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Public Health, Environmental Cancer Epidemiology, and Sustainability

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Our day-to-day experience of health ailments easily misconstrues health as a local and individual-level issue. We thus fail to recognize that the health profile of a population is the real “bottom line” indicator of prevailing environmental and social conditions.

For man, environmental sustainability must be ultimately about sustaining health-supporting environmental conditions (McMichael 2001). Many civilizations have faltered or collapsed along the way as local environmental resources became depleted. But, it is only now, in the 21st century, that striving for the betterment of human living conditions and social experience must, for the first time, take account of constraints at the global and major regional levels; constraints imposed as a result of humankind having reached, indeed exceeded, many of the natural environment's limits to its carrying capacity for human populations. That poses a new, huge challenge to modern societies (McMichael 2001; Raven 2002; WHO 2009; Soskolne, Westra, et al. 2008). What role can there be for sustaining human life from the field of cancer epidemiology as we adapt to global environmental change?

Epidemiology is a branch of biomedical science, dedicated to the study of health in populations. The objective of this chapter is to explicate some issues around sustainability through a state of the art example from cancer epidemiology. I will describe some methodological obstacles and challenges for the future (Bencko 2007) in the broader context of “risk assessment” and the “precautionary principle” (Bencko 2010).

The field of epidemiology has reached a crucial point with both challenges and opportunities. On the one hand, it seems that most of the major occupational carcinogens have already been identified. Many of the chemicals classified as carcinogens by the International Agency for Research on Cancer (IARC) were first evaluated in the workplace. Occupational exposure to known human carcinogens has diminished in many countries over the past decades, and awareness of their hazards has increased. At the same time, we are still confronted with a long list of substances for which epidemiological data are lacking or inconclusive. Estimates of the number of chemicals in commerce range from tens of thousands to over 140,000 (Stayner, Boffetta and Vainio 2006); for most of them, relevant toxicological information needed for setting up regulatory standards is still lacking (Gemignani, Landi, et al. 2007; Hung, Hashibe and McKay 2007).
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Document Type: Research Article

Publication date: 01 January 2011

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