Volume 221 - Issue 8
Planetary care is good cancer care
Authors: Nikki Burdett and Ben Dunne
Med J Aust 2024; 221 (8): 447-447. || doi: 10.5694/mja2.52455
Published online: 21 October 2024
Published online: 21 October 2024
Comment
To the Editor: Recently, more than 400 Australian doctors (including both authors) signed an open letter published in The Australian,1 calling on our federal government to protect the health of Australians by banning any new fossil fuel projects.
From the perspective of clinicians treating cancer, there are many reasons that this is an urgent request. Aside from their contribution to greenhouse gas emissions, fossil fuel projects increase air pollution and particulate matter less than or equal to 2.5μm in diameter (PM2.5), which are both risk factors for lung cancer.2 This includes EGFR‐mutated lung cancer, which is classically associated with never smoking or light smoking.3 Disturbingly, air pollution is linked to increased mortality in paediatric and young adults with cancer.4 Air and wastewater pollution generated by fossil fuel projects contains multiple carcinogens. This includes benzene, which is associated with haematological malignancies; additional studies demonstrate a positive association between residential proximity to petrochemical facilities and leukaemia.5,6,7,8
While new projects have been recently approved across the nation, the Beetaloo Basin and Middle Arm project are the most notable, with echoes of the distressing Louisiana petrochemical corridor (United States), which is also referred to as “cancer alley” due to residents’ disproportionate exposure to toxic industrial by‐products.8,9 Australia risks creating its own “sacrifice zone”, harming the health of its people and contributing irrevocably to the climate crisis.
Natural disasters and extreme weather events amplified by climate change also disrupt access to care, which is critical for patients undergoing cancer treatment and translates to poorer outcomes.
Aside from cancer, there are various other risks, including asthma, cardiovascular disease and pre‐term birth. These are avoidable and unacceptable illnesses, which can lead to deaths.
When the evidence that smoking harmed health was overwhelming, doctors championed this message and took action. In 2024, we — as physicians — need to convey the message that banning new fossil fuel projects is not a political ask, rather is essential to protect the health of our nation.
Competing interests
Both authors are active members of Doctors for the Environment Australia, and signed the open letter, which is referenced in this manuscript.
References
- The Australian. Coal, oil and gas are health hazards [letter to the Australian Government]. Doctors for the Environment Australia and The Australia Institute, 12 June 2024. https://assets.nationbuilder.com/docsenvaus/pages/1049/attachments/original/1718144440/Doctors_for_Environment_Open_Letter__PRESS_‐_540x372_AUTH_.pdf?1718144440 (viewed June 2024).
- Loomis D, Grosse Y, Lauby‐Secretan B, et al. The carcinogenicity of outdoor air pollution. Lancet Oncol 2013; 14: 1262‐1263.
- Hill W, Lim EL, Weeden CE, et al. Lung adenocarcinoma promotion by air pollutants. Nature 2023; 616(7955): 159‐167.
- Ou JY, Hanson HA, Ramsay JM, et al. Fine particulate matter air pollution and mortality among pediatric, adolescent, and young adult cancer patients. Cancer Epidemiol Biomarkers Prev 2020; 29: 1929‐1939.
- McHale CM, Zhang L, Smith MT. Current understanding of the mechanism of benzene‐induced leukemia in humans: implications for risk assessment. Carcinogenesis 2012; 33: 240‐252.
- Elliott EG, Ettinger AS, Leaderer BP, et al. A systematic evaluation of chemicals in hydraulic‐fracturing fluids and wastewater for reproductive and developmental toxicity. J Expo Sci Environ Epidemiol 2017; 27: 90‐99.
- Jephcote C, Brown D, Verbeek T, Mah A. A systematic review and meta‐analysis of haematological malignancies in residents living near petrochemical facilities. Environ Health 2020; 19: 53.
- James W, Jia C, Kedia S. Uneven magnitude of disparities in cancer risks from air toxics. Int J Environ Res Public Health 2012; 9: 4365‐4385.
- Robinson ES, Tehrani MW, Yassine A, et al. Ethylene oxide in Southeastern Louisiana's petrochemical corridor: high spatial resolution mobile monitoring during HAP‐MAP. Environ Sci Technol 2024; 58: 11084‐11095.
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