POP's & Cancer Risks

from Center for Children's Health and the Environment, Mt. Sinai School of Medicine

http://www.childenvironment.org

The good news about cancer is that, overall, the death rate is declining, thanks to early detection, advances in treatment, and preventive efforts (less smoking, less exposure to second hand smoke, and less exposure to certain industrial chemicals and to asbestos). Some cancer incidence rates have also declined (lung in men, uterine, stomach).

But this good news masks some serious bad news: Reported incidence rates of several cancers--the number of new cases per 1,000 people--continue to rise.

Several cancers whose rates are rising have been persuasively linked to exposure to persistent organic pollutants (POPs), and pesticides.

The cancers most clearly linked to POPs and pesticides include non-Hodgkin's lymphoma, multiple myeloma, and childhood cancers.

Increased rates of these cancers are not the result of better detection or better access to medical care, although those factors may account for some fraction of the reported increases.

Non-Hodgkin's Lymphoma

The most clearly POP-related cancer is non-Hodgkin's lymphoma (NHL). Its incidence has tripled since 1950.1 AIDS accounts for some of this increase, but the trend was evident long before AIDS first appeared.2

NHL has been linked to exposure to many POPs, notably the phenoxy herbicides, which often contain the highly toxic POP, dioxin.3 The best-known phenoxy herbicide is Agent Orange, a mixture of two compounds, 2,4,5,-T and 2,4-D, which also contain dioxin. Agent Orange was sprayed extensively in Southeast Asia during the Vietnam War.

Many Vietnam veterans were exposed. As a group, Vietnam vets and those chemical workers who produced Agent Orange4 have unusually high rates of NHL, and their risk increases in direct proportion to their exposure to Agent Orange.5

The U.S. banned 2,4,5-T in 1979,6 but 2,4-D and other phenoxy herbicides are still widely used in U.S. agriculture, as well as on lawns, gardens, schools, and parks. Compared with most Americans, farmers and agricultural workers are more heavily exposed. They also have unusually high rates of NHL. Like Vietnam veterans, as their exposure to phenoxy herbicides increases, so does their risk of NHL.7

The same association has been discovered in other countries. Compared with the general population of the Netherlands, Dutch men occupationally exposed to phenoxy herbicides have almost twice the normal risk of NHL.8

In Canada, men occupationally exposed to pesticides and herbicides have unexpectedly high rates of NHL, with increasing duration of exposure directly related to risk.9 Swedish lumberjacks exposed to high concentrations of phenoxy herbicides also show an increased risk.10

Even more disturbing, it's not necessary to have occupational exposure to phenoxy herbicides to face increased risk of NHL. A Swedish study shows that for the general population, NHL risk rises with increasing exposure to phenoxy herbicides.11

In agricultural areas of northern Italy, researchers have shown that compared with area residents exposured low concentrations of 2,4-D, those exposed to high concentrations have twice the risk of NHL.12

A Finnish study of unexpectedly high NHL rates in one community explains why: Sawmills in the area contaminated the local water supply with chlorophenols, close chemical relatives of the phenoxy herbicides.13 Similar findings turned up in Iowa, where NHL rates vary widely by county. The highest rates occur in counties whose drinking water comes from sources contaminated with dieldrin, an organochlorine pesticide chemically similar to the phenoxy herbicides.14

Even if your water is pure, you may still be at risk of NHL because of exposure to widely used home, lawn, and garden pesticides. These products often contain 2,4-D or other compounds linked to NHL risk.

Compared with children whose parents never use home pesticides, children of parents who use them frequently have seven times the risk of non-Hodgkin's lymphoma, according to a study in Southern California.15 And a German study shows that children who live in homes regularly treated by professional exterminators have 2.6 times the average risk of NHL.16

Risk of hematologic and lymphatic cancers also increases with exposures to other chemicals: DDT, PCBs, benzene, and organochlorine insecticides.17

National Cancer Institute researchers took blood samples from 74 people with NHL and 147 healthy matched controls. Compared with those whose blood had the lowest levels of these POPs, those with the highest levels had 4.5 times the risk of NHL.18 NHL has also been linked to the chemicals used in dark-colored hair dyes.19

At the molecular level, NHL is strongly associated with specific mutations on chromosomes 14 and 18. According to studies of Minnesota pesticide applicators, exposure to POPs causes these same mutations.20

Multiple Myeloma

Another POP-related cancer with a rising incidence rate is multiple myeloma (MM). Once rare, its rate has tripled since 1950.21 MM is associated with exposure to a variety of industrial and agricultural chemicals, notably, paints, petroleum, industrial solvents, pesticides,22 and dark-colored hair dyes.23

Residents of industrialized countries have higher rates of this disease than those living in nonindustrialized nations.24

Farmers occupationally exposed to POP pesticides are at highest risk.25 In fact, a recent analysis of 32 studies worldwide showed "consistent, positive findings suggesting an association between farming and MM."26

MM is also related to exposure to dioxin. In 1976, an explosion at a pesticide-manufacturing plant in Seveso, Italy, released a chemical cloud containing substantial amounts of dioxin. By the early 1990s, residents of the surrounding community showed unexpectedly high rates of several cancers, among them, MM.27

Childhood Cancers

Cancer also strikes children. In fact, after injuries and violence, cancer is the leading killer of children.28 The overall childhood cancer incidence rate has increased about 13 percent since 1973, according to the National Cancer Institute.29

But during the same period, some childhood cancer rates have risen much faster: Childhood NHL has increased 30 percent. Childhood brain cancer has increased 21 percent. And acute lymphocytic leukemia in children has increased 21 percent.30 Have POP exposures contributed to these increases? We don't know for sure. But consider the following:

* Children don't smoke, drink alcohol, or face occupational exposures to POPs. However, compared with adults, they are exposed to more pollutants in water, food, and air.

In proportion to their body weight, children breathe twice as much air, eat 3 to 4 times more food, and depending on age, drink 2 to 7 times more water.31

* Many studies show that as children's exposure to home, lawn, and garden pesticides (including lice shampoos) increases, so does their risk of NHL, brain cancer,32 leukemia,33 and other cancers.34

* Parental exposure to POPs also increases their children's risk of NHL35, brain cancer,36 and leukemia,37 among others.38

* Other studies show that infants are exposed to POPs in breast milk.39

Exposures to POPs are probably not the sole cause of the rising rates of NHL, MM, and childhood NHL, brain cancer, and leukemia. Indeed, a few studies have shown no association between exposure to POPs and these cancers.40 But we believe that compelling evidence points to POPs--chlorinated pesticides and industrial chemicals--as a significant contributor to increased rates of these diseases.

Better safe than sorry. We believe that despite remaining uncertainties, enough evidence has accumulated to warrant moving aggressively to phase out persistent organic pollutants as quickly as possible. Ideally, immediately.

This summary was prepared by the Center for Children's Health and the Environment (CCHE) of the Mount Sinai School of Medicine. Please visit CCHE's website for other fact sheets and background papers on children's environmental health issues.

Resources: Lymphoma Foundation of America

See also:

Persistent Organic Pollutants: Chemicals That Won't Go Away and Hurt Us All

Pest Control without Pesticides

Pesticides in Rentals and Condominiums: No More Pesticides at Home

Pesticides in Your Home

The Green Pet: Alternatives to Conventional Pesticides

References

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2. Hardell, L. and M. Eriksson. "A Case-Control Study of Non-Hodgkin's Lymphma and Exposure to Pesticides," Cancer (1999) 85:1353-1360. P. Hartge et al. "Hodgkin's and non-Hodgkin's Lymphomas," In R. Doll et al. (eds.) Trends in Cancer Incidence and Mortality. Cancer Surveys 19/20 (Cold Spring Harbor Larboratory Press, Plainview, NY, 1994) pp. 423-453.

3. Zahm, S.A. and A. Blair, "Pesticides and Non-Hodgkin's Lymphoma," Cancer Research (1992 suppl.) 52:5485s-5488s.

4. Fingerhut, M. New England Journal of Medicine.

5. Institute of Medicine, National Academy of Sciences. Veterans and Agent Orange: Health Effects of Pesticides Used in Vietnam. (National Academy Press, Washington, D.C.1994)

6. Colburn, T. et al. Our Stolen Future (Plume, NY, 1997) p. 114.

7. Keller-Byrne, J.E. et al. "A Meta-analysis of Non-Hodgkin's Lymphoma Among Farmers in the Central U.S." Am. J. Industiral Medicine (1997) 31:442-444. Zahm, S.H. et al. "A Case-Control Study of Non-Hodgkin's Lymphoma and the Herbicide 2,4-D in Eastern Nebraska," Epidemiology (1990) 1:349-356. Zahm, S.H. and A. Blair. "Cancer Among Migrant and Seasonal Farmers: An Epidemiological Review," Am. J. Industrial Med. (1993) 24:753-766. Blair, A. et al. "Clues to Cancer Etiology from Studies of Farmers," Scandinavian J. of Work Environment and Health (1992) 18:209-215. Davis, D.L. "Agricultural Exposures and Cancer Trends in Developed Countries," Environ. Health Perspectives (1992) 100:39-44.

8. Hooiveld, M. et al. "Second Follow-Up of a Dutch Cohort Occupationally Exposed to Phenoxy Herbicides, Chlorophenols, and Contaminants," Am. J.Epidemiology (1998) 147:891-901.

9. Mao, Y. et al. "Non-Hodgkin's Lymphoma and Occupational Exposure to Chemicals in Canada," Annals of Oncology (2000) suppl. 1:69-73.

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11. Hardell, L. and M. Eriksson. "A Case-Control Study of Non-Hodgkin's Lymphma and Exposure to Pesticides," Cancer (1999) 85:1353-1360.

12. Fontana, A. et al. "Incidence Rates of Lymphomas and Environmental Measurements of Phenoyx Herbicides: Ecological Analysis and Case-Control," Archives of Environ. Health (1998) 53:384-387.

13. Lampi, P. et al. "Cancer Incidence Following Chlorophenol Exposure in a Community in Southern Finland," Archives of Environ. Health (1992) 47:167-175.

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16. Meinert, R. et al. "Leukemia and non-Hodgkin's Lymphoma in Childhood Exposure to Pesticides: Results of a Register-Based Case-Control Study in Germany," Am. J. Epidemiology (2000) 151:639.

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18. Rothman, N. et al. "A Nested Case-Conrol Study of Non-Hodgkin's Lymphoma and Serum Organochlorine Residues," Lancet (1997) 350(9073):240-244.

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20. Garry, V.F. et al. "Pesticide Applicators with Mixed Pesticide Exposure: G-Banded Analysis and Possible Relationship to Non-Hodgkin's Lymphoma," Cancer Epidemiology, Biomarkers, and Prevention (1996) 5:11-16. Garry, V.F. "Survey of Health and Use Characterization of Pesticide Appliers in Minnesota," Archives of Environ. Health (1994) 49:337-343.

21. Steingraber, S. Living Downstream (Vintage, NY, 1998) p. 54.

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23. Correa, A. et al. "Use of Hair Dyes, Hematopoietic Neoplasms, and Lymphomas: A Literature Review. II. Lymphomas and Multiple Myeloma," Cancer Investigations (2000) 18:467-479. Altekruse, S.F. et al. "Deaths from Hematopoietic and Other Cancers in Relation to Permanent Hair Dye Use in a Large Prospective Study," Cancer Causes and Control (1999) 10: 617-625. Thun, M.J. et al. "Hair Dye Use and Risk of Fatal Cancers in U.S. Women," Journal of the National Cancer Institute (1994) 86:210-215.

24. Schwartz, J. "Multinational Trends in Multiple Myeloma," in D.L. Davis and D. Hoel (eds.) Trends in Cancer Mortality in Industrialized Countries, Annals of the New York Academy of Sciences. (1990) 609:215-224.

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