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The World Cancer Report released by the World Health Organisation (WHO) early this year was shocking. Not only the worldwide burden of cancer has increased many times, middle-income and poor countries account for more than 60% of the globe’s cancer cases and 70% of deaths. This confirms what we know from India’s cancer registry released by Indian Council of Medical Research last year. Cancer is exploding. Way back in 2006, India’s National Cancer Control Programme’s forecast was that by 2026, more than 1.4 million people will be in the grip of some form of cancer. It also said that exposure to environmental carcinogens is the most important reason for cancer.

People are living longer but cancer deaths are also taking a heavy toll. Is public policy in India responding adequately? Clearly not, as is evident in the case of air pollution. The International Agency for Research on Cancer of WHO has declared outdoor air pollution, particulate matter and diesel particulates as top carcinogens with strong links with lung cancer. But India’s public policy has not responded to this.

Official policy remains mute even when the joint epidemiological study of Central Pollution Control Board and Chittaranjan National Cancer Research Institute throw up stunning evidence. Their 2012 study states that most of the airway diseases including cancer take a long latent period to develop and early cellular changes can help to identify the persons at risk. They have found early changes in airways cells—the pathway of cancer—to be “four to five-times more prevalent among the residents of Delhi who are chronically exposed to high level of air pollution".

Scientists from the Chittaranjan National Cancer Research Institute in Kolkata say they are now seeing higher incidence of cancer among the young. Doctors from All India Institute of Medical Sciences say 30% of lung cancer patients do not have any history of smoking. A few Indian studies have evaluated volatile organic compounds, benzene, polycyclic aromatic hydrocarbons (PAH), all known carcinogens that come largely from vehicles. In Delhi, Kolkata and Bangalore, air quality data indicate unacceptable levels of benzene, PAH and heavy metals.

These official findings and the minimal toxin programme are not used effectively to inform public policy for stringent emissions standards for vehicles and industry. CPCB has notified hazardous pollutants for the industrial sector. Its reports have listed toxins from vehicles including benzene, butadiene, chromium and diesel particulate matter. Ambient air quality standards have been revised to include six air toxins and heavy metals. But their capacity to monitor and regulate toxins is dismal. Some deadly carcinogens like mercury are not even regulated despite their proven links to cancer.

What’s slowing down action in India is the refusal to act on available evidence, dismissing them as insufficient and inconclusive, and using lack of local research as an excuse for inaction. But globally, regulators are using hard evidences as well as applying the precautionary principle to restrict use of toxins and cut emissions that have a reasonable chance of causing significant harm. This is important when thousands of chemicals have found ways into manufacturing processes and consumer products, and emissions from vehicles and industry have increased even before their toxic effects could be evaluated fully.

It is suicidal to wait for the perfect proof to act on suspected or proven carcinogens because exposure today will show up as cancer much later in life. It takes 15 to 30 years for cancer to surface and pass on to the next generation. This requires urgent action to prevent exposure early in life. The US Environmental Protection Agency (EPA) has identified about 190 air toxins, but to set standards and regulations for each of them will take far too long. So far, detailed regulations have been developed only for a bunch of them. The EPA has taken the extra step to set emissions limits of a toxin in relation to the best performing technologies in the industry through the maximum achievable control technology programme to cut risk. It can also ask for more stringent limit to protect health. Europe regulates as well as takes the precautionary approach to bar toxins.

It’s clear that more research is needed. But India cannot shift the burden of proof to the victims of pollution. The onus should be on the industry that introduces chemicals and technologies. People cannot offer to be the guinea pigs to prove the lethal effects for our government to act.

The policy question is not whether India has enough evidence but whether it has the wisdom to respond to the global body of knowledge to kick in stringent controls quickly. What is the point of rapid economic growth if the current and future generations mutate?

Anumita Roychowdhury is executive director, research and advocacy, at Delhi-based non-profit Centre for Science and Environment.

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