Death rates for second cancer higher for Black, Hispanic people

Black and Hispanic Americans who have cancer for a second time are at higher risk of dying than their white counterparts, new research shows. 

Published Aug. 4 in JAMA Network Open, the study found that Black people with a second cancer experienced 21% higher cancer-related death rates than whites, and Hispanic people experienced 10% higher death rates. 

Black and Hispanic patients tended to be diagnosed with a second cancer at a later stage than white patients, complicating treatment, the American Cancer Society researchers noted. Later-stage diagnoses were more common for breast cancer, uterine cancer and melanoma among patients of color.

Black patients also were more likely to die from cardiovascular-related causes than white patients, with 41% higher death rates. 

Social determinants such as lower access to care or income may play a role in the disparities, the researchers said. Compared to white patients with a second cancer, both Black and Hispanic patients were more likely to be younger and live in a metropolitan area, and Black patients were most likely to live in counties with the lowest household incomes.

About 20% of cancer cases diagnosed annually in the U.S. occur in people who have previously had the disease, other research has found.

EPA: Alabama coal ash plan falls short

Alabama’s plan to manage coal ash doesn’t go far enough to protect human health or water sources and should be denied, officials with the U.S. Environmental Protection Agency said Aug. 3.

Citing potential threats to community health, the EPA proposed that the Alabama Department of Environmental Management’s application for a coal ash permit program be rejected. 

The Alabama plan falls short on issues such as groundwater monitoring and management of surface disposal areas and would not meet federal safety regulations, the agency review concluded. For example, Alabama’s application failed to adequately address how groundwater would be kept from infiltrating coal ash storage sites as they are being closed, the EPA said.

Coal ash is a byproduct of coal-fired power plants and can pollute drinking water with mercury, chromium arsenic and other contaminants, endangering human health. 

The rejection, which is subject to a 60-day public comment period, would be the EPA’s first denial of a state coal ash permit program.

Air pollution raises risks for colorectal, prostate cancers

Researchers have identified a possible new contributor to increasing rates of colorectal and prostate cancer: air pollution. 

Chronic exposure to airborne fine particulate matter, also known as PM2.5, can raise risks for the two cancers, even at low levels, according to new research.

Published Aug. 1 in Environmental Epidemiology, the study examined 10 years of data on older adults and their exposure to air pollutants. The longer the people in the study were exposed to PM2.5, the greater their risks were for the two cancers. 

Increased risks were also found for exposure to nitrogen dioxide, also known as NO2, though at lower rates.

The study also confirmed links between breast cancer risk and exposure to NO2, a pollutant primarily linked with vehicle emissions. Black Americans and low-income people were at highest risk for prostate and breast cancer from PM2.5 exposure.

Prostate cancer cases are on the rise in the U.S., increasing 3% per year from 2014 to 2019, a January report found. Colorectal cancer rates have been climbing among people under age 50, increasing by as much as 2% a year over the past three decades.

Diesel exhaust harmful for mine workers

Underground mine workers can add more diseases to the confirmed list of dangers they face from on-the-job exposure to diesel exhaust.

Previous research has linked diesel engine exhaust to lung cancer deaths in mine workers, who can be exposed to high levels of the carcinogen while working underground. A new study in Environmental Health Perspectives confirmed that link and additionally found an elevated risk for death from non-Hodgkin lymphoma. Diesel exhaust exposure was also linked to heart and cerebrovascular disease, though not to deaths.

Diesel engines are commonly used in underground mining work. While workers in other professions that use heavy equipment — such as construction, truck driving and the railroad industry — also breathe in diesel exhaust, their exposure levels tend to be lower. Underground miners can be exposed to more than 10 times the level found in other workplaces, according to the National Institute for Occupational Safety and Health.

The new research, led by scientists from the National Cancer Institute, used data from the Diesel Exhaust in Miners Study, which tracked the health of more than 12,000 mine workers at eight facilities.

Antibiotic resistance worsened by air pollution

Air pollution may be worsening antibiotic resistance, contributing to nearly half a million deaths in 2018 alone, new research says. 

The study — published Aug. 7 in The Lancet Planetary Health — found a link between PM2.5 and growing antibiotic resistance. 

Using data collected in more than 100 countries from 2000-2018, researchers calculated that for every 1% increase in PM2.5, antibiotic resistance rose as much as 1.9%. 

While PM2.5 is commonly associated with sources such as wildfire smoke and power plant emissions, it may also carry particles from farms, sewage treatment facilities or hospitals, thereby spreading resistant bacteria or genes, the study suggested.

The researchers estimated PM2.5 accounts for 11% of increases in antibiotic resistance worldwide and as much as 19% of increases in North Africa and western Asia. At current rates, global antibiotic resistance linked to PM2.5 pollution could grow by 17% by 2050, leading to 840,000 annual premature deaths.

More than 2.8 million antimicrobial-resistant infections occur annually in the U.S., resulting in an estimated 35,000 deaths, according to the Centers for Disease Control and Prevention.

The Watch is written by Michele Late, who has more than two decades of experience as a public-health journalist.