Occupational Chemical Exposures in California and Breast Can

Institution: Public Health Institute
Investigator(s): Robert Harrison,  -
Award Cycle: 2015 (Cycle 21) Grant #: 21ZB-0901 Award: $1,367,710
Award Type: SRI Program Directed Awards
Research Priorities
Community Impact of Breast Cancer>Health Policy and Health Services: better serving women's needs

Initial Award Abstract (2016)

For most women who are diagnosed with breast cancer it is not possible to identify the cause of their cancer. The increases in breast cancer seen in the latter half of the last century coincided with the large-scale entry of women into the paid workforce. Today, more women work outside the home than ever before and women spend a substantial portion of their lives in the workplace. Currently, an estimated 80,000 chemicals are used in U.S. commerce, offering substantial opportunities for occupational exposures. While less than 1% of these chemicals have been tested to see if they cause cancer, at least 200 have been shown to cause mammary tumors in rodents. The potential role of these compounds in the development of breast cancer in humans, however, is poorly understood and understudied. An important first step towards furthering our understanding of breast risks associated with occupational chemical exposures is to map out what women’s employment looks like in California and what the significant chemical exposures are in the jobs where substantial numbers of women work. This research project is designed to identify the potential scope of the problem, characterize the populations likely to be most affected, and provide important preliminary data to guide future research aimed at understanding breast cancer risks associated with occupational chemical exposures. The key research questions this project aims to address are:

The first step in addressing these research questions will be to identify, evaluate and summarize all existing available data resources with information pertinent to these questions. To characterize where women work, we primarily will rely on U.S. and California-based census, employment, and labor data. To identify and prioritize the industries/occupations that are likely to pose the most significant breast cancer risks, and to summarize the characteristics of the women that are most likely to work in those jobs, we will cross-reference the labor/employment data with a number of data sources on chemical exposures including measured and estimated levels of exposure from international and national occupational health agencies, as well as lists of compounds generated by scientific researchers that have been identified as relevant to breast cancer (including chemicals that cause mammary tumors, disrupt mammary development, or interfere with hormone regulation). Through this process we will generate a profile of potential breast cancer-related occupational chemical exposures among California women based on existing data. These data will then be complied into a publically-available searchable online database that would provide an interactive visualization tool that could be used by decision makers, advocates, and researchers to identify which California industries/occupations and occupationally-used chemicals pose the highest potential risk for breast cancer. The scope of this data visualization tool will be determined (and likely limited) by the availability of accurate and complete data relevant to the workplaces of California women. Importantly, this process will help to identify key gaps in data required to build a more systematic and comprehensive system to better track these exposures – gaps that could be filled by policy efforts to enhance government-maintained data resources. Additionally, these initial efforts will guide us in the development of a more in-depth study of occupational exposures that we will conduct during the final phase of this research project. The objective of this pilot exposure study will be to collect detailed information on occupational chemical exposures in a workforce identified as a priority of concern for breast cancer. Depending on what is most appropriate to the workforce and exposures being studied, we will consider a variety of approaches for data collection including participant questionnaires/interviews, field observations, workplace exposure sampling, and biological monitoring. The results from this pilot study will provide important preliminary data to inform the design of future studies of breast cancer, as well as the development of intervention strategies to reduce exposures.

Our approach has a number of innovative elements, foremost of which is the integration of community, worker and employer input throughout the entire course of the project. Input from a diverse advisory committee and periodic town-hall style meetings with key stakeholders who have an interest and expertise in worker health will be used to inform the design and implementation of the study. In particular, such input will help to identify women employed in the so-called ‘informal economy’ consisting of jobs that are not captured by government data and may operate outside established labor laws and lack health safeguards. This engagement will enhance the dissemination of our results to affected communities and policy-makers, ensuring our findings are appropriately translated to meaningful efforts that ultimately could lead to the prevention of occupationally-caused breast cancer.