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It's well established that high estrogen exposure is a major breast cancer risk factor. Endocrine-disrupting chemicals that mimic estrogen, also known as xenoestrogens, have been associated with increased breast cancer risk, even at low doses. The two most common xenoestrogens, phthalates and parabens, are used widely in personal care products such as shampoo, deodorant, lotion, nail polish, fragrances and more. While most toxicology cancer research uses animal models or cancer cell lines, the new study, published in Chemosphere, aimed to understand how reducing real-world exposure to these toxics affects early markers of breast cancer in people’s bodies.
Breast cancer survivors and researchers partnered to recruit cancer-free women who used personal care products with parabens and phthalates daily. Randomly assigning some women as controls, they collected blood, urine and breast tissue cells from participants at the start and end of a 28-day intervention period, where non-control participants switched to phthalate- and paraben-free products. They observed significant reversal of known cancer-associated cell signaling pathways, significant shifts of known cancer-associated genes to a ‘normal’ profile, and significant reduction in phthalate and paraben urine levels post-intervention.
“For us [breast cancer survivors] this study changes the paradigm for breast cancer research,” Polly Marshall, executive director of Breast Cancer Over Time and a co-author of the study, told Environmental Health News (EHN). “Instead of looking at correlations, we found a way to actually study causation in people's bodies.”
A community-based shift for breast cancer research
As a community-based participatory research project, breast cancer survivors were involved in all steps of the study, from generating research questions to recruiting and educating participants.
The study design is a strength beyond being performed on humans. The fact that pre- and post-intervention samples came from the same women keeps outside factors that could otherwise skew results, such as diet and exposure to pollution, constant. Researchers were also able to see results in a short period of time rather than waiting decades to follow a cohort of women.
Funding for cancer research typically goes toward finding a cure and treatment rather than prevention. However, the potential to protect future generations is what motivated both the survivors and participants, most of whom had a loved one with breast cancer. “There are a lot of people out there who want to move beyond awareness and pink ribbons and actually do something to prevent breast cancer,” Marshall said.
Next steps in breast cancer research
The researchers said the study needs to be replicated in a larger study to confirm results.
According to Shanaz Dairkee, a cancer researcher at Sutter Health and the lead investigator on the paper, this pilot study opens many doors for future research. “This study design could be applied to other suspect chemicals in conjunction with other accessible human tissues with risk of cancer or other diseases,” she told EHN. Dairkee also believes that future research should assess the combined health impact of chemical reduction from multiple sources, such as personal care products and diet.
Authors say this type of research could also help close the research gaps necessary for chemical regulation. Organizations, such as Breast Cancer Prevention Partners, have advocated for safer personal care products since the early 2000s. While there has been some recent progress with the passing of the Modernization of Cosmetics Regulations Act, which improves ingredient transparency and requires adverse-event reporting, the federal government has yet to ban or restrict chemicals linked to breast cancer and other chronic diseases.
Kaley Beins, a senior scientist at the Environmental Working Group, focuses on improving public health by reducing chemical exposure from personal care products. “Intervention-based studies like this one, that link behavior changes not only to exposure reduction but potentially to mechanisms of risk reduction, will support the importance of regulating consumer products overall,” she told EHN.
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Experts say the report is one of the most comprehensive to date in compiling evidence of plastics’ risks for humans, the environment and the economy at every stage of their lifecycle. The commission — a group of researchers organized by the Australian foundation Minderoo, the Scientific Center of Monaco and Boston College — found plastics disproportionately harm low-income communities, people of color and children. They’re urging negotiators of the United Nations Global Plastics Treaty to take bold steps, such as capping plastic production, banning some single-use plastics and regulating the toxic chemicals added to plastics. Countries launched the plastics treaty process in March 2022, with the goal of adopting it in 2024.
From production through disposal, plastics impact people and the environment. At fossil fuel extraction sites (most plastics are made from fossil fuels like oil or natural gas) and plastic production facilities workers and surrounding communities are exposed to pollutants that can cause reproductive complications such as premature births and low birth weights, lung cancer, diabetes and asthma, among other illnesses.
Use of plastic products can expose people to toxic chemicals, including phthalates, which are linked to brain development problems in children, and BPA, which is linked to heart attacks and neurological issues. At the end of the plastics supply chain are growing landfills that leach harmful materials into the environment and surrounding communities. These landfills are often found in poor countries, described in the report as “pollution havens.”
“The bottom line is that plastic is not nearly as cheap as we thought it was, it’s just that the costs have been invisible,” Dr. Philip Landrigan, a pediatrician, director at the Boston College Global Observatory on Planetary Health and lead author of the report, told Environmental Health News (EHN). In fact, health-related costs resulting from plastic production were more than $250 billion in 2015, the report found.
He explained that the commission's recommendations for those discussing the treaty could prevent many of those costs to environmental health and the economy.
Plastics production caps and bans
Countries launched the plastics treaty process in March 2022, with the goal of adopting it in 2024.
Credit: United Nations
“There needs to be a global cap on plastic production,” Dr. Landrigan said. This cap would allow some plastic production, but prevent the anticipated growth of plastics in the coming years. Production is increasing in part because the fossil fuel industry is looking for new markets as rising demand for renewable energy could decrease the need for fuel, the report says.
The commission hopes countries signing the Global Plastics Treaty will ban avoidable plastics alongside capping production. Roughly 35% to 40% of plastic goes into disposable single-use items, and that fraction is expected to increase.
“We need to get in charge again of why we use plastic,” Jane Muncke, managing director and chief scientific officer at the Food Packaging Forum who was unaffiliated with the report, told EHN.
Plastic waste and health harms
Less than 10% of plastics are reused or recycled, according to the report, and the rest is burned or goes into landfills with devastating human and environmental tolls. Areas where plastic is burned experience elevated pollution and health risks. For example, plastic burning is linked to about 5.1% of lung cancers in cities in India, according to the report. Waste from electronics, with plastic and metal components, creates harmful exposures for the people around them, including roughly 18 million children working with electronic waste, the report says.
For plastics that remain on the market, the commission hopes to see improved health and safety testing of the thousands of chemicals added to plastics. There are more than 2,400 chemicals added to plastics that are considered a high risk, the report says, and many others have never been tested.
“The burden of proof that a chemical is problematic ends up being on society, when people start having health problems,” Andrea Gore, a professor of pharmacology and toxicology at the University of Texas at Austin, told EHN. To change this, the commission proposes testing chemicals for toxicity before they’re added to plastic products that are sold.
Exposure to plastics “falls most heavily on poor people, minorities, Indigenous populations, and of course, kids,” Dr. Landrigan said. He explains that generally, poor countries facing plastic pollution want to see global commitments to reduce plastics and their health harms, while countries that produce plastics might be wary of regulations that reduce the industry’s profits.
“It’ll spin out of control”
The second negotiation meeting for the Global Plastics Treaty will start in Paris in late May. The initial meeting covered procedures and included representatives from 160 countries. It saw conflict between the High Ambition Coalition, made up of 40 countries who advocate for the treaty to include mandatory actions, and others, including the United States, who want the treaty to result in pledges from each country.
For individuals concerned about plastic in their own life, Gore recommends reducing contact with plastic wherever is practical and avoiding heating plastic in the microwave, which can leach toxics.
“Don’t panic, because it is easy to get very alarmed,” she said. ”This document gave me hope and has very strong recommendations.”
Dr. Landrigan points out that while reducing harms from plastic can seem daunting, there are examples of policy changing the environment for the better, such as the Clean Air Act, which reduced U.S. air pollution by 77% from 1970 to 2019. But, he said, “if we don’t act courageously and just let the plastic crisis continue to escalate, it’ll spin out of control.”
The video, made by independent filmmaker Arman Dzidzovic, also features Dr. Terry Collins, a Carnegie Mellon University professor, who talks about the health risks from burning vinyl chloride, and Judith Enck, Beyond Plastics president and former U.S. Environmental Protection Agency regional administrator under President Obama, who calls on the EPA to ban vinyl chloride.
Vinyl chloride was deemed a cancer-causing chemical in 1974 and banned in some products, but it remains widely used in drinking water pipes, building materials, some packaging and children’s toys. When burned, dioxins and other highly toxic chemicals are released.
Watch the video above and visit Beyond Plastics, where you can learn more about the dangers of vinyl chloride and sign their petition to ban the chemical.