The major challengers of the estimates made by Doll and Peto from the late 1970s and 1980s. Epstein and Schwartz give greater weight to toxicological and clinical research and challenge the relatively low estimates given by Doll and Peto to work and wider environmental factors. Self-interest of the chemical industry apart, the lifestyle theory of cancer causation is held to reflect misinformation and ‘inactive conservatism’.
Epstein S and JSchwarz. Fallacies of lifestyle cancer theories. Nature, volume 289, pages 127–130, 1991.
This groundbreaking guide from the US autoworkers’ union UAW, issued in 1980 and reprinted in 1992, gave workers the information to interpret epidemiological studies for themselves, identify their strengths and weaknesses and to identify work-related cancer risks for themselves. The initiative came as the UAW leadership declared “war on workplace cancer” in response to an alarming series of cancer mortality studies conducted among autoworkers by government, company, and union epidemiologists.
These studies revealed an “increased proportion of cancer deaths” among “workers in machining operations, foundry workers, and workers in vehicle assembly plants”; the epidemiologists believed those deaths were related to occupational carcinogen exposure.
The Case of the Workplace Killers: A Manual for Cancer Detectives on the Job, UAW, November 1980. For a review of UAW’s ‘war on workplace cancer’, see: Josiah Rector. Environmental Justice at Work: The UAW, the War on Cancer, and the Right to Equal Protection from Toxic Hazards in Postwar America, Journal of American History, volume 101, number 2, pages 480-502, September 2014. Full text of the article is posted online here.
Two major US reports published shortly before the 1981 Doll/Peto report – one from US government organisations and another backed by employers’ organisations – put the occupational cancer contribution at least 20 per cent of all cancers, with the industry-backed report conceding occupational cancer constituted “a public health catastrophe”.
Bridbord K and others. Estimates of the fraction of cancer in the United States related to occupational factors. Bethesda, MD: National Cancer Institute, National Institute of Environmental Health Sciences, and National Institute for Occupational Safety and Health, 1978.
Proctor R. Cancer Wars. New York: Basic Books, 1995 (includes reference to the early industry-backed estimate).
The study uncovered high rates of leukaemias in a population exposed only to the solvent benzene and where benzene levels were generally below recommended limits. The authors acknowledge that the figures underestimate the scale of the problem. It was the first cohort study of workers linking benzene exposure directly to leukaemia. Under-reporting remains a problem to the present. The industry was criticised in 2014 after it was revealed it has operated a long-term project to suppress or rebut evidence of this cancer link (see CPI, 2014). A 2004 study confirmed health risks at low level exposure to benzene. Concerns were raised in 2014 about harmful benzene exposure levels in the vicinity of fracking operations (see Macey and others, 2014).
Peter Infante, Robert Rinsky, Joseph Wagoner, and Ronald Young. Leukaemia in benzene workers, Lancet, volume 2(8028), pages 76-78, 9 July 1977.