The authors review epidemiological evidence up to 2007, when the International Agency for Research on Cancer had identified 415 known or suspect carcinogens. The report stresses the need for a new approach recognizing multiple interacting causes of occupational cancer. The paper challenges the attributable fraction approach of Doll and Peto as well as Rushton, who was the author of the UK Health and Safety Executive’s estimates of occupational cancer toll estimates. “We argue for a new cancer prevention paradigm, one based on an understanding that cancer is ultimately caused by multiple interacting factors rather than a paradigm based on dubious attributable fractions. This new cancer prevention paradigm demands that we limit exposure to avoidable environmental and occupational carcinogens, in combination with additional important risk factors like diet and lifestyle,” the report notes, adding: “The current state of knowledge is sufficient to compel us to act on what we know. We repeat the call of ecologist Sandra Steingraber: ‘From the right to know and the duty to inquire flows the obligation to act’.”

RW Clapp, M Jacobs, and E Loechle. Environmental and occupational causes of cancer: New evidence, 2005-2007, Reviews of Environmental Health, volume 23.1, pages 1-37, January-March 2008.