Motivating public health policy: A case for national environmental carcinogen exposure surveillance

Public health policy targeting environmental cancer risk factors is lacking due to an absence of information, and consensus, on the risks posed by these exposures.  Surveillance of cancer incidence and mortality data has traditionally informed public health action on cancer risk factors; however, this approach is not compatible with the ubiquitous exposures and small risk factors often associated with environmental exposures.  Primary prevention efforts are therefore better served by a precautionary approach that examines population exposures to known or suspected risk factors.  The Canadian Partnership against Cancer recently funded Carex (carcinogen exposure) Canada to create a national environmental and occupational carcinogen exposure surveillance unit.  The objective of this unit is to produce national exposure estimates to improve primary prevention activities.  

Here we will present examples of national exposure estimates of environmental carcinogens and demonstrate how this information can improve primary prevention. We will include examples of environmental exposure to fine particulate matter,  benzene, and radon.  The policy implications resulting from these exposure estimates are then discussed.  For example, PM_2.5 exposure levels are estimated for the general public and for children, a susceptible population, using school locations to determine potential exposure levels during the day.  How these exposures compare to those of the general population have important public health implications. 

Environmental carcinogen exposure surveillance provides new data to policy makers to target prevention efforts.  The current lack of information on who is exposed to carcinogens, how and where they are exposed, and to what levels, restricts targeted policies and interventions. Carex Canada therefore provides a significant new resource to motivate environmental public health policy.