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Cancer Plan: Environmental Health
About 20 chemicals found in the environment, including arsenic, asbestos, benzene, cadmium, chromium, radon, and vinyl chloride, have been identified as known human carcinogens by national and international agencies. Many additional chemicals have been identified as being potential human carcinogens. The cancer burden posed by specific environmental carcinogens (aside from occupational exposure) has not been well defined. Despite the fact that the contribution of environmental carcinogens to the cancer burden is not as well understood as some of the other major causes of cancer, such as tobacco use, preventive measures should be initiated. Such measures are largely based on what is known at the present and include the reduction of exposure to hazardous chemicals in the workplace and the reduction of environmental pollution.
Radon
Radon is a naturally occurring radioactive gas that enters homes primarily through soil, gas, and well water. Radon is the second leading cause of lung cancer after tobacco use. Most of the cancers attributed to radon exposure are expected to occur among Mainers who have used tobacco, a consequence of a synergistic effect of the two exposures together. The National Research Council has estimated that one-third of the radon attributed lung cancer cases could be avoided if all homes had radon levels below the Environmental Protection Agency’s action guidelines of 4 picocuries of radon per liter (pCi/L).
One survey estimated that 30% of Maine homes have indoor air radon levels exceeding 4 pCi/L, and a study of 650 schools across the state found 32% had at least one classroom with a radon concentration above 4 pCi/L. Radon from domestic well water may also constitute a significant indoor air radon problem in Maine. Results of a survey of over 3,000 homes found that one in six homes with domestic wells had high levels of radon in the water that could result in high indoor air levels. Of those homes found with high radon concentration, roughly 33% were mitigated in 2000-2001 (Figure 16).
Figure 16: Maine Homes Found with High Radon Concentration, 1993-2001
Source: Maine Department of Human Services, Maine CDC, Program Files, 1993-2001
See Appendix G for Environmental Protection Agency map of radon zones in Maine.
Arsenic
Arsenic is a naturally occurring element found in ground and surface water, as well as in many foods. Arsenic-containing pesticides were commonly used in many agricultural settings in Maine in the early to mid-1900s. The effect this has had on ground water is unknown. In a recent report on arsenic in drinking water, the National Research Council concluded that there is a causal relationship between chronic ingestion of inorganic arsenic and skin, bladder, and lung cancer. Current data indicate that somewhere between 2 – 14% of Maine homes with domestic wells have water with arsenic levels exceeding the national guidelines. Data from 1998 – 2002 indicate that Maine has the highest bladder cancer mortality rate for males and the sixth highest for females in the country. Bladder cancer incidence is also higher in Maine than for the United States but to a lesser degree (Figures 17 & 18).
See Appendix H for a map of arsenic distribution in Maine.
Figure 17: Age-Adjusted Bladder Cancer Incidence Rates. 1995-2002
Source: Surveillance, Epidemiology and End Results Program and the Maine Cancer Registry Program
Figure 18: Age-Adjusted Bladder Cancer Mortality Rates, 1995-2002
Source: National Center for Health Statistics
Goal: Reduce the risk of cancer from carcinogens in Maine’s environment.
Objective 1: Decrease to 20% the proportion of homes that have indoor air radon levels in excess of the U.S. EPA action guideline of 4 pCi/L by 2010.
Baseline: 33% of homes have indoor radon levels in exceed 4 pCi/L, 1989-1991, EPA State Radon Survey-Maine Chapter.
Strategies
1. Test 5,000 homes annually for indoor radon air levels.
2. At least 450 homes known to have radon levels above 4 pCi/L were mitigated annually by 2010.
Objective 2: Increase annually the number of homes with private wells that are tested for radon in water.
Baseline: Approximately 2,800/year, Maine CDC Radiation Control Program.
Strategies
1. Annually promote radon and well water testing through public education and awareness activities.
2. Reduce maximum exposure levels for radon in well water downward from current value of 20,000 pCi/L (in conjunction with a downward revision in the radon in air standard).
3. Seek funding to support and expand efforts.
Objective 3: Decrease the proportion of homes that have drinking water with arsenic levels above the federal drinking water standard and Maine Maximum Exposure Guideline for arsenic of 10 micrograms per liter(ug/L).
Baseline: 11% of homes have drinking water with arsenic levels above federal standards, Maine CDC, Program Files, Random Sample Survey 2000/2001.
Strategies
1. Promote arsenic and well water testing through public education and awareness activities.
2. Increase the number of private testing laboratories that include arsenic to standard water potability tests.
3. Ensure that at least 75% of Maine homes with private wells are tested for arsenic.
4. Complete and disseminate research on the effectiveness of point-of-use treatment systems in reducing arsenic exposure from drinking water.
5. Seek funding to support and expand efforts
6. Seek funding and corresponding personnel to dedicate time to private well arsenic issues.
Objective 4: Increase public awareness of and protection from carcinogens in the environment by 2010.
Strategies
1. Increase awareness of fish advisories and consumption guidelines.
2. Generate at least one news story in at least three major Maine media outlets regarding fish consumption guidelines annually.
3. Increase the number of policies that reduce carcinogens in the environment by at least one through coordination with specific projects of the Alliance for a Clean and Healthy Maine.
4. Advocate for the legislative reauthorization and strengthening of Maine’s Toxics Use Reduction/Pollution Prevention Program.
5. Assist in the development of effective regulatory strategies to reduce exposure to high- ranking carcinogens through the Maine Air Toxics Initiative.
6. Evaluate and disseminate the results of the New England Study of Environment and Health on bladder cancer incidence and risks in the New England states.
Objective 5: Improve the completeness and usability of data available to inform public policy on the connections between environmental exposure and cancer incidence.
Strategies
1. Develop the capacity of the Maine Cancer Registry for rapid reporting of childhood cancer and the geocoding of all cancers.
2. Assess the feasibility of using risk factor data from the Maine Cancer Registry to assess cancer incidence and toxic exposure.
3. Develop a state Environmental Public Health Tracking Program that links health data with environmental data for the purpose of investigating the role environmental exposures play in chronic disease.
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