Ebook Environmentally Attributable Cancers in Washington State, US: Applying Economic Cost Estimates and the Precautionary Principle
There are currently over 85,000 anthropogenic chemicals circulating in the world’s environment (City of San Francisco, 2003). Many of these chemicals have been found in the breast milk of mothers, the tissues of children, and measured in the most remote corners of the Earth (Thornton, McCally, & Houlihan, 2002). Science has established that every single day our bodies absorb and store toxic chemicals; this phenomenon is appropriately called the ‘body burden’ (Northwest Environment Watch, 2004). Some of these compounds have been determined to cause a variety of cancers and other adverse health outcomes. There is a great deal of evidence linking the increased production of chemicals to the increasing rates of breast cancer, Non-Hodgkins lymphoma, as well as childhood leukemia and brain cancer (National Cancer Institute, 2003; Solomon, Ogunseitan, & Kirsch, 2000). However, to what degree these chemicals are contributing to health problems such as cancer is under debate, as is the best policies to protect our communities. Furthermore, the economic burden of cancer has not been fully calculated or internalized. It is now believed that approximately 75% of all cancer cases in the US can be attributed to some form of environmental exposure (American Cancer Society, 2004). These cancers are entirely preventable. This study proposes that preventive measures, such as the precautionary principle (PP), are needed to sufficiently safeguard the health of our people and the environment from the effects of toxics through improved chemical regulation. The definition of the PP originates from the 1992 Rio Declaration, Principle 15: “In order to protect the environment, the precautionary approach shall be widely applied by States according to their capabilities. Where there are threats of serious or irreversible damage, lack of full scientific certainty shall not be used as a reason for postponing cost-effective measures to prevent environmental degradation” (United Nations, 1992). The proper mixture of common sense, scientific awareness, and preventative action will promote a sustainable future. This study will focus its attention on environmentally attributable cancers in Washington State (WA) of the United States, the current attempts made to advance the implementation of the precautionary principle, the interaction between chemicals in the environment and cancer, and the economic costs resulting from these cancers.
In January 2004, the Seattle Precautionary Principle Working Group submitted a discussion paper titled, A Policy Framework for Adopting the Precautionary Principle, to the City of Seattle and King County. The objective of this document was to incorporate the precautionary principle into the language of the 2004 city and county comprehensive plans. The Seattle and King County governing officials and policy makers are currently considering this proposal. When discussing the economic costs of childhood disease attributable to environmental quality, the authors had stated, “Researchers and policymakers do not know the overall costs of childhood illness in Washington State” (Gilbert, Diver, & Miller, 2004: 9). Their argument had to be associative using cost-estimates from other states. In response to this lack information, one fundamental goal of this analysis is to determine the economic costs of pediatric cancer. A cost assessment will bolster the argument of the Precautionary Principle Working Group to advocate for precautionary measures and promote the political ambition necessary to do so.
Currently, Washington State is the only state in the union with a comprehensive strategy for managing persistent bioaccumulative toxic substances (PBTs). Many of theses chemicals are known carcinogens. In 1998, the Washington State Department of Ecology (DOE) announced a statewide strategy to end all releases of PBTs by 2010, prohibit future releases, and clean up previously polluted locations. The statewide action plans, mandating the reduction of toxic chemicals in the environment, are based on the ideological foundations of the precautionary principle. In December 2000, the Proposed Strategy to Continually Reduce Persistent, Bioaccumulaitve Toxins in Washington State, was published. This document identified nine specific PBTs, and established the need and framework to remove these chemicals from circulation in WA. (The working list of PBTs has now grown to twenty-four). As a result, two action plans to eliminate PBTs have subsequently been released. First, in 2002, under the auspices of the Washington State Legislature, the DOE developed the Mercury Chemical Action Plan. The proposed measures of this plan went into effect in January 2003. The purpose of the document is to identify anthropogenic sources and describe strategies to eliminate mercury (Peele, 2003). Second, in October 2004, the Draft PBDE Chemical Action Plan was released to promote the voluntary phase-out of two forms of flame retardants called polybrominated diphenyl ethers (PBDEs) (Peele, 2004). However, stakeholder disputes exist regarding the implementation of such precautionary measures. Industry is concerned that heavy regulations will put WA businesses at a competitive disadvantage in the national and world market, and that costs may be too high to invest in cleaner practices (Gallagher, 2001: 37-54). There is also current disputes regarding the application of the precautionary principle, which chemicals should be included in the PBT action plans, and if there is enough scientific evidence to warrant concern. This study will discuss the validity of stakeholder opposition and aspires to strengthen the rebuttals of PP advocacy based on economic cost assessment and public health arguments. (Gallagher, 2001)
In 1775, the first cause and effect relationship between cancer and toxic substances in the environment was established. A British surgeon, named Percival Pott, published his observations on the increased incidence of scrotal cancer in men working as chimney sweeps. Pott attributed the rise in cancer to the soot that the chimney sweeps were in daily contact (Rodricks, 1992: 108-144). Unbeknownst to Pott, the carcinogenic effect of soot can be attributed to polycyclic aromatic hydrocarbons (PAHs). These are the same PAHs that are currently under review for inclusion on the Washington State’s PBT reduction list. It may bewilder health advocates that it has taken over 200 years to consider banning this substance in Washington. Furthermore, our long running knowledge of the carcinogenic properties of certain chemicals is not isolated to PAHs. Polychloronated biphenyls (PCBs) are also currently being considered for the PBT working list and have been linked with causing chloroachne (a painful disfiguring of the skin) since 1899. Due to three deaths of factory workers from PCB exposure in the 1930s, Monsanto, the main US producer of PCBs, became aware of its carcinogenic properties. PCB production continued until the 2001 decree of the Stockholm Convention for Persistent Organic Pollutants. Benzene is another example of a compound with early indication to cause cancer. In 1897, increased observations were reported of aplastic anaemia amongst young Swedish women working in a bicycle tire manufacturing plant. That same year, hemorrhaging had been observed in men in a dry-cleaning business in France. Despite clinical observations linking benzene to adverse health outcomes, a century later, benzene is still produced and contained in everyday products such as automobile petrol. In 1987, a ten-year delay in the United States in setting a benzene regulation under 1 part per million can be held responsible for an additional 198 adult leukemia and 77 multiple myeloma deaths of workers acutely exposed to benzene. (European Environmental Agency, 2001)
By considering the long latency period between when science first suspects compounds as harmful and when any action or regulation takes place, leads us to an imperative question: When is there enough evidence enough to act? Sir Austin Bradford Hill, Professor Emeritus of Medical Statistics at the University of London, had addressed this issue when he said, “All scientific work is incomplete- whether it be observational or experimental. All scientific work is liable to be upset or modified by advancing knowledge. That does not confer upon us a freedom to ignore the knowledge we already have, or to postpone the action that it appears to demand at a given time” (Tickner, 2003:7). Washington State is in a position where it may protect its citizens from the harms of PBTs. However, progress is slow and encounters resistance from competing stakeholders. The Washington State PBT advisory committee has heard industry’s objection that the precautionary principle is not based on sound science, and arguments are made against the inclusion of certain chemicals on the PBT reduction list due to inconclusive causal evidence (Gallagher, 2001). Opponents of the PP must heed the early warning signs, as government and industry did not in the cases of PAHs, PCBs, and benzene. The precautionary principle states that if early an indication of plausible harm exists, and scientific uncertainty persists, it is our obligation to implement preventative actions. Inconclusive science must not be a reason to delay justifiable actions. Had the precautionary principle been implemented in cases of the past, thousands of people and their families would have been saved from the detriments of cancer and other adverse outcomes.
Contents
List of Abbreviations & Acronyms
1. Introduction
- 1.1. Four principle problems
I. Current policy paradigm is too reactionary, focuses not enough on precaution
II. Insufficient understanding of the linkages between cancer and environment
III. High rates of cancer in Washington State
IV. Lack of information detailing the economic costs of cancer
- 1.2. Connection to sustainable development
2. Objectives, Scope, & Methodology
3. Hypothesis
4. Analytical / Theoretical Framework
- 4.1. Current policy paradigm
4.2. Promoting an alternative policy paradigm
6. Literature Review
- 6.1. Defining key concepts
6.2. The history of the precautionary principle
7. Application / Empirical Analysis
- 7.1. Difficulty in proving causation
7.2. Cancer and the environment
7.3 The body burden of chemicals
7.4. Cancer and children
7.5. Overview of cancer in Washington State
7.6. Cancer and environmental linkages
I. Breast cancer
II. Lung cancer
III. Melanoma
IV. Bladder cancer
V. Non-Hodgkin’s lymphoma
VI. Childhood leukemia
VII. Childhood Brain and CNS cancer
8. Results
- 8.1. Comparing adult cancer statistics
8.2. Cost estimates for pediatric cancers in Washington State
9. Discussion / Analysis
10. Conclusions
11. References
12. Appendix
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