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

Carolina Espina¹, Miquel Porta², Joachim Schüz³, Ildefonso Hernández Aguado⁴, Robert V. Percival⁵, Carlos Dora¹, Terry Slevin⁶, Julietta Rodriguez Guzman⁷, Tim Meredith¹, Philip J. Landrigan⁸, Maria Neira¹

¹Department of Public Health and Environment, World Health Organization (WHO), Geneva, Switzerland; and Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France; ²Hospital del Mar Institute of Medical Research (IMIM Hospital del Mar prbb), Barcelona, Spain; Ciberesp; and Universidad Autónoma de Barcelona (UAB), Barcelona, Spain; ³Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France; ⁴Department of Public Health, Facultad de Medicina, Universidad Miguel Hernández, Ciberesp, San Juan de Alicante, Spain; ⁵Environmental Law Program, University of Maryland Carey School of Law, Baltimore, MD, USA; ⁶Cancer Council Western Australia, Perth, WA, Australia; ⁷Occupational Health Program, El Bosque University, Bogota, Colombia; and Department of Sustainable Development and Environment, Pan-American Health Organization/World Health Organization (PAHO/WHO), Washington D.C., USA; ⁸Department of Preventive Medicine, Mount Sinai School of Medicine, New York, NY, USA

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Abstract

Background: Nearly 13 million new cancer cases and 7.6 million cancer deaths occur worldwide each year; 63% of cancer deaths occur in low and middle-income countries. A substantial proportion of all cancers are attributable to carcinogenic exposures in the environment and the workplace.

Objective: To develop an evidence-based global vision and strategy for the primary prevention of environmental and occupational cancer.

Methods: We identified relevant studies through PubMed by use of combinations of the search terms “environmental”, “occupational”, “exposure”, “cancer”, “primary prevention” and “interventions”. To supplement the literature review, we convened an international conference on “Environmental and Occupational Determinants of Cancer: Interventions for Primary Prevention”, under the auspices of the World Health Organization, in Asturias, Spain on 17-18 March 2011.

Discussion: Many cancers of environmental and occupational origin could be prevented. Prevention is most effectively achieved through primary prevention policies that reduce or eliminate involuntary exposures to proven and probable carcinogens. Such strategies can be implemented in a straight-forward and cost-effective way based on current knowledge. They have the added benefit of synergistically reducing risks for other noncommunicable diseases by reducing exposures to shared risk factors.

Conclusions: Opportunities exist to revitalize comprehensive global cancer control policies by incorporating primary interventions against environmental and occupational carcinogens.

Citation: Espina C, Porta M, Schüz J, Hernández Aguado I, Percival RV, Dora C, Slevin T, Rodriguez Guzman J, Meredith T, Landrigan PJ, Neira M. Environ Health Perspect (): .doi:10.1289/ehp.1205897

Received: August 15, 2012; Accepted: January 31, 2013; Published: February 5, 2013

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