Environmental Pollutants and Occupational Exposures
Outdoor air pollution kills about 300,000 people every year from lung cancer alone.
Cancer-causing environmental pollutants can occur naturally (e.g., radon or arsenic) or are man-made (e.g., air pollution from burning fuels), and they can be found in the air, soil, or water. Radon, a radioactive gas that can accumulate in buildings, is the second leading cause of lung cancer in many countries, after tobacco use. Elevated levels of arsenic in drinking water or soil have been found in parts of Asia and throughout the Americas and are linked to an increased risk of skin, lung, and bladder cancer.
“The places where we live, work, and play should nurture us, not harm us.”
Outdoor air pollution level is particularly high in rapidly growing cities in low- and middle-income countries (LMICs) (Map 10.1).
Also, the use of cooking fuel (e.g., wood, other biomass, and coal) remains a major source of indoor air pollution in some of these countries, although it is declining. Overall, outdoor air pollution alone accounts for about 15% (300,000) of lung cancer deaths worldwide, with the proportion varying from 34% in Qatar and Egypt to 2% in Tuvalu and Finland (Map 10.2).
Emerging man-made environmental pollutants, such as per- and poly-fluoroalkyl substances (PFAS), are another growing concern due to their persistence in the environment and ubiquity across settings.
Numerous chemical substances and physical agents are known to cause cancer in occupational settings (Figure 10.1). Occupational exposure to carcinogens is particularly concerning in LMICs, where exposure levels may be higher and regulations and enforcement less strict.
Examples of occupational carcinogens and associated cancer types
Certain occupations, such as rubber manufacturing, are associated with prolonged exposure to these agents, increasing the risk of stomach, lung, and bladder cancer among workers (Figure 10.2). Enforcing laws and regulations is critical to ensure removal or substitution of carcinogenic materials, implementation of engineering solutions, and adequate provision of personal protective equipment to minimize, reduce, or eliminate exposures.