Air pollution as a carcinogenBMJ 2013; 347 doi: https://doi.org/10.1136/bmj.f7607 (Published 20 December 2013) Cite this as: BMJ 2013;347:f7607
- Krishnan Bhaskaran, lecturer in statistical epidemiology,
- Ben Armstrong, professor of epidemiological statistics,
- Paul Wilkinson, professor of environmental epidemiology,
- Andy Haines, professor of public health and primary care
- 1London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
The possibility that air pollution might increase the risk of cancer is not a new idea. Richard Doll and Austin Bradford Hill initially believed that general atmospheric pollution from car exhaust fumes, surface dust of tarred roads, gas works, industrial plants, and coal fires might be responsible for the increased incidence of lung cancer in the first half of the 20th century. However, their landmark 1950 paper implicated tobacco smoking and set the direction for decades of research that firmly established smoking as a leading cause of lung cancer.1 By contrast, research into other possible causes was relatively neglected, and further evidence on the effects of air pollution was slow to accumulate.
However, more than 60 years later, the International Agency for Research on Cancer has released a monograph concluding that there is sufficient evidence to establish outdoor air pollution as carcinogenic to humans.2 This conclusion is based on consistent associations between pollution levels and the risk of lung cancer in animals and humans, as well as strong mechanistic evidence. …