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Review
. 2023 Dec;131(12):125001.
doi: 10.1289/EHP12681. Epub 2023 Dec 13.

An Approach to Assessing the Influence of Environmental and Occupational Cancer Hazard Identification on Policy Decision-Making

Suril S Mehta  1 , Isabelle Morin  2 , Kimberly Osborn  2 , Courtney R Lemeris  2 , Michael Conti  2 , Ruth M Lunn  1
Affiliations
Review

An Approach to Assessing the Influence of Environmental and Occupational Cancer Hazard Identification on Policy Decision-Making

Suril S Mehta et al. Environ Health Perspect. 2023 Dec.

Abstract

Background: Cancer hazard identification is critical to informing decisions on preventive actions. However, the influence of cancer hazard assessments on the creation of health-protective regulations is poorly understood. Although prior studies have measured the health and economic benefits of regulatory actions in general, we are not aware of efforts to explicitly study the influence of cancer hazard identification on policy decisions in the United States.

Objectives: In this commentary, we present an approach to examine whether formal identification of a substance as a human carcinogen may prompt a regulatory action to reduce exposure to carcinogens and enhance public health. Further, we discuss the broader implications of cancer hazard identification on policy decision-making, including identifying gaps and providing recommendations.

Methods: Using the Report on Carcinogens (RoC) as a test case, we systematically searched U.S. federal and state databases for notices of regulations mentioning the RoC from 1995 to 2023. For each regulation, we extracted information on the carcinogen(s) regulated, the regulatory agency, the regulatory purpose, the economic sector exposure sources, and the analyzed public health benefits and costs. We created a publicly available, web-based interactive tool to visualize the data.

Discussion: U.S. regulatory agencies have been using cancer hazard evaluations, such as the RoC, for decades to inform public health policy actions to prevent or mitigate cancer risks. Specifically, nonregulatory cancer hazard assessments have been used to prioritize chemical evaluations, support regulatory-based assessments, and trigger regulatory action. Our approach showed that assessing the influence of cancer hazard identification on science-based public health policies is feasible, informative, and needed, and our study is a first step in this direction. We recommend expanding this approach to other cancer and noncancer hazard assessments to ultimately inform our understanding of the influence of hazard classifications on policymaking. https://doi.org/10.1289/EHP12681.

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Figures

Figure 1 is a Public Health and Economic Influences of NTP Report on Carcinogens, Summary of federal and state actions dashboard webpage. On the top, there are four options, namely, Home, Summary, Federal actions, and State actions. Under Agents, the following options are displayed: 1-amino-2,4-dibromoanthraquinone; 1-bromopropane; 1,2-dibromethane; 1,3-butadiene; 1,4-dioxane; 2-nitropropane; 2,2-bis-(bromomethyl)-1,3,propanediol; 2,3,7,8-tetrachlorodibenzo-p-dioxin; 3,3′dichlorobenzidene and its dihydrochloride; 3,3′-dimethoxybenzidine and dyes metabolized. “Any Report on Carcinogens” was extracted in cases where the action is triggered by any chemical listed in Report on Carcinogens. Under Action type, the following options are displayed: accident prevention, ambient standards, compensation, emissions limits. Under Federal agencies or states, the following options are displayed: D H H S or C D C, D H H S or F D A, D O D, D O E, D O L or M S H A. A tabular representation titled Economic sector exposure source(s), in three columns, lists Categories, Sources, and Counts. Row 1: Agricultural production; 3 sources of crop farming and 2 sources of herbicides and pesticides. Row 2: Food and consumer products; 9 sources of buildings, furnishings, and textiles, 6 sources of consumer products, 9 sources of drinking water, 1 source of flame retardants, 4 sources of food and food additives, 1 source of sunscreen, and 4 sources of tobacco products. Row 3: Industrial combustion and other processes; 5 sources of boilers and heaters; 4 sources of industrial and commercial processes; and 2 sources of waste processors and incinerators. A tabular representation titled Actions citing the Report on Carcinogens has eight columns, namely, Action title, Publication date, Action phase, Agency type, Agency, Quantified cancer effects, Regulatory info extracted, and E O 12866 significance. Row 1: 2017 and later model year light-duty vehicle greenhouse gas emissions and corporate average fuel economy standards; October 15, 2012; Final; Federal; and United States Department of Transportation, National Highway Traffic Safety Administration, and United States Environmental Protection Agency (E P A). Row 2: 2020 New York regulation text 29068—Department of Environment Quality; January 1, 2021; Final; State; New York Department of Environmental Conservation. Row 3: 2021 Oregon regulation text 46220—Department of Environmental Quality; June 29, 2021; proposed; state; Oregon Department of Environmental Quality; November 17, 2021; Final; State; Oregon Department of Environmental Quality. Row 4: 2022 California regulation text 27728—Office of Environmental Health Hazard Assessment; August 26, 2022; proposed; state; California Environmental Protection Agency, Office of Environmental Health Hazard Assessment. Row 5: 2022 New Jersy regulation text 22894—Department of Health; February 7, 2022; proposed; state; New Jersy Department of Health. Row 6: 2022 Oregon regulation text 48094—Department of Environmental Quality; May 24, 2022; proposed; state; Oregon Department of Environmental Quality. Note: Counts and totals represent distinct number of actions applying to each criteria. Multiple criteria may apply to a single action. The total number of actions shown is 174. Quantified cancer effects, E O 12866 significance, and regulatory information extracted, each in two columns, list Categories and Actions.
Figure 1.
Public Health and Economic Influences of NTP Report on Carcinogens dashboard. This is a thumbnail image of the interactive dashboard that is filterable by agent, action type, agency/state, economic sector exposure sources, quantified health effects (yes/no), Executive Order 12866 significance (yes/no), and regulatory information extracted (yes/no). The numbers (counts) indicate the distinct number of actions that investigated a particular criterion. If an action evaluated multiple agents (top left), action types (top middle), or economic sector exposure sources (top right), an action may be counted in multiple categories. The “Actions Citing the Report on Carcinogens” panel (bottom left) includes each action’s title, publication date, stage, publishing agency, whether the action addressed quantified cancer effects, if the action was considered “significant” as defined in Executive Order 12866, or had regulatory information extracted. Note: CA, California; CDC, Centers for Disease Control and Prevention; DHHS, Department of Health and Human Services; DOD, Department of Defense; DOE, Department of Energy; DOL, Department of Labor; EO, executive order; FDA, Food and Drug Administration; MSHA, Mine Safety and Health Administration; NJ, New Jersey; NTP, National Toxicology Program; NY, New York; OR, Oregon; RoC, Report on Carcinogens.
Figure 2A is a set of one pie chart and two horizontal bar graphs. The pie chart displays the following information: There are 174 total actions, of which 29 are state actions and 145 are federal actions. The two horizontal bar graphs, plotting Department of Defense, Department of Energy, V A, Department of Health and Human Services or Centers for Disease Control and Prevention, Department of Health and Human Services or Food and Drug Administration, Department of Transportation or Federal Motor Carrier Safety Administration, Department of Transportation or National Highway Traffic Safety Administration, Department of Labor or Mine Safety and Health Administration, Department of Labor or Occupational Safety and Health Administration, and Environmental Protection Agency; and states, including New York, Illinois, Washington D C, Oregon, Massachusetts, New Jersy, and California (y-axis) across count of federal actions and count of states actions (x-axis). Figure 2B is a horizontal stacked bar graph, plotting lead and lead compounds, polycyclic aromatic hydrocarbons (P A Hs), nickel compounds and metallic nickel, Diesel Exhaust particulates, Naphthalene, 1,3-Butadiene, Formaldehyde, any Report on Carcinogens agent, Acetaldehyde, and Benzene (y-axis) across Counts (x-axis) for Count of federal actions and Count of state actions.
Figure 2.
Report on Carcinogens (RoC)-cited listings: federal and state actions citing the RoC. (A) Proportion of federal and state actions, with a display of action counts for specific federal agencies and states citing the RoC. (B) The 10 most addressed RoC listings among 121 distinct actions (70% of total actions). Counts include both proposed and final regulatory actions. See the interactive dashboard for the frequency of citations for all RoC-listed substances. All counts shown represent distinct numbers of actions associated with the accompanying criteria. In (A), five actions were produced jointly by the U.S. EPA and DOT and are included in both counts. In (B), we note that many actions address more than one RoC agent and are included in multiple bar totals. In (B), “Any RoC Agent” was assigned in cases where the action is triggered by any chemical listed in RoC. Note: CA, California; CDC, Centers for Disease Control and Prevention; DC, District of Columbia; DHHS, Department of Health and Human Services; DOD, Department of Defense; DOE, Department of Energy; DOL, Department of Labor; DOT, Department of Transportation; EPA, Environmental Protection Agency; FDA, Food and Drug Administration; FMCSA, Federal Motor Carrier Safety Administration; IL, Illinois; MA, Massachusetts; MN, Minnesota; MSHA, Mine Safety and Health Administration; NHTSA, National Highway Traffic Safety Administration; NJ, New Jersey; NTP, National Toxicology Program; NY, New York; OSHA, Occupational Safety and Health Administration; OR, Oregon; VA, Department of Veterans Affairs.
Figure 3A is a tabular representation with four main columns, namely, Action type, Federal actions or agency, All state actions, and Total count of actions. The federal actions or agency column is subdivided into seven columns, namely, Environmental Protection Agency, Department of Labor or Occupational Safety and Health Administration, Department of Labor or Mine Safety and Health Administration, Department of Transportation or Federal Motor Carrier Safety Admin, Department of Defense, and Department of Energy. The action type displays the following categories: emission limits, hazard communication, exposure limits, trade or use restrictions, and total counts of actions. A scale depicts distinct count of actions ranging from 1 to 67. Figure 3B is a tabular representation with two main columns, namely, Action type and Exposure source category. The Exposure source category column is subdivided into 10 columns, namely, Other or general, Manufacturing releases, Occupational, Transportation, Food and consumer products, Mining, quarrying, and oil and gas extraction, Industrial combustion and other processes, Utilities (power, water, and waste), Agricultural production, and Total count of actions. The action type displays the following categories: emission limits, hazard communication, exposure limits, trade or use restrictions, and total counts of actions. A scale depicts distinct count of actions ranging from 1 to 26.
Figure 3.
Action purposes, agencies, and types. (A) 145 distinct actions (83% of total actions) address the top four purposes of regulatory action, categorized by federal agency or state. (B) 143 distinct actions (82% of total actions) addressing the top four regulatory action purposes, categorized by major exposure source groupings. Counts include both proposed and final regulatory actions. See the interactive dashboard for the frequency of citations for all action types and exposure sources. All counts shown represent distinct numbers of actions associated with the accompanying criteria. Seven additional action types are excluded from this visual. In (A), three federal agencies are excluded because they addressed only purposes also excluded. Five actions were produced jointly by the U.S. EPA and DOT and are included in both (A) and (B). Some actions address more than one exposure source and/or purpose and are included in multiple totals in both (A) and (B). In (B), “Other/general” describes specific exposure sources that did not fit into other existing exposure categories. Note: FDA, Food and Drug Administration; DHHS, Department of Health and Human Services; DOD, Department of Defense; DOE, Department of Energy; DOL, Department of Labor; DOT, Department of Transportation; EPA, Environmental Protection Agency; MSHA, Mine Safety and Health Administration; NHTSA, National Highway Traffic Safety Administration; OSHA, Occupational Safety and Health Administration.
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References

    1. Siegel RL, Miller KD, Fuchs HE, Jemal A. 2022. Cancer statistics, 2022. CA Cancer J Clin 72(1):7–33, PMID: , 10.3322/caac.21708. - DOI - PubMed
    1. Islami F, Goding Sauer A, Miller KD, Siegel RL, Fedewa SA, Jacobs EJ, et al. . 2018. Proportion and number of cancer cases and deaths attributable to potentially modifiable risk factors in the United States. CA Cancer J Clin 68(1):31–54, PMID: , 10.3322/caac.21440. - DOI - PubMed
    1. Cogliano VJ. 2020. Governmental action to control carcinogen exposure. Multiple options covering diverse scenarios. In: World Cancer Report: Cancer Research for Cancer Prevention. Wild CP, Weiderpass E, Stewart BW, eds. Lyon France: International Agency for Research on Cancer, 557–564.
    1. Cogliano VJ, Baan RA, Straif K, Grosse Y, Secretan MB, El Ghissassi F, et al. . 2004. The science and practice of carcinogen identification and evaluation. Environ Health Perspect 112(13):1269–1274, PMID: , 10.1289/ehp.6950. - DOI - PMC - PubMed
    1. WHO (World Health Organization). 2020. WHO Report on Cancer: Setting Priorities, Investing Wisely and Providing Care for All. https://www.who.int/publications/i/item/9789240001299 [accessed 22 November 2022].