chemical exposures but also prescription and non-prescription drugs. In addition, they say physical agents such as vibration, heat and noise must be considered as well. (And, if Ames is correct in his estimate of the potency of natural toxins in our food, natural toxins must be factored in too.)

The NIOSH team points out that, in nearly every work environment, there is a pervasive physical agent: non-ionizing electromagnetic radiation. One type of non-ionizing radiation, radio-frequency (RF) radiation, is used in a number of industries, including communications, electronics, medical and manufacturing. Many workers in these industries are exposed to RF energy at the same time they are exposed to exotic chemicals.

For years, RF exposures were assumed to be benevolent because they do not ionize (knock electrons off of) molecules or cells the way higher-energy radiation (ionizing radiation, such as x-ray energy) does. To test the hypothesis that RF might enhance the effects of chemicals, the NIOSH researchers exposed rats to a combination of 2-methoxyethanol (2ME) and RF energy. 2ME is a common glycol ether used in some degreasing solvents, and in some paints and varnishes. Alone, 2ME causes developmental toxicity in every species of animal tested to date, including non-human primates (monkeys). To test the interaction of RF energy and 2ME, rats were exposed to these substances on the 13th day of gestation, alone and in combination. RF radiation caused malformations in 30 percent of the rat fetuses, and 2ME produced malformations in 14 percent. Yet, combined exposure to 2ME and RF induced external malformations in 76 percent of the fetuses, "and these malformations were more severe than after single-agent exposure," the NIOSH researchers reported. Subsequent studies of different doses during various gestation times confirmed these findings, they said.

Another study reported by the NIOSH researchers indicates that noise and solvents combine to induce hearing loss in workers to a greater degree than either solvents or noise alone. They studied 200 workers (50 controls, 50 exposed to noise, 39 exposed to organic solvents alone, and 51 exposed to noise and toluene, a common organic solvent). The authors concluded that simultaneous occupational exposure to excessive levels of toluene and noise increased the probability of developing hearing loss. The NIOSH workers summarized, "The effect of combined exposure also suggested a synergistic [multiplier] interaction between noise and toluene on hearing loss. The level of hearing loss was much greater in workers exposed to both hazards than would be predicted by adding the effect of each agent."

Thus we can see that Bruce Ames --and others like him who belittle effects of chemicals on human and environmental health based on incomplete data and erroneous assumptions --may be underestimating the true hazards because they test only one substance at a time. Humans almost never encounter substances one at a time. Toxins in food, drugs (both pharmaceutical and "recreational"), air pollution, water pollution, noise, vibration, heat, electromagnetic radiation and ionizing radiation usually impact us simultaneously. They not only cause cancer but they affect the nervous, endocrine and immune systems in ways that are poorly understood. Risk assessment has no way to take into account such complex and cumulative interactions. The only approach that can consider all these effects together is prevention, the principle of precautionary action. (See RHWN #284, #319, and #378.) Bruce Ames represents solid 19th-century toxicological thinking, but a complex technological world requires that we adopt more modern and more prudent views, based on real-world exposures to combinations of natural and industrial hazards. For developing such a modern approach, many of Bruce Ames's sweeping generalizations are not only wrong and wrong-headed; they are also largely irrelevant.

--Peter Montague

===============

[1] Jane E. Brody, "Strong Views on Origins of Cancer," NEW YORK TIMES July 5, 1994, pgs. C1, C10.

[2] In Brody, cited above, David Rall, former director of the National Institute of Environmental Health Sciences, says Ames's generalizations are based on "incomplete data" since "most of the chemicals we're exposed to haven't been tested for carcinogenicity."

[3] "Statement from the Work Session on Environmentally-Induced Alternations in Development: A Focus on Wildlife; Wingspread Conference Center, Racine, Wisconsin December 10-12, 1993." [A consensus statement from 23 scientists published, accompanied by a news release, April 20, 1994 by the World Wildlife Fund in Washington, D.C.; for a copy, phone: (202) 778-9510 or (202) 778-9536.]

[4] David W. Talmage and others, BIOLOGIC MARKERS IN IMMUNOTOXICOLOGY (Washington, D.C.: National Academy Press, 1992), pg. 1.

[5] B.K. Nelson, David L. Conover, and W. Gregory Lotz, "Combined Chemical, Physical Hazards Make Exposure Harder to Calculate," OCCUPATIONAL SAFETY AND HEALTH Vol. 63, No. 6 (June 1994), pgs. 50, 52-54.

Descriptor terms: bruce ames; cancer; carcinogens; policy; immunotoxicity; immune system; nervous system; endocrine system; niosh; occupational safety and health; standards; regulations; studies; teratogens; di(2-ethylhexyl phthalate); dehp; caffeine; electromagnet radiation; emf; rf; radio frequency radiation; non-ionizing radiation; 2-methuxyethanol; glycol ether; 2me; toluene; solvents; hearing loss; noise; synergism; multiplier effect; precautionary principle; principle of precautionary action; prevention;

#412: A Turnabout for Cancer Policy?

=======================Electronic Edition========================
RACHEL'S ENVIRONMENT & HEALTH WEEKLY #412
---October 20, 1994---
News and resources for environmental justice.
==========
Environmental Research Foundation
P.O. Box 5036, Annapolis, MD 21403
Fax (410) 263-8944; Internet: erf@igc.apc.org
==========
RACHEL-4CM = DIOXIN FOCUSED DIRECTORY Remote Access Chemical Hazards Electronic Library. Dioxinnz.com =======================Original Source========================

The National Cancer Advisory Board (NCAB), an official body of the National Cancer Institute, last month issued a stinging indictment of the nation's cancer programs. Furthermore, for the first time in memory the Board said industrial chemicals, environmental chemicals that mimic hormones, and pesticides need to be investigated as causes of cancer. [1]

In 1971 the U.S. Congress declared "War on Cancer," but year after year many cancers have steadily increased. See Table I. In a blunt assessment of the failed War on Cancer, the NCAB last month said, "The alarming statistics are that one in three people in this country will be diagnosed with cancer during their lifetime; every minute, another person in the United States dies of cancer; in 1994, 1.2 million new cancer cases will add to the more than 8 million people in this country alive today who have already been diagnosed; and within five years, cancer will surpass heart disease as the leading cause of death," the NCAB said. [pg. 9]

"The great strides made in understanding the disease still pale in comparison to the problem. It is disturbing that since 1971 the overall incidence of cancer has increased 18 percent, and the mortality rate has grown by 7 percent. Tobacco use and inadequate health care access account for much of this alarming and wholly unacceptable increase," the NCAB said. [pg. 10]

"While individuals have a responsibility to change high-risk behavior, government and society have responsibilities to identify and prevent workplace and environmental hazards, restrict advertising of unsafe products, require accurate product labeling, and provide culturally targeted education about cancer risk and prevention," the NCAB said. [pg. 17]

Throughout its report, the NCAB makes reference to industrial chemicals, environmental chemicals that mimic hormones, and pesticides, as suspected causes of cancer. Until now, the National Cancer Institute has taken the official position that chemicals cause such a small percentage of cancers that they are not worth investigating.

In a turnabout, the NCAB now says, "The elimination or reduction of exposure to carcinogenic agents is a priority in the prevention of cancer. We are just beginning to understand the full range of health effects resulting from the exposure to occupational and environmental agents and factors." [pg. B-6]

And: "Lack of appreciation of the potential hazards of environmental and food source contaminants, and laws, policies, and regulations protecting and promoting tobacco use worsen the cancer problem and drive up health care costs." [pg. 6]

The report makes 13 recommendations for applying research dollars more effectively; recommendation No. I-5 says, "Examine and change laws and regulatory policies and practices, including those related to the environment and food supply, that contribute to the cancer problem and frustrate cancer prevention and control efforts." [pg. 21]

Furthermore, under "recommendations for translational research" (research to translate existing knowledge into practical benefits) we find, "Establish the role of hormones in the etiology [cause] and prevention of certain cancers." [pg. 26] And: "Develop cancer risk assessments for occupational and environmental carcinogens, based on sound epidemiologic evidence, potency of the carcinogen, and prevalence of human exposure." [pg. 26] Recommendation II-2(4) reads: "Establish the role of external hormones (e.g., from plant or environmental sources) in the etiology [cause] and prevention of certain cancers." [pg. 26]

The report says, "Cancers developing in reproductive tissues such as the breast, ovary, endometrium, and prostate account for approximately 30 percent of all cancers. These tissues are dependent upon an interactive network of various hormones (estrogens, progestins, and androgens) for their structural and functional development. In recent years, investigators have shown that there is a relationship between the level and duration of hormone exposure and tumor development in these hormonally sensitive tissues." [pg. B-5]

In an appendix, the NCAB report lists known and suspected causes of various cancers. Pesticides are listed for cancers of the female breast; the prostate; the stomach; the brain; and the lymph system (non-Hodgkin's lymphoma). As Table I shows, several of these are major killers and/or are rapidly increasing.

Perhaps most importantly, the report focuses on poverty as a major stumbling block to winning the war on cancer: "Unless proven advances in cancer prevention and care are made available to our people in all walks of life, the cancer burden will never be markedly reduced. Bringing existing knowledge and technologies to all of the people will achieve the greatest and most rapid impact on cancer incidence, suffering, and death," the NCAB says. [pg. 17]

"Over 38 million people have no health insurance at all; 50 million are uninsured at some time during the year. Eighty million more have health insurance insufficient to cover the costs of a catastrophic illness such as cancer," the NCAB says. [pg. 18]

"The problem of access is severe among the 35 million poor. African-Americans represent one-third of the poor although they comprise only 12 percent of the United States population. The poor, who typically experience substandard living conditions, lower educational levels, risk-promoting lifestyles, and insufficient access to health care, have a higher incidence of many cancers, are diagnosed with more advanced disease, and have lower survival rates than the more affluent. Even the poor on Medicaid may fare no better than the uninsured," the NCAB says. [pg. 18]

"Anecdotal evidence indicates that even those with insurance may delay seeking diagnostic and other medical care for fear of employment discrimination, future uninsurability, and financial ruin should cancer be discovered," the NCAB says. [pg. 18]

Lastly, the report says that "Current health care reform proposals" [i.e., the Clinton administration's proposals AND the Republicans' suggested alternatives] "are devastating to the War on Cancer" because they deny resources for research and for quality cancer care. [pg. 5]

In sum, the National Cancer Institute is showing definite signs of beginning to "get" the connection between environmental justice, economic justice, and cancer prevention. So far, however, there are no signs of an awakening in the White House or in Congress.

--Peter Montague

===============

[1] Paul Calabresi and others, CANCER AT A CROSSROADS: A REPORT TO CONGRESS FOR THE NATION (Bethesda, Md.: National Cancer Institute, September, 1994). Available free; phone 1-800-422-6237.

---

TABLE 1
U.S. Cancer Incidence (Occurrence) and Deaths in 1990, and the
Percent Change in Rates of Incidence and Death (Per 100,000
Population) During the Period 1950 to 1990.*

	-----ALL RACES------		----------------WHITES----------------
Cancer Type	Incidence in 1990	Deaths in 1990	Percent change in incidence, 1950-1990**	Percent change in deaths, 1950-1990
mouth & pharynx	30,500	8,405	- 32.2	-28.3
uterus	33,000	6,027	-3.8	- 66.3
stomach	23,200	14,072	-74.6	- 76.3
cervix	13,500	4,627	-75.1	- 73.6
esophagus	10,600	9,719	- 13.3	+9.4
colon/rectum	155,000	57,154	+9.9	- 28.2
larynx	12,300	3,709	+59.3	- 10.5
testicles	5,900	342	+124.7	- 68.6
bladder	49,000	10,340	+53.7	- 34.5
Hodgkin's	7,400	1,632	+26.9	- 65.8
childhood cancers	7,600	1,697	+1.3	-59.2
leukemia	27,800	18,725	+5.7	- 2.4
thyroid	12,100	1,026	+102.4	- 50.3
liver	14,600	8,511	+87.8	+18.3
pancreas	28,100	25,081	+11.8	+16.9
ovaries	20,500	12,566	+10.7	+1.0
lung	157,000	141,146	+258.6	+261.5
skin (melanomas)	27,600	6,419	+336.1	+156.0
breast (female)	150,000	43,389	+52.3	+4.0
prostate	106,000	32,376	+134.4	+17.8
kidney	24,000	9,843	+116.1	+33.3
brain	15,600	11,630	+73.6	+47.9
non-Hodgkin's lymphoma	35,600	18,461	+171.9	+113.7
multiple myeloma	11,800	8,896	+182.5	+189.8
All types excluding lung	883,000	364,149	+31.7	-14.4
All types	1,040,000	505,295	+45.6	+10.0

Source: Barry A. Miller and others, editors, CANCER STATISTICS REVIEW 1973-1990 [National Institutes of Health Publication No. 93-2789] (Bethesda, Md.: National Cancer Institute, 1993), Table I-3, pg. I.27.
* All data are age-adjusted to the 1970 U.S. population.
** Certain data are for all races combined, not just whites; specifically: all types; all types excluding lung; liver; brain; and childhood cancers. For other cancers, the National Cancer Institute says historical data for non-whites are not considered reliable.

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