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FILE NAME: Newspaper & Magazine Articles (NMA) DATE: 1956 DOC#: NMA122 DOCUMENT DESCRIPTION: Journal Article - Environmental Cancer - Cancer News 1 nvironmenial cancer- * 5 Sugar, white flour, preserves, spices, cheese, canned "modern living," with its rapid 6 iy goods, cooked foods and tomatoes all cause cancer, tempos and nervous tensions, is held by many people to be a cause for the we hear. Grapes, on the other hand, can ward off cancer and even cure it. These are some of the increase in cancer which has been noted since the first World War. This, actually, can be considered to misconceptions about cancer which various food fanatics and crackpots have held throughout the ages. None of them, of course, is true. Science has not have some slight basis in fact, since modern living-- in the sense of mod ern science-- has contributed to the greater longevity of our people, found that any dietary item can lessen one's chances of getting cancer or recovering from cancer. making it possible for more of them to live on to old age when cancer strikes most frequently. Aluminum cooking utensils were once thought by some to cause cancer. A lot of people still believe On the other hand, modern man sometimes does unwittingly create an environment conducive to the that chemical fertilizers, used instead of the oldfashioned organic kind, make people more suscep growth and development of certain cancers. Man in his unceasing quest to add to or improve upon his crea tible to cancer. Another myth which has grown only in comparatively recent years is that water fluor ture comforts and conveniences has already developed, as an offshoot or by-product of his present indus idation causes cancer. trial civilization, more than 400 chemical substances which have Sommer, 1956 3 been identified as carcinogens -- meaning they can cause cancer in human beings or, experimentally, in animals. Hence, as regards cancer, the so-called "blessings of civiliza tion" would appear to be not un mixed. T h e very air we breathe may contain cancer-causing particles. Science has known for a long time that certain hydrocarbons cause cancer. These exist in coal tar prod ucts, soot, incompletely combusted gasolines and oils. Traces of them have been reportedly found in ciga rette smoke, and they exist in smog and industrial dust. A scientist work ing under an American Cancer So ciety grant at the University of Southern California and Los An geles County Hospital has recently induced cancers in mice merely by having them live in and breathe an atmosphere contaminated with these compounds. However, there is a vast-- and re assuring---difference in the carcino genic potential of the air we breathe as compared to the extremely dense smogs in which the laboratory mice were reared. The analogy might be that of breathing concentrated poi son gas in a closed chamber as against inhaling minute quantities of it in the open air; the difference is that of degree and length of expo sure. Federal, state and municipal governments as well as private agen cies, are becoming increasingly aware of the smog problem, and in dustry and labor are working right along with them to protect us. As yet science has not proved that any human being has ever gotten cancer by the act of breathing. The effects of environmental in fluences on cancer become more clear when we get down into specific industries where the workers employ materials which are known to be carcinogenic. The conclusion is in escapable that certain chemical agents, particularly of industrial ori gin, are important factors in the causation of certain types of human cancer. It has been noted that there are at least 400* such chemicals known to be carcinogenic to some degree, and it is probable that others will crop up as the result of continuing scientific laboratory ex perimentation. In short, as our re search progresses and industrializa tion grows we will continue to find more cancer causes in our occupa tional environment. In general, the occupational agents known to cause cancer do so only in specific organs of the body. The list of well-established to proved causes of occupational cancer is im pressive. Arsenic, tar, creosote, crude paraffin oil, ionizing radiation (x-rays, radium), and sunlight can, if the contact is intense enough and long enough, result in skin cancer. Asbestos, chromate compounds, nickel carbonyl, tar fumes and ioniz ing radiation increase the likelihood of cancer of the lung. Nickel car bonyl, isopropyl oil (not to be con fused with isopropyl alcohol, which is made from it), and radioactive dusts and gases are accepted causes of cancer of the nasopharynx and sinuses. Aromatic amines used in the manufacture of synthetic dyes cause cancer of the bladder. Radium and mesothorium, radioactive ele ments, produce sarcoma of bone. Benzene and radiations can cause the malignant diseases of the bloodforming tissues, such as the spleen, lymph nodes, bone marrow, which we call leukemia. All the causes of cancer listed here are well-demonstrated and widely accepted causes encountered in specific occupations. Many other causes are suspected on the basis of statistical and experimental re search. And these are under con stant study. O n e point should be remem bered: In general, the agents men tioned as causing occupational can cer are hazardous only in the form and in the amount in which they are handled in manufacturing processes. For instance, in the little town of Ampere, N. J., toward the end of World War I, a number of women were employed at painting the ra dium hands and numbers on watch dials-- to make them glow in the dark. It was their common practice to twirl the brush between their lips in order to get a fine point on it, be tween dippings into the radium-con taining liquid. In time these workers had swallowed and absorbed into their systems minute quantities of radium which ultimately found its way into their bones. Years later many of the women had developed cancer of the bone, which proved fatal in almost all cases. This is a well known and even notorious case of cancer in industry. Since then, of course, other techniques of radium application have been adopted and safeguards for workers installed. P itchblende miners in Czecho slovakia were developing lung can cer at an alarming rate until it was discovered that the air of the mine contained a fine radioactive dust which, inhaled over the years, pro duced such cancer. Vineyard work ers in France sometimes get skin cancer from contamination with arsenic used to spray the fields. Some workers in the synthetic azo dye industries of Germany and Switzerland contracted cancer of the bladder; later it developed that these dyes contained two strong carcino gens-- betanaphthylamine and ben zidine. In the oil industry, high boil ing fractions of petroleum and pe troleum products, shale oil, coal tar and related compounds are estab lished inciters of cancer of the skin. Leukemia is seen more frequently in physicians who work with x-rays than in those who are not exposed so heavily to radiation. The prob lem of bladder cancer in Egypt is believed due to the marked infesta tion with schistosoma, a parasitic ailment, that occurs there, particu larly among farmers. Skin cancer is seen more frequently in sailors, ranchers and farmers than in people who are not so heavily exposed to sunlight. In the manufacture of products from propylene gas there appears to be a higher than expected Summer, 1956 5 incidence of cancer of the nasal sinuses-- perhaps due to inhalation of irritating fumes. "In general, there is no difference between a cancer caused by an oc cupational poison and one of un known cause," says Dr. Herbert K. Abrams, Medical Director of the Building Service Employees Union, Local 25, Chicago. "Cancers of the bladder, lung or skin, for example, are the same whether caused by in halation of a certain chemical in the factory, or resulting from an un identified cause. The most important tool to aid the doctor in making the diagnosis of occupational cancer is a thorough occupational history. "Occupational cancers usually re quire years of exposure to develop. The time will depend upon the in tensity of exposure, potency of the chemical or physical agent, and the Mine worker -- 1900 feet underground. ( FHEKI.AiNCE PH O T O G U IL D ) relative susceptibility of the indi vidual affected. Occupational can cers have been reported to occur in from one to many years of expo sure. It is possible for a cancer to become manifest years after the worker has left the place of employ ment where the exposure occurred. This is another reason why a thor ough history is so important." r Vancer-causmg agents are dis covered in two ways: experimenta tion with animals, and epidemio logical investigation. Epidemiologi cal research works theoretically like this: it is known that in a certain state only 0.02 per cent of the popu lation get cancer of the bladder, but in one county of that state 0.1 per cent of the population is affected. In a single plant in that county, it is discovered that 5 per cent of the employees get bladder cancer. Further research then reveals that 50 per cent of the employees in one specific department of the plant, and over 90 per cent of the workers employed in one phase of this oper ation get this type of the disease; it also may be observed that these workers get cancer at an earlier age than persons in the general popula tion. So now there is a solid basis for a detailed study of the chemicals and processes to which those work ers are exposed. The outlook for reducing cancer in industry is more hopeful than that for the general population because exposure to the carcinogenic agent can be controlled. Prevention is based on the same principles as is prevention of other occupational diseases. Some notable safeguards are: 1. Substitution, where possible, of a less harmful chemical or process for a harmful one. For example, replacement of benzol by a less dangerous solvent. 1. Introduction of a production system to prevent escape of noxious dusts, fumes, and gases into the air. 3. Exhaust ventilation to remove noxious dusts, fumes, and gases. 4. Protective clothing, goggles, gloves, and respirators, for the worker. Change of work clothing daily with showers at the en'd of the day. 5. Medical supervision of the workers with periodic exami nations to detect early signs of trouble. 6. Education of the worker. Unless he knows what he is doing and handling, and how to protect himself, all other measures are apt to fail. "The primary purpose of medi cine in industry is to guard the worker's health so he can continue to earn a livelihood uninterrupt edly," adds Dr. Leo Price, Director of the Union Health Center, New York City. "One great safeguard of good health is the periodic medical examination and prompt medical treatment following early signs of disease. The worker who takes ad vantage of this service can usually maintain good general health and be free from fear of disability. With medical supervision and treatment, even chronic diseases and conditions are no bar to continued employ ment. Therefore medical service on or near the job helps the worker take care of his immediate require ments while he keeps on working. The purpose of labor health centers is to provide this direct medical service. "Regular periodic medical exami nations help identify cancer early when it is most easily controlled. In 1954 the following different types of that malady were found among garment workers who attended the Union Health Center: 55 cancers of the skin, 31 cancers of the rectum. 24 cancers of the colon, 20 lung cancers, 14 breast cancers, 13 stom ach cancers, 8 of the cervix." And how many American indus tries are cooperating in the safe guarding programs of their workers health? A great many-- although the number could and should be in creased. Among some examples of participating industries cited by the National Cancer Institute of the U, S. Public Health Service are: The Monsanto Chemical Company discontinued manufacturing 4-amino diphenyl which was used as an anti oxidant after it was discovered that this chemical is highly carcinogenic and had caused cancers of the blad der among the workers within a relatively short period of years. Several chromate manufacturers, such as the Mutual Chemical Com pany and the Diamond Alkali Com pany, have constructed during recent years new plants in order to reduce the lung cancer hazard among chro mate workers. The Union Carbide and Carbon Company has made some fundamenlal changes in the technological aspects of the production of iso propyl alcohol to obviate the cancer hazards affecting the nasal sinuses, Summer, 1956 Chromate plant: ore storage piles and test ing chromate dust with particle accumulatoranalyzer. (below) Coding health records of chromate workers. larynx and lung of producers of isopropanol. The American Petroleum Institute has been financing, over the last five or six years, an extensive research program for the determination of carcinogenic derivatives of petro leum. Some twelve manufacturers, processors and users of coal tar and related products (pitch, asphalt, creosote oil, anthracene oil, methyl ated naphthalene) have banded to gether to provide financial support for the study of carcinogenic haz ards related to these products. Improvements have been made in the processing of asbestos by some of the American manufacturers, thereby reducing the hazard of asbestosis as well as of asbestosis can cer of the lung. Manufacturers of household deter gents have financed, daring recent years, a large-scale investigation of the raw products of chemicals pro vided by the petroleum industry used in the manufacture of detergents, to determine their possible harm-- if any. How one specific company took cognizance of and action on this problem is illustrated in the wellrounded program of the Esso Stand ard Oil Company of New Jersey. Extensive studies carried out by the Esso Research and Engineering Division had shown that the residual material left over after the com pany's high boiling catalytic crack ing process had taken off the gaso line, kerosene, heating oils and diesel oils, was highly carcinogenic to lower animals. It was concluded that a potential cancer hazard existed where man came into con tact with these residual oils. Some 4,000 Esso refinery employees were engaged in working with or han dling them. Prompt steps were taken to 1) expand the experimental bio logical studies to obtain additional information relative to the carcino genic properties of the oils; 2) ini tiate physical and chemical studies 10 eliminate or diminish the carcino genic qualities of the oils; 3) put all employees exposed to these oils under close medical supervision; 4) institute measures throughout the company to eliminate or diminish contact of employees with the oils. The company, under the direction tot Dr. Leo Wade, Medical Director . fof Esso Standard, and with the a d -' vice of Dr. Robert E. Eckardt, Medical Director of the Research and Engineering Division, restricted the number of men exposed to the ' oils and put into effect a program to make physical examination obliga tory four times a year. Protective clothing is required on these jobs-- aprons, boots, gloves, whole suits. Employees are obliged to shower before leaving the plant and to don clean work clothes daily. All-equip ment used in the production'of the more carcinogenic oils is painted bright orange. Assisting Dr. Ec kardt in the basic studies have been Dr. Horace W. Gerarde, head toxi cologist; Nathan B. Hendricks, head industrial hygienist; Dr. Bertrand E. Bennison, chief clinical research physician. How a whole industry took action on the problem was demonstrated within the past two years. Extensive studies had shown a close associa tion between cigarette smoking and deaths from lung cancer. American tobacco interests were naturally con cerned, and set up a Tobacco Indus try Research Committee supported by a half million dollar fund con tributed by various companies. Dr. Clarence Cook Little, head of the Roscoe B. Jackson Memorial Labo ratory at Bar Harbor, Me., and one of the foremost cancer researchers in the country, was called in to head the tobacco research group-- whose funds have since been swelled an other million dollars. total tar. This fraction causes skin cancer in 9 out of 10 mice, and may well contain the agent which is con cerned in the production of many cases of human lung cancer. The studies of Dr. Wynder and his asso ciates have been supported thus far by $35,509 in American Cancer So ciety grants, and his group is only one such ACS-supported team look ing into the growing seriousness of the lung cancer problem. The ACS has allocated a million dollars to the lung cancer study during the past AAeanwhile, Dr. Ernest L. Wynder, a scientist heading an ACS-supported smoking study at the Me morial Center for Cancer and Allied Diseases, New York City, has, within months, announced the sepa ration of a fraction of the conden sate from tobacco smoke represent ing approximately 1.0 per cent of the two years, and in March 1955 estab lished an Ad Hoc Advisory Com mittee on Lung Cancer, composed of America's foremost doctors and scientists, to guide its research. The increase in lung cancer death rates-- greatest of any cancer site over the past few decades-- is attrib utable to many possible causes. The evidence which links smoking is no more than circumstantial at pres ent. The existence ot respiratory cancer hazards has, on the other hand, been reliably demonstrated among those who inhale hot coal tar fumes during the manufacture of gas and coke, workers exposed to certain petroleum mists and fogs, others exposed to vapors from iso propyl oil, refinery workers having contact with nickel dust and nickel carbonyl vapors, workers who , Doctors working with wet x-ray film use protective aprons goggles. Rays from radium in glass dish fur nished only light for inset photo. breathe in chrom ium -containing compounds, asbestos workers with pulmonary asbestosis. Investigators working on one research'project at the University of Pittsburgh, supported by the Ameri can Cancer Society and the National Cancer Institute, have challenged several common scientific concepts of cancer induction. They suggest that "co-carcinogens" -- agents which have been regarded as harm less by themselves but capable of in creasing the potency of cancercausing substances -- themselves cause cancer if exposure is great enough. Once again, it may all be a matter of dosage and length of ex posure, they contend. The Pittsburgh scientists report that the cancer-causing potency of an agent can be varied at will by the experimenter, since it is dependent on dosage, time, and concentration. They found that a single applica tion of 0.01 cc. of 1.25 per cent solu tion of 3,4 benzpyrene-- a total ot 125 micrograms of the substance-- will not cause cancer when painted on the shaved skin of a mouse. If a lesser amount, 120 micrograms, is given over a longer (40-week) pe riod, however, it causes tumors in the mice. Most of these disappear if exposure is stopped, but continued exposures produce cancers which kill the test animals. The results of this and other re search make questionable the idea of "sub-minimal" single doses of a carcinogen being entirely harmless. They indicate that very slight expo sures have a cumulative effect which can add up to cancer if the doses arc repeated often enough. This line of research has signifi cance for humans. It suggests that a single slight exposure to cancercausing agents may not be harmful, but repeated slight exposures could lead to cancer. Lending further credence to this theory, Volume 70, No. 3 (March '55) of Public Health Reports issued by the U. S. Department of Health. Education and Welfare, carries an 9 Inhalation chambers for atmospheric experiments on mice: New York Uniuersity-Bellerue Medical Center. article titled, "Relationship of indus trial Carcinogens to Cancer in the General Population," which states: "A rapidly growing accumulation of evidence suggests that industryrelated or occupational cancer haz ards carry as a corollary a similar, though diluted or attenuated hazard for the general population. The in dustrialization of society during the past half century has resulted in certain new socio-economic phe nomena, one of which has been the concentration of population in close proximity to industrial sources of environmental pollution. This con'centration of population and the re cent advent of the atomic age, the era of synthetics and the petroleum economy when combined with epi demiological observations, indicate that a general population hazard is of more than theoretical signifi cance." Such an everyday essential to life as drinking water has been known to carry cancer-causing factors. An endemic appearance of skin cancers due to the consumption of drinking water polluted with arsenicals has been reported from such divergent places as Reichenstein, Silesia, and Cordoba, Argentina. In Reichen stein, the arsenic which entered the drinking supply originated from water seeping through arsenic-con taining slag heaps from the mines, while in Cordoba the water had a naturally high arsenic content. At tention has also been called to the pollution of water supplies through the discharge of wastes from chem ical factories, paper plants, cellulose manufacturing establishments, gas works, rayon plants, textile dyeing plants, tanneries, steel plants, oil re fineries, and similar industrial estab lishments, and to the introduction of substances from freshly tarred or oiled roads into the rain water, or of arsenicals used for the spraying or dusting of fields, orchards and woods, or released from copper smelters into the air and thus carried down by rain. Concerning definition and types of environmental carcinogens, Dr. W. C. Hueper, Chief of the En vironmental Cancer Section of the National Cancer Institute, has said in a Public Health Report, Supple ment 209, titled "Environmental and Occupational Cancer" : "Any physical, chemical, or para sitic agent forming a part of our natural or artificial environment that, on proper exposure, directly or indirectly elicits cancerous growths in one, several, or all types of human tissues represents an environmental carcinogen. Exposure to these fac tors is related to a great number of highly diverse environmental condi tions, such as occupational activi ties, diets, medicines and medicinal devices, cosmetics, wearing apparel, building materials, habits and cus toms, climate, fauna, contaminants in drinking water, atmospheric air, foodstuffs, and-- in recent years-- procedures of warfare. "Some of the evidence is of cir- 10 cancer news cumstantial character, derived from statistical observations showing defi nite differences in the incidence rates of cancers. These appear in different regions, among different races, sexes, and social and occupational groups, and with different climates, and also are to be noted in marked variations in the relative distribution of cancers upon the different organs in different countries and popula tion groups. Another type of evi dence is of a more definite nature, and applies to the environmental tumors proper." D r . Hueper has assessed the rela tive significance of various chemical carcinogens from the public health viewpoint, and has proposed a pri ority formula for the screening of suspected materials. He would give the highest priority rating to those chemicals with which the largest part of the genera! popu lation has the most contact. Agents of this nature include chemical ad ditives and contaminants of food stuffs: industrial and military pol lutants of the air, water, and soil; wrapping and packaging agents of foodstuffs; cosmetics; household drugs (over-the-counter items); cleaning and polishing agents (waxes, dry cleaning fluids, deter gents, metal-, furniture-, and silverpolishes, etc.); sanitary goods; paints; herbicides; pesticides, etc.; i.e., any chemical which enters the general human environment in the form of consumer goods or as an environmental contaminant. The second highest priority would be given to chemicals to which large worker groups employed in pro ducing, processing, and consuming industries become exposed, but which either are not incorporated into consumer goods or may be pres ent only in inactive form. The lowest priority would go to potentially carcinogenic chemicals of relatively less significance from a public health viewpoint, such as medicinal agents dispensed only upon prescription, and industrial chem icals with numerically re stricted occupational contacts and no general environmental human ex posures. As has been pointed out previ ously, certain segments of American industry are being most conscien tious about the growing problem of environmental cancer. Other seg ments are not so cooperative. Some industries which have instituted studies of the problem are not pub lishing data on the symptomatology and epidemiology of cancers within their industries. Through such se cretiveness the medical profession is thereby deprived of the benefit of factual evidence which is essential for an intelligent approach to a pre ventive control of cancer by medi cal and technological procedures. In fact, some companies have taken ac tive steps to prevent the publication of incriminating evidence obtained by investigators in their several fields. A few industrial concerns and Synthetic diet tests. certain industrial consultants have even gone to the length of endeav oring to undermine the professional standards of workers in the field of occupational cancer. Considerably more educational work remains to be done in this area. One state health official recently visited a small asphalt plant where there was a known carcinogen haz ard. He tried to persuade the owner to improve his ventilating system and provide other safeguards. The owner, who worked in the plant himself, scoffed at the idea, said he'd been working with asphalt for over 20 years, declared that no bureau crat was going to persuade him it was dangerous. "Even as he spoke," the state official reported later, "I could clearly see half a dozen wart like growths on his face and hands -- a kind that are often precancerous-- and I recognized what was probably an actual cancer the size Summer, 1956 11 of a dime growing just above his cheekbone." A half a dozen bills are now pend ing in Congress which would help safeguard the foods we eat-- not from carcinogens alone, but from all potentially dangerous or untried additives. These would require proc essors adding new chemicals to foods to test them for their chronic effect on animals before they are put on the market. Secretary of Health, Indian natives often get cancer from chafing of fibrous clothing-- gathered at waist. (tREELANCE PHOTO CLILd ) Our ancestors often devel oped lip cancer from smoking clay pipes-- too hot. (cLLVER SERVICE) Marion B. Folsom, has stated, "There is no responsible group in either the food or the chemical in dustries which, so far as we know, opposes the objectives of such legis lation." There has been some delay in passage, however, while commit tees are determining just how strict the new law should be and how it should be enforced. Meanwhile the man on the street, the plain American citizen interested in maintaining the health and wel fare of his family, is concerned with keeping himself and his loved ones free of cancer. But no amount of Congressional legislation will tree him of his own personal responsi bility. Knowledge of cancer and its symptoms, and an awareness of the necessity of early protection and prompt treatment, will still be his first safeguards against the disease. Many types of cancer are preceded by recognizable conditions, and many cancers are incurable only be cause they are detected too late. The once-yearly medical examination for adults and the alertness to cancer's well-known seven danger signals re main the best precautions. . Modern man in his modern en vironment can take solace from one fact. Environmental cancer is not at all new, and is not at all unique to our present industrial civilization. Cancer of the lip was a hearthside hazard among our ancestors who smoked clay pipes-- too hot. Scalp tumors prevail among Moslem males whose religious practices in spire them to shave their skulls with blunt-- and hence chronically irri tating-- instruments. In The Philip pines the natives get mouth cancer by sucking on a leaf-wrapped betel nut. Certain natives of India develop cancer from the constant chafing of their fibrous clothing-- gathered at the waist. Then there is a cancer found in the people of Northern China who sleep on a perforated mat under which is placed hot bricks to keep them warm: they gradually develop low-grade burns which later become tumorous. Thus, literally, they get cancer from going to bed. cancer news 9 S 6 L 'U3WWri<