The Windsor Star by Jane McArthur 08 December 2018
How did the experts get it so wrong? Turns out, they failed to really look at the evidence.
A paper published last week in New Solutions Journal helps set things right. By re-weighing the evidence presented at a worker’s compensation hearing, Dr. Michael Gilberston, former federal government biologist who studied the health effects of toxins, and Dr. Jim Brophy, occupational health researcher and founder of two Occupational Health Clinics for Ontario Workers, point to workplace exposures as a likely cause for one woman’s breast cancer, in spite of the ruling by the experts on the Ontario Workplace Safety and Insurance Appeals Tribunal.
Can the evidence in the case of one woman at one workplace tell us something about breast cancer that we don’t already know? It can. Her story highlights something that is often missing when we talk about breast cancer: our environment, and the important role it is likely playing in contributing to breast cancer, among many other health conditions.
Estimates of breast cancer from the known risk factors — such as family history, age, gender, ethnicity and hormones — apply to about 30 per cent of cases. The other 70 per cent have researchers looking to environment as the cause. That’s a lot of women, given that in Canada more than 26,000 women are diagnosed with breast cancer each year.
Studies of breast cancer tell us that women tend to focus on cures, detection and treatments. What’s missing from this list is prevention — and that means primary prevention, not to be confused with early detection.
Recent reports looking at the future of cancer show rising rates of many cancers, including breast. Dr. Ted Schettler, author of The Ecology of Breast Cancer, says “breast cancer is not only a disease of abnormal cells, but also of communities we create and live in.” This means we have the ability to create conditions for fewer breast cancers in the future. But how? We need to make prevention at least as much a priority — or perhaps more — as early detection, better treatments or finding a cure.
We have to take a good look at all suspected causes. We need to trust what the science is already telling us about environmental and workplace exposures and the causal agents within them. We need more awareness and programming with a focus on environmental and workplace causes. And we need to put policies and regulations in place that prevent exposures and the breast cancers they cause.
The prevention conversation often comes with debate about why we have breast cancer at the rates we do. An aging population featuring members who make bad lifestyle choices doesn’t explain the increase in breast cancers in more and younger women. It also doesn’t explain why women who migrate from countries with lower rates of breast cancer develop the same rates within ten years of living in a new country. And it doesn’t explain the clusters of breast cancers in locations with high levels of pollution that are known carcinogens.
The case of the woman in the Gilberston & Brophy report places us at the Ambassador Bridge, the busiest international border crossing in North America, where 20,000 commercial trucks and vehicles cross every day. The woman’s case is now being linked to this air pollution hot spot. Her story, like many of the women who work there, is one of exposure to carcinogens found at other border crossings and at sites including many Canadian urban environments with high levels of traffic and industrial pollution, and potentially the Gordie Howe International Bridge being built between Windsor and Detroit.
But her story gives us an enormous opportunity: to accept that many breast cancers — like other health problems including other cancers, cardiovascular disease, fertility problems, asthma, adverse birth outcomes, disabilities, diabetes, stroke and more — are linked to the environment. It also gives us an opportunity to make prevention of ill health related to air pollution a priority.
And her story should reinforce that we shouldn’t have to trade our health for a pay cheque, or permit our communities to be used as science labs.
Jane McArthur is a doctoral fellow in sociology at the University of Windsor whose research explores environmental and occupational health issues.