Environmental cancer spreading far and wide

By Gopal Krishna
24 Dec 2009

There's an alarming rise in work-related cancers in the country, but the government has failed to put any measures in place to prevent the epidemic or raise awareness
As we cry ourselves hoarse about dreaded diseases like AIDS or 'pandemics' like H1N1 or avian flu, a more lethal epidemic has been quietly spreading its tentacles. India is facing a cancer epidemic which has almost entirely been missed in official statistics. Shockingly, out of more than 900 substances and chemicals evaluated since 1971, approximately 400 have been identified as carcinogenic.

Worldwide, occupational cancer claims at least one life every 52 seconds, a startling figure completely ignored by both Indian regulators as well as employers. Over 600,000 deaths a year are caused by occupational cancer, making up almost one-third of all work-related deaths. However, none of the 300 medical colleges in India have the capacity to deal with the alarming rise in use of unregulated chemicals and hazardous substances. Contrast this with Europe, where about half of occupational diseases are related to dangerous substances and every fifth recognised as occupational neurological diseases.

In India, this monstrous problem has been swept under the carpet. The decay in our public health system has ensured that exposed populations are not recorded and thus not protected. Besides this, scientists and doctors don't disclose their affiliation to companies while investigating cancer risks from the industry. The goings-on in the National Institute of Occupational Health (NIOH), Gujarat, where industry-sponsored research was conducted, is illustrative of this fact.

In October 2009, 23 scientists from six countries met at the WHO's International Agency for Research on Cancer (IARC) to reassess the carcinogenicity of a number of chemical compounds, complex mixtures and occupational exposures and to identify additional tumour sites and mechanisms of onset of cancer. In their 33-page report, there is sufficient evidence about the carcinogenicity of benzene, formaldehyde, Mustard gas and Vinyl chloride.

Among other findings, sufficient evidence was also found about the carcinogenicity of soot, seen in occupational exposure of chimney-sweeps. Soot causes cancer of the skin (observed in the scrotum) and of the lung. Similarly, coal gasification is said to cause lung cancer while exposure in aluminium production can lead to cancer of the bladder and of the lung.

The list doesn't end here. The iron and steel industry, painting work and even rubber manufacturing carry massive cancer risks. While exposure during iron and steel founding can cause cancer of the lung, painters can get mesothelioma, cancers of the urinary bladder, and lung. Causal association of maternal exposure to painting (including preconception and during pregnancy) has also been linked to leukaemia in the offspring. Exposure in the rubber manufacturing industry causes leukaemia, lymphoma, cancers of the urinary bladder, lung and stomach.

The menace of asbestos

One of the biggest hazards emanates from the asbestos industry. Experts at a recent international scientific conference called for elimination of the disease caused worldwide by exposure to environmental and occupational hazards such as asbestos. The tragedy of the asbestos epidemic is that all illnesses and deaths related to it are entirely preventable. Italy-based Collegium Ramazzini, one of the co-organizers of the conference, stated that safer substitutes for asbestos exist and they have been introduced successfully in many countries.

Experts took note of the advertisement by the Asbestos Cement Products Manufacturer's Association published in a newspaper (The Times of India, 17 December, 2009), which coincided with the inauguration of the conference and debunked the misleading claims and disapproved the attempts by the industry to hide behind government agencies like Directorate General, Factory Advice Service and Labour Institutes (DGFASLI), which took note of Prevalence of Asbestosis and Related Disorders in a Asbestos Fibre Processing Unit in West Bengal as early as in 1996. (http://www.dgfasli.nic.in/newsletter/jan_march_96.pdf)

Officials from the Labour Ministry, who were present at the conference, joined Prof Arthur Frank and Dr Barry Castleman - both well-known asbestos experts - in dismissing industry references to absence of asbestos diseases in India as junk science. The seminar advised press and advertising watchdogs as well as newspapers to avoid publishing such ads.

Scientists at the conference noted that the health consequences of the use of asbestos in contemporary industrial society have been amply documented in the international scientific literature. The toll of illness and death among asbestos workers in mining, construction and heavy industry is well-known. The risks from toxic exposures affect not only those who work with asbestos, but also their families and neighbours (from material on clothing or plant emissions), users of products that contain asbestos and the public at large.

The experts repeatedly urged government of India to harbour no illusions about the "controlled use" of asbestos because there is no realistic alternative to a ban. Moreover, even the best workplace controls cannot prevent occupational and environmental exposures to products in use or to waste. The alarming rise in the consumption of asbestos in India in hospitals, schools, homes and commercial buildings now resemble those that existed in the industrialized countries before the dangers of asbestos were widely recognized.

The conference took note of the hazards faced by construction industry, including asbestos, silica, dust, chemicals and noise etc which most workers and employers are unaware of. Construction has five times higher rates of injuries and deaths. Most of these environmental and occupational health hazards are preventable.

So far, the government has failed to learn anything from Bhopal and others disasters. There was a chimney collapse in Bhilai last month, that killed more than 40 workers. The rise in the rate of accidents in the construction of Delhi Metro Rail Corporation (DMRC) and for Commonwealth Games Village is illustrative of how no one is held accountable. Infrastructure development projects choose not to take cognisance of occupational and environmental hazards and neither workers nor consumers are ever informed of the irreversible health damages by building materials such as asbestos products.

At the conference, Katja Radon, a researcher from Munich, said the social system in Germany is geared to provide pension to asbestos victims and their families besides compensation. Such a system is a far cry in India. Health experts and officials admitted that there is no occupational and environmental health infrastructure in place and the cancer registry of the country of does not even record occupational cancers.

The three day conference entitled 'Preventing Emerging Occupational and Environmental Risks in South Asia and Beyond' was organized by Centre for Occupational & Environmental Health (New Delhi), Collegium Ramazzini (Italy), and Drexel University, School of Public Health, Philadelphia. It was supported by Union Ministry of Labour and Employment, Government of India, and WHO, SEARO and held at capital's Maulana Azad Medical College where Dr Andrew Watterson from UK asked Indian public health experts, trade unions and civil society organizations to be part of a Global Occupational Cancer Prevention Campaign and Hemantha D. Wickramatillake from Sri Lanka underlined a need for a South Asian Forum for Occupational and Environmental Health Researchers.