Traf­fic pol­lu­tion and breast can­cer

Malta Independent - - NEWS -

Joseph Grech is to be con­grat­u­lated for his ex­cel­lent ar­ti­cle on preven­tion of breast can­cer (Weigh­ing the risk of breast can­cer... where do you stand, 10 Oc­to­ber) As he says, the essence of preven­tion lies in main­tain­ing a healthy body weight, healthy diet, do­ing plenty of ex­er­cise, lim­it­ing al­co­hol in­take and avoid­ance of smok­ing. Since it is Pink Oc­to­ber fur­ther com­ment is in place.

First of all, the mes­sage on ex­er­cise needs to be re­in­forced.

It is now clear that a phys­i­cally ac­tive life­style pro­tects against a great many dis­eases which lead to dis­abil­ity or early death. The ma­jor ben­e­fits of ex­er­cise were re­cently re-em­pha­sised in a re­port aptly ti­tled ‘Ex­er­cise, the Mir­a­cle Cure’ pub­lished by the UK Academy of Medicine (2015). Here it was stated that ex­er­cise re­duces the chances of de­vel­op­ing heart dis­ease by over 40%; the risk of stroke by 30%; the risk of de­vel­op­ing de­men­tia by 30%; the risk of breast can­cer by 25% and the of risk bowel can­cer by 45%.

Se­den­tary life­styles with ac­com­pa­ny­ing adi­pos­ity and di­a­betes have in­creased in par­al­lel with in­comes and car own­er­ship. As in some other West­ern coun­tries, typ­i­cally the UK and USA, pri­vate car use is pre­dom­i­nant in Malta and this con­trib­utes to high obe­sity rates and street-level pol­lu­tion – both risk fac­tors for breast can­cer.

A world­wide survey has shown Malta to be the least phys­i­cally ac­tive coun­try in the world. Mal­tese chil­dren are also the least phys­i­cally ac­tive chil­dren in the EU. Part of the ex­pla­na­tion for this must lie in Malta’s car-de­pen­dence for mo­bil­ity and the num­ber of hours per day spent watch­ing tele­vi­sion by Mal­tese chil­dren – also the high­est in the EU.

Un­for­tu­nately pro­mo­tion of phys­i­cal ac­tiv­ity on a na­tional ba­sis re­mains a ma­jor chal­lenge in most coun­tries. Malta’s de­te­ri­o­rat­ing ur­ban en­vi­ron­ment and dys­func­tional trans­port sit­u­a­tion tends to fur­ther re­duce phys­i­cal ac­tiv­ity at ev­ery op­por­tu­nity.

Our streets are be­com­ing less pedes­trian-friendly; they have ceased to be ‘peo­ple spa­ces’ and are fast be­com­ing traf­fic spa­ces. Pave­ments are be­ing nar­rowed to cre­ate more space for cars.

Over-de­vel­op­ment continues to de­grade our ur­ban en­vi­ron­ment, add to our traf­fic con­ges­tion and our govern­ment re­mains hell-bent on en­cour­ag­ing car use by its pre­oc­cu­pa­tion with cre­ation of cen­trally sit­u­ated ur­ban car parks so that peo­ple might use their car more and need to walk even less.

So much for ex­er­cise; it now re­mains to draw at­ten­tion (again) to a dis­turb­ing as­pect of streetlevel traf­fic pol­lu­tion which is of piv­otal rel­e­vance to breast can­cer: A com­po­nent of traf­fic pol­lu­tants re­spon­si­ble for in­creases in breast can­cer is a group of com­pounds known as “poly­cylic aro­matic hy­dro­car­bons” or PAHs.

Traf­fic sources are re­spon­si­ble for 90% of am­bi­ent PAHs. These are also present in par­tic­u­lates emit­ted by traf­fic – es­pe­cially from diesel en­gines.

De­tailed re­search on epi­demi­o­log­i­cal data con­ducted at McGill Univer­sity Health Cen­tre re-con­firmed the link be­tween breast can­cer and ex­po­sure to traf­fic pol­lu­tants.

Be­sides con­tribut­ing to cases of lung and other can­cers, ex­po­sure to PAHs from traf­fic has another wor­ry­ing as­pect. In ad­di­tion to the long time lag, mea­sured in years or even decades, be­tween crit­i­cal ex­po­sure to PAHs and ad­verse health out­comes, there is ev­i­dence which sug­gests that the dam­age from PAHs can be “trans-gen­er­a­tional” in the case of breast can­cer. This means that the ad­verse ef­fects of ex­po­sure to PAHs can skip a gen­er­a­tion and be passed on to chil­dren of peo­ple by par­ents who were ex­posed to traf­fic pol­lu­tion.

This raises the spec­tre of “silent en­vi­ron­men­tal her­itage” passed from par­ent to child. These find­ings were reaf­firmed by the EU in its State of the En­vi­ron­ment re­port, En­vi­ron­ment and Health and the Qual­ity of Life (2007),

The World Health Or­gan­i­sa­tion and the UK Com­mit­tee on the Med­i­cal Ef­fects of Air Pol­lu­tants now en­dorse that ex­po­sure to traf­fic-re­lated par­tic­u­late air pol­lu­tion is one of the most im­por­tant en­vi­ron­men­tal risk fac­tors for ex­cess mor­tal­ity from car­diopul­monary dis­ease and lung and other can­cers.

To that is added the causative role in breast can­cer of ex­po­sure to PAHs across gen­er­a­tions.

All the for­go­ing stresses the tremen­dous im­por­tance of tak­ing steps to re­duce traf­fic pol­lu­tion.

The govern­ment has shown lit­tle con­cern and re­mains in­dif­fer­ent to the de­gree of traf­fic pol­lu­tion in densely ur­banised ar­eas; no at­tempt is made to limit pol­lu­tion by tak­ing steps to dis­cour­age ur­ban traf­fic and ren­der­ing streets pedes­trian-friendly.

Nei­ther is our Health Depart­ment in­volved in de­ci­sions on street plan­ning as the cre­ation of ur­ban car parks.

This con­tin­u­ing in­ac­tion can be ex­pected to re­sult in sig­nif­i­cant de­layed health im­pacts, in­clud­ing breast can­cer, which will be­come ap­par­ent over the com­ing years by virtue of cu­mu­la­tion of ef­fect in gen­er­a­tions cur­rently ex­posed and their chil­dren.

The so­lu­tion does not lie en­tirely with our govern­ment – ev­ery one of us who drives a mo­tor ve­hi­cle is part of the prob­lem. It is also up to you.

Ge­orge De­bono

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