Occupational cancer and social inequities.

Absent from five relevant papers on Environmental Inequities (Eur J Public Health, Jan 2010) was any mention or discussion of occupational health and safety among the lower economic status workforce. These papers oriented more towards the negative impacts that social inequities have on environmental health and the influence of waste management policies, ambient air quality and residential location. The late Lorenzo Tomatis championed blue-collar workers and their struggling plight in unhealthy, unsafe and discriminatory occupational conditions, and especially being exposed chronically to known mutagens and carcinogens.1–3 This led from his equal campaign struggle for primary prevention of cancer,3–5 culminating in his establishing in the 1960s/early 1970s the Monographs Programme, International Agency for Research on Cancer,3–5 now in Volume 100 (http://monographs.iarc.fr/). Our collective battle to eliminate or minimize the impact that social injustice has on occupational cancers and other work-related diseases continues as fewer and fewer efforts are devoted to either poverty and cancer1–3 or primary prevention of cancer.3–5 For the latter, identifying likely carcinogens using animal surrogates receives lesser funding and diminished attention beginning in the 1990s onwards than in earlier decades of 1950–80s. Much of this decline likely centers on the glamorous rush to replace carcinogenesis bioassays with molecular biology and mechanistic research discerning carcinogenesis processes, hoping for eventual molecular or genomic intervention. This is unfortunate as ‘New developments in molecular biology do not invalidate ipso facto all that has been done before. While the new insights about certain aspects of the carcinogenesis process and the new techniques that have been developed in parallel demand that new approaches be explored and developed, there is little justification for downgrading long-term carcinogenicity tests, which provide proven, efficient warning about possible hazards to humans.’4 Not only do occupational cancers continue to show up in older or retired workers, but also myriad exposure circumstances of younger workers to potential carcinogens are multiple and enormous as more chemicals, mixtures of chemicals and product formulations remain or newly enter commerce. Often overlooked are chemicals, mostly untested; and sources the general public is exposed to adds significantly to the burden of those exposed to higher levels in the workplace: personal care products, shampoo, lotions, toothpastes, cleaning products, laundry and washing soaps, synthetics, pharmaceuticals, fluoride and chlorine in water, herbicides/pesticides/fungicides and other chemicals in food, hormones/steroids/antibiotics in food animals, pesticides and other chemicals for yard or inside homes, air fresheners in cars and homes, dry cleaning chemicals, drugs, alcohol and so on (from ‘The Hundred Year Lie’ by Randall Fitzgerald, 2006). Newer innovations like nanotechnology represent another burgeoning yet untested human health threat having worldwide distribution with little or minimal toxicologic evaluation for potential hazards. And much of these new hazards again fall disproportionately onto the lower social classes of workers or residents living near manufacturing plants and unsanitary conditions. Older industries like asbestos and chemicals or pesticides are often exported to developing nations, previously banned in developed countries; another debilitating source of social inequities and invisible punishment.1 These profit-minded practices need better and more protective health and safety export regulations and legislation. Conflict of Interest Statement: None declared.