Reducing Environmental and Occupational Cancer Risks Toolkit


As noted in earlier sections, policy-level interventions are important strategies for creating change, including at the institutional level. Schools, universities, and businesses may issue their own policies to support the use of healthier products and processes, for example.  Additional policy-level intervention strategies include approaches being used by municipalities and state governments to support chemical restrictions and air quality improvements.

Intervention Strategy Types: Eliminate, Substitute, Redesign

There is consistency in the research literature regarding the increased risk of childhood leukemias associated with the use of home and garden pesticides (Chen et al. 2015); (Van Maele-Fabry et al. 2019). These same pesticides are used by facility staff at schools, daycares, public parks, and other public locations and facilities. Integrated Pest Management (IPM), is a strategy that focuses on the long-term prevention of pests or their damage, using chemical pesticides as a last resort. The creation of policies to support the implementation of IPM as a substitute for conventional pesticides is an intervention strategy being utilized by state-wide and municipal-level asthma programs. Where IPM reduces or eliminates pesticides that contribute to cancer, these programs provide co-benefits by reducing cancer risk. Most states have agricultural extension programs with deep experience with IPM that can be leveraged for a variety of use needs. However, since IPM practices still allow for the use of conventional pesticides as a last resort, it is important that jurisdictions pursue aligned policies that also restrict the use of carcinogenic pesticides, for example use of Round-up, given links with non-Hodgkin lymphoma (IARC 2015). Policies directing the use of IPM as substitutes for conventional pesticides are available at the state level, e.g., Massachusetts, and municipal level e.g., San Francisco, CA, Portland, OR, Santa Fe, NM.

  • Example ObjectiveIncrease the use of integrated pest management via policy change.
  • Example Intervention strategy: (A) Develop partnerships to provide education and outreach to facility managers at schools, municipal parks and recreation departments, as well as owners of facilities such as daycares, to leverage and expand upon existing programs to support greater adoption of IPM; (B) Develop partnerships to explore policy opportunities that restrict the use of carcinogenic and other problematic pesticides and support the use of IPM as a safer alternative in public facilities and recreational areas, based on model examples used in other jurisdictions.

Intervention Strategy Type: Substitute

Although the U.S. EPA has recently pursued several chemical restrictions made possible by recent amendments to the Toxics Substances Control Act, the U.S. lags significantly behind banning or restricting from commerce highly hazardous chemicals, including carcinogens. As such, states across the country have issued a range of chemical restrictions, many of which focus on chemicals in consumer products because of widespread exposuresSafer States tracks and creates a compendium of state chemicals policies which can be used as motivation and models for other states. Prohibition policies range from PFAS in food packaging, heavy metals in children’s jewelry, a number of chemicals in cosmetic and personal care products, and halogenated flame retardants in textiles, furnishings, and children’s products (e.g., clothing, and mattresses).

  • Example Objective: Reduce exposure to carcinogenic chemicals in consumer products.
  • Example Intervention strategy: Work with partners to advance policies that restrict the use of specific carcinogenic substances in processes or consumer products.

Intervention Strategy Types: RedesignSubstitute

 Air pollution can be an important contributor to the development of cancers. The mixture of air pollution as well as individual components in the air pollution mix are considered known human carcinogens by the World Health Organization’s International Agency for Research on Cancer (IARC) (IARC 2015). Increasing evidence suggests that near roadway air pollution exposure is also a risk factor for childhood cancers (Boothe et al. 2014); (Heck et al. 2013); (Filippini et al. 2019). In addition, evidence suggests that exposure to air pollution is associated with poorer cancer survival and treatment complications among cancer patients (Eckel et al. 2016); (McKeon 2022); (Ou et al. 2019). Researchers recently reviewed a number of evidence-based interventions to support air pollution exposure reductions (Turner et al. 2020).

  • Example Objective: Reduce exposure to air pollution. 
  • Example Intervention Strategies. Partner with state-wide asthma program partners and environmental advocacy organizations to explore the development of policies that reduce air pollution levels through:
  1. The adoption of mixed-use urban designs encourages shifting from the use of private vehicles to public transportation and increased active transportation (walking and biking).  
  2. Transition local government vehicles to electric vehicle fleets. 
  3. Changes in zoning policies to improve set-back distances from roadways and other strategies such as establishing “clean air zones” and enhanced zoning provisions for public transport services

Intervention Strategy Types: Encourage; Educate; Redesign; Substitute; Eliminate

In the 1980s, a growing number of Massachusetts communities were suffering the consequences of poorly managed hazardous waste sites, including the emergence of cancer clusters. In July 1989, the Massachusetts legislature passed the Toxics Use Reduction Act which was supported by environmental advocacy organizations, academic institutions, public health organizations, and industry associations alike. Key features of the business-focused policy include: (a) requiring “polluters to pay” – mandating a reporting fee associated with the use of toxic chemicals to support understanding of where, why, and how much toxic chemicals are being used and generated as waste; (b) requiring education and planning to identify options to reduce toxic chemical use; and (c) using revenue generated from fees to provide direct technical support to industry to implement toxics use reduction options.  

The law has been highly effective at reducing the use of toxic chemicals in the state, including carcinogens. In a published evaluation, the state documented a 32% decline in the use of carcinogens and a 93% decline in carcinogenic emissions over a 20-year period (1990-2010). During this period, there was a 92% decline in the use of trichloroethylene, an 85% reduction in tetrachloroethylene, and a 69% reduction in the use of cadmium and cadmium compounds. Use reductions in particular showcase the importance of encouraging and educating companies about toxic use reduction options; redesigning industrial processes to minimize or eliminate the use of toxic chemicals; and using substitution strategies to transition to safer alternatives.  

  • Example Objective: Establish a Toxics Use Reduction Program. 
  • Example Intervention Strategies: Partner with state-wide organizations to explore the development of a Toxics Use Reduction policy that includes provisions to (1) track the use of toxic chemicals in the state; (2) incentivize toxics use reduction through a graduated fee structure and toxics use reduction planning requirements; and (3) support pollution prevention programming, including research and technical assistance programs to regulated entities and communities.

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