The government’s top public health adviser has said introducing smoking bans in public places including bars is ‘the only way’ to successfully tackle the health risks from second-hand smoke. The State of Public Health, the annual report of government Chief Medical Officer Sir Liam Donaldson, recommends ‘very serious consideration should be given to introducing a ban on smoking in public places soon.’ It adds: ‘All employers should plan to introduce smoke-free workplaces.’ It would be four more years before a ban in England was introduced.

CMO annual report, On the State of Public Health, 2003. Risks 113.

There is ‘appreciable’ evidence of a link between breast cancer and shiftwork, a report published by the HSE has found. Report author Professor Anthony Swerdlow, concludes: ‘Overall, the evidence for an association is appreciable, but not definitive’ and adds ‘further epidemiological research is needed to clarify the relationship.’ HSE commissioned this research following the publication of two articles in the Journal of the National Cancer Institute in the United States, which linked shift work and breast cancer. In 2014 HSE was still facing criticism for inaction on the issue.

HSE news release, 15 July 2003. Shift work and breast cancer: a critical review of the epidemiological evidence, Research Report 132, 2003. ISBN 0 7176 2708 X.

Smoking bans in pubs and cafes would protect the health of UK hospitality workers and result in increased profits for landlords and restaurant owners, according to a story in the latest edition of the TUC-backed magazine, Hazards. In the light of the findings, TUC and Action on Smoking and Health (ASH) say the government should now act on the independent research on the effects of any smoking bans.

Smoke screen, Hazards magazine, No.82, May 2003.

Campaigners and authorities including the TUC have attacked a report partly funded by the tobacco industry which concluded that passive smoking might not increase the risk of heart disease and lung cancer by as much as has been claimed. The study in the British Medical Journal said the link between these conditions and exposure to second-hand smoke could be much weaker than generally believed. Previous research has suggested that exposure to environmental tobacco smoke could increase the risk of heart disease by 30 per cent. The BMA criticised the study because it only re-analysed a small part of data from a study that was dropped by its original funders, the American Cancer Society.

JE Enstrom and GC Kabat. Environmental tobacco smoke and tobacco related mortality in a prospective study of Californians, 1960-98, British Medical Journal, volume 326, pages 1057-61, May 2003. EurekAlert, 15 May 2003. Risks 106.

A coalition of public health experts and campaigners is saying the long-running US ‘war on cancer’ is being lost because too little priority is given to prevention. A report from the Cancer Prevention Coalition (CPC) says Americans face increasing cancer risks from occupational and environmental exposure to industrial carcinogens, but established government and non-profit cancer organisations are fixated on treatment rather than prevention. ‘This report makes it clear that we are losing the war against cancer,’ said Dr Samuel Epstein, CPC chair and author of ‘The stop cancer before it starts campaign: How to win the losing war against cancer.’ He said the usual approach tended to ‘blame the victim’ for contracting cancer, rather than explore the environmental causation that could be responsible for their illness.

Risks 95. Cancer Prevention Coalition.

A racial inequality in occupational cancer risks has been reported in a number of studies, notes Linda Rae Murray. She concludes: “The exposure-related attributes involve discrimination in the workplace that may result in job ghettos and disproportionate exposure to certain hazards. Studies should be designed to address the questions of how class, race, and ethnicity differentially effect occupational health risks, and how class and race/ethnicity affect exposure- and susceptibility-related attributes. Such studies might help us unravel how socioeconomic factors, race, and ethnicity contribute to occupational health injury and disease.” The 2005 UMASS Lowell report (Clapp and others) also highlights racial inequalities in occupational cancer risks, noting: “Unequal workplace exposures among different populations provide further indications of the ability of occupational exposures to cause harm.” It adds that studies in the US steel industry found the highest rates of lung cancer – 10 times expected – were in non-white workers, employed in the highest risk jobs. Other examples, including chromate workers, are cited in the Murray paper.

Murray LR. Sick and tired of being sick and tired: Scientific evidence, methods, and research implications for racial and ethnic disparities in occupational health, American Journal of Public Health, volume 93, pages 221-226, 2003.

International union bodies have raised their concerns about industry bias in the International Agency for Research on Cancer’s (IARC) deliberations on substances being evaluated for their cancer risks. The 10 October 2002 letter to Jerry M Rice, the head of IARC’s identification and evaluation unit, expresses concern at “reports of conflicts of interest, bias toward industry and of questionable evaluation practices by IARC.” The letter was signed by five global union federations, the European TUC’s health and safety unit and the national union federations from the UK (TUC), US (AFL-CIO) and Australia (ACTU). The letter noted: “As international and national union organisations representing tens of millions of workers worldwide, we call on you to address as a matter of urgency” issues raised by the US Natural Resources Defense Council (NRDC), “particularly its charge that meetings can be dominated by an industry perspective that ‘has not historically represented the interests of public health, worker safety, or environmental protection’.” The union letter concludes: “We feel at this time, it is particularly important IARC distances itself – and is seen to distance itself – from any suggestion of improper corporate influence.”

Reported in Cancer in the system: Corporate disease infects the international cancer agency, Hazards, number 80, page 16, October-December 2002.

Dr James Huff, who headed the International Agency for Research on Cancer (IARC) chemical evaluation programme until 1980, has warned that the agency had lost its position as “the most authoritative and scientific source” on cancer risks “due to the increasing influence of those aligned with the industry point of view regarding chemicals and their inert hazards to public and occupational health.” He found representatives with industry sympathies or affiliations routinely outnumbered those aligned with public health at IARC evaluation meeting. In the decade from 1993, ratings for eight chemicals were upgraded, but 12 were downgraded. In the preceding decade, before industry asserted its influence on the decision making process, no IARC assessments were downgraded. It can take a concerted campaign to get action to prevent cancer risks, even when the evidence of harm is overwhelming. Huff noted in meetings discussing IARC monographs volumes 62 to 80, “in all but one of the Monographs meetings those aligned with industry ‘out-numbered’ those aligned with public health.” Huff was also a signatory to a parallel February 2002 letter to Gro Harlem Bruntland, director-general of the World Health Organisation (WHO) complaining about IARC’s perceived collusion with industry. IARC comes under the aegis of WHO.

Huff J. IARC monographs, industry influence, and upgrading, downgrading, and under-grading chemicals: A personal viewpoint. International Journal of Occupational and Environmental Health, volume 8, number 3, pages 249-270, July/September 2002. Also see: Cancer in the system: Corporate disease infects the international cancer agency, Hazards, number 80, October-December 2002.

Letter to Dr Gro Harlem Bruntland, director-general, WHO, International Journal of Occupational and Environmental Health, volume 8, number 3, pages 279–280, 1 July 2002.

A solvent the UK Health and Safety Executive (HSE) had been promoting as an environmentally friendly alternative is ‘carcinogenic’ the safety regulator said in March 2002. HSE said the exposure standard for the common workplace solvent would be tightened from 2002 because the European Union had revised its cancer rating to ‘category 2’, which applies to “substances that should be regarded as carcinogenic to humans.” Use of solvent – also known as trike or trichloroethene – increased after alternative, safer solvents were phased out as part of efforts to protect the ozone layer. HSE actively touted trichloroethylene as an environmentally friendly substitute. This came years after union campaigns to remove the highly hazardous solvent. Unions can campaigners had argued that alternative, solvent-free methods were available for many tasks.

Engineering solvent reclassified as a carcinogen HSE tells managers, HSE news release, 18 March 2002. Risks 46, 23 March 2002.

The UN’s cancer agency has been questioned about its “bias towards industry” and “questionable evaluation practices.” In a follow up letter to a 1 March 2002 meeting with the International Agency for Research on Cancer’s (IARC) Jerry M Rice in Washington DC, Jennifer Sass of the non-profit Natural Resources Defense Council (NRDC) wrote she was “hopeful that our discussions will lead IARC towards compliance with the WHO/IARC Declaration of Interests (DOI) policy. Clearly, IARC’s current practice of collecting the DOI forms, but allowing all financially conflicted persons to remain as voting, fully participating members of the Working Group (WG) cannot be considered compliance. Further, to allow scientists who have a financial interest in the decision outcome to prepare the discussion documents, or, worse, to chair the discussion groups pertaining to the chemical is simply unacceptable.” The letter concludes “it is of great importance that IARC complies with the WHO/IARC disclosure of interest policy, and that public interest organizations such as NRDC and governmental agencies world-wide be able to have confidence that the Monographs represent the truly objective state-of-the-science, untainted by the influence of financially interested parties.”

Reform Needed at the International Agency for Research on Cancer: Letter to Jerry M Rice, chief of the identification and evaluation unit, IARC, from Jennifer Sass, NRDC, 13 March 2002. Also see: Cancer in the system: Corporate disease infects the international cancer agency, Hazards, number 80, October-December 2002.