Study suggests pollution plays an outsized role in western Pennsylvania cancer rates
The analysis, published as a letter to the editor in the journal Environmental Health, used existing data on smoking and cancer rates in 612 counties across the U.S. to estimate what would have happened if everyone in those counties had quit smoking 20 years ago.
The researchers used census data and county-specific data on cancer rates and smoking to estimate how many cancer cases were caused by smoking, then used statistical modeling to estimate how cancer rates would have changed over time if smoking was eliminated.
Related: Cancer in Pittsburgh: Prevention lags as pollution persists
They found that in some counties lung cancer rates would have declined by more than 80 percent, while other counties would have seen a decline of less than 15 percent, with an average reduction of 62 percent. Allegheny County, which encompasses Pittsburgh, would have seen a decline of just 11 percent, putting it in the bottom 2 percent of counties when it comes to the potential for quitting smoking to lower lung cancer rates.
"Very few rural counties had a high residual cancer risk after removing smoking risk, which indicates that air pollution is likely an important piece of this puzzle," David Kriebel, a professor and director of the Lowell Center for Sustainable Production at the University of Massachusetts and one of the study's authors, told EHN.
Allegheny County in the top 2 percent of counties nationwide
Previous research has already put Allegheny County in the top 2 percent of counties nationwide for cancer risk specifically caused by air pollution. Radon exposure is the second leading cause of lung cancer nationally and is a known factor in western Pennsylvania, as are traffic emissions and unusually high levels of industrial pollution—particularly from coke ovens used by the steel industry, which generate highly carcinogenic emissions. Cancer-causing chemicals in the region's drinking water could be another contributing factor.
The new analysis follows a 2020 paper published in the journal Environmental Health that looked at the impacts of smoking cessation on the rates of lung cancer and 11 other smoking-associated cancers (including esophageal cancer, cancer of the larynx, and stomach and bladder cancer) nationwide. That study, which was conducted by the same group of researchers at Boise State University and the University of Massachusetts, found that about 60 percent of smoking-associated cancers would not have gone away even if no one in the U.S. had smoked cigarettes for the last 20 years, suggesting that environmental factors play a larger role than previously thought.
When the researchers presented their early findings for that study at a symposium on cancer and the environment in Pittsburgh in 2019, local health advocates asked them to look at the same data specifically for lung cancer in Allegheny County. The researchers did, and also created a tool that any U.S. county can use to do the same type of analysis.
They said they hope the tool will help public health departments in places like Allegheny County assess how much of their efforts aimed at reducing local lung cancer rates should be directed toward smoking-related initiatives versus cleaning up the air and reducing other environmental exposures to carcinogens.
"Smoking is obviously a hugely important risk factor when it comes to lung cancer," said Polly Hoppin, one of the study's authors, former Senior Advisor at the U.S. Department of Health and Human Services and Environmental Protection Agency, and program director at the Lowell Center for Sustainable Production at the University of Massachusetts.
"Lowering smoking rates goes a long way toward reducing cancer rates, and we don't want to detract from the importance of those efforts in any way," Hoppin told EHN. "But our analysis does suggest that it's not the only important factor, and that in some places putting resources toward reducing air pollution and other environmental exposures could go even further toward reducing the region's lung cancer rates."
Thinking beyond smoking to tackle cancer
Edgar Thomson Mill in western Pennsylvania. (Credit: Mark Dixon/flickr)
The researchers' previous analysis found that even if Allegheny county eliminated smoking entirely, it would still be in the highest 10 percent of all U.S. counties for these cancers. But most current cancer prevention strategies in the county (and in the U.S. as a whole) are focused on individual behaviors: diet, exercise, and smoking.
"There's no question that these are important causes of cancer," Kriebel said, "but we're concerned over the degree to which we focus on smoking, obesity and exercise may lead people to conclude that the solution to the cancer epidemic lies solely in individual actions and lose sight of how socioeconomic and political decisions could be made that would also help prevent cancer."
Doug Myers, a professor at Boise State University and another of the study's authors, pointed out that other types of cancer that aren't associated with smoking could also be reduced by lowering environmental exposures to cancer-causing chemicals.
"There are lots of other cancer types that aren't related to smoking, and our analysis doesn't address those at all," he said. "So the impacts of lowering environmental exposures on reducing overall cancer rates would likely be even greater."
EHN asked the Allegheny County Health Department whether they had reviewed the study, what portion of their cancer prevention resources are allocated toward smoking cessation vs. environmental factors, and how they're working to protect the residents of Allegheny County from carcinogens in the local environment. A spokesperson wrote they "have no comment to offer."
"If you remove the progress we've seen as a result of people quitting smoking, we've made no headway whatsoever in the so-called war on cancer [at the national level]", Kriebel said. "That doesn't mean we shouldn't focus on tobacco control. But it does mean it's a big mistake to stop there."
Banner photo credit: Revival Vape/flickr
Judge kills Bayer’s plan to limit future Roundup legal liability, issues harsh criticism
Saying parts of the plan were "clearly unreasonable" and unfair to cancer sufferers who would be part of the class settlement, U.S. Judge Vince Chhabria castigated Bayer and the small group of lawyers who put the plan together in conjunction with Bayer.
He pointed out that the company has been "losing trials left and right" in claims brought by people suffering from non-Hodgkin lymphoma (NHL) who alleged exposure to Monsanto's Roundup and other glyphosate-based herbicides were the cause.
Bayer has owned Monsanto since 2018 and has been struggling to defend the cancer claims ever since. Cancer victims have won three trials held to date and tens of thousands of other plaintiffs have filed lawsuits alleging exposure to Monsanto's herbicides caused them to develop NHL while Monsanto spent decades hiding the risks.
Bayer did not respond to a request for comment about the ruling.
Glyphosate trials
Elizabeth Cabraser, one of the lawyers who structured the settlement plan, said the proponents were "disappointed" by the ruling and "continue to believe that a multi-billion-dollar class settlement that includes free legal services and substantial compensation to claimants, NHL diagnostic assistance, research into NHL treatment, and Roundup label reform to inform users and the public on all the science regarding a Roundup/NHL link, would provide tremendous financial, health and safety benefits for class members."
Judge Chhabria said in his decision that the company's desire to set up a "science panel" to determine whether or not the herbicides actually cause cancer rather than leave that question to future juries is because of the trial losses the company has so far suffered.
The "reason Monsanto wants a science panel so badly is that the company has lost the 'battle of the experts' in three trials, the judge wrote in his order. "At present, the playing field on the issue of expert testimony related to causation is slanted heavily in favor of plaintiffs."
Roundup exposure
The ruling comes after a lengthy hearing last week held to discuss widespread opposition by personal injury attorneys across the United States to the settlement proposal. The proposed plan called for Bayer to put up roughly $2 billion for a series of actions that would help the company avoid future Roundup cancer trials.
The class action settlement would apply to people exposed to Roundup products as of Feb. 3, 2021 who have not yet sued Monsanto or retained a lawyer to do so. The settlement plan would set up a framework for addressing new claims brought by those exposed individuals who develop NHL they attribute to their Roundup exposure. It would apply to people who already have NHL but who have not yet sued the company and to people who develop NHL in the future.
The plan was structured by Bayer in coordination with a small team of plaintiffs' lawyers who stood to be paid millions of dollars for their participation.
'Speedy compensation' for glyphosate victims
Proponents of the proposed class action plan told the judge it "will save lives," and provide "speedy compensation" to people who get NHL they blame on Roundup exposure.
But opponents said the proposal actually did little for cancer patients while benefiting Bayer and the lawyers who helped develop the plan.
At the heart of the objections is the view that if approved, the class action plan could limit the due process rights of people to go to trial and seek punitive damages awards in the future if they are diagnosed with NHL after Roundup exposure, while allowing Bayer to keep selling Roundup products with no express warning of a cancer risk on the label.
The limiting of plaintiffs' ability to seek punitive damages while not limiting Bayer's ability to keep selling Roundup distinguishes this settlement from any similar class action, according to an opposition brief filed by the nonprofit legal group Public Justice. The plan is a "blueprint for how manufacturers can cut off victims' rights to seek punitive damages from injuries caused by hazardous pesticides, the group said.
Monsanto's 'own system of justice'
Another key problem with the plan, according to critics, is that everyone in the United States who meets the criteria as a potential plaintiff would automatically become part of the class and subject to its provisions if they did not actively opt out of the class within a specified time period. If people did not opt out – even if they didn't know about the plan – they would be stripped of the right to seek punitive damages if they ever did file a lawsuit.
"Monsanto tried to buy its own system of justice and it is wonderful that the court saw through what they were trying to do," said lawyer Gerson Smoger, who is among the opponents. "The settlement would've been a travesty for those who use Roundup."
$11b Roundup litigation
The class action plan, which is separate from an $11 billion settlement of Roundup litigation announced by Bayer last June to address already filed lawsuits, needs approval from Chhabria. The judge has been overseeing the federal multidistrict Roundup litigation involving thousands of plaintiffs from around the United States.
Bayer's desire to find a settlement is "not surprising because the alternative to settling – continuing to lose trials left and right – is not attractive," the judge wrote in his ruling.
"In sum, the settlement proposed by these attorneys would accomplish a lot for Monsanto," he wrote. "It would substantially diminish the company's settlement exposure and litigation exposure at the back end, eliminating punitive damages and potentially increasing its chances of winning trials on compensatory damages. It would accomplish far less for the Roundup users who have not been diagnosed with NHL—and not nearly as much as the attorneys pushing this deal contend."
Carey Gillam is a journalist and author, and a public interest researcher for US Right to Know, a not-for-profit food industry research group. You can follow her on Twitter @careygillam.
Her new book is The Monsanto Papers: Deadly Secrets, Corporate Corruption, and One Man's Search for Justice, published by Island Press.
