Policy and Research Recommendations Emerging from the Scientific Evidence Connecting Environmental Factors and Breast Cancer

Abstract

A substantial body of evidence links environmental exposures to increases in breast cancer incidence over the past decades. State and federal legislative initiatives that could help prevent breast cancer include: federal standards to achieve consistency in radiation-emitting medical and dental equipment; improved state quality assurance standards for radiation-emitting equipment; federal and state exposure limits for electromagnetic radiation; an overhaul of the federal Toxic Substances Control Act to reduce unsafe chemical exposures; strengthened premarket health and safety testing and regulation of pesticides; a federal ban on the manufacture, distribution and sale of consumer products containing bisphenol A and phthalates; and strengthened oversight and regulation of the cosmetics industry. We recommend public and private investment in research on low dose exposures, mixtures, and the timing of chemical exposures, as well as the development of health tracking and biomonitoring programs designed to link data from pollution surveillance systems with disease registries.

Environmental and Occupational Interventions for Primary Prevention of Cancer: A Cross-Sectorial Policy Framework

“…Reviewing the existing scientific literature and policy approaches and interventions for the primary prevention of cancer, we found that a rich body of legislation, regulations, and policies for eliminating or reducing exposure to carcinogens exists at both national and international levels. Examples related to chemical exposures are summarized in the Appendix (European Commission 2012; Massachusetts Department of Environmental Protection 1989; National Committee on Environmental and Occupational Exposures 2006; Nudelman et al 2009; President’s Cancer Panel 2010; United Nations Economic Commission for Europe 2003). Examples of specific bans of chemicals include prohibitions on the use or export of asbestos (using economic and technological mechanisms to encourage replacing asbestos with available safer substitutes); the cessation of arsenic pesticides use and the banning of cosmetic pesticides use in residential lawns and gardens (President’s Cancer Panel 2010); and the banning of smoking in indoor workplaces, public transport, and indoor public places (WHO 2009c).…”

“…Regarding radiation exposures, several measures or proposals oriented to avoid ionizing radiation exposures in occupational and medical settings are listed in the Appendix (National Committee on Environmental and Occupational Exposures 2006; Nudelman et al 2009; President’s Cancer Panel 2010). …”

“…Measures to control work hazards should therefore have a high priority in any program of cancer prevention, even if they are responsible for only a small proportion of all cancers. Measures may include those described by the National Committee on Environmental and Occupational Exposures (2006), Nudelman et al (2009), O’Neill (2007), the President’s Cancer Panel (2010), and WHO (2006a, 2009c). [For a list of example control measures, see Supplemental Material (pp.…”

“…Recently, a relationship between computer tomography and childhood cancer risk has been observed (Pearce et al 2012) that could be reduced by appropriate dose optimization for children. These issues deserve an even more sensitive approach when they affect secondary prevention interventions (e.g., mammography for early detection of asymptomatic breast cancer) (Nudelman et al 2009; President’s Cancer Panel 2010; WHO 2006a). Another example is advising the public about the benefits of different radon prevention and remedial actions to control radon in dwellings (such as checking levels of radon, installing a ventilation system in the basement) (WHO 2009b).…”

“…However, a large number of environmental exposures are understudied and therefore remain classified as being possibly carcinogenic. Knowledge is also limited on the consequences of cumulative lifetime exposure to carcinogens, relevant time windows of exposure (e.g., early life), and on the interaction of multiple concurrent exposures (Nudelman et al 2009; President’s Cancer Panel 2010). In addition, further research is needed on the impact of environmental and occupational exposures in low- and medium-income countries, which often have higher exposure levels or higher lifetime cumulative exposure, lesser protection levels, or different exposure patterns (e.g., an earlier age at first exposure because of child labor) compared to high-income countries that currently provide most of the data (McCormack and Schüz 2011).…”