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Blessing Afolabi
Cancer is believed to be the leading cause of death globally. There have been concerns over the increase in carcinogens in food, water, and other household items humans come in contact with daily.
The World Health Organisation stated that cancer accounts for an estimated 10 million deaths in 2020 or one in six deaths. WHO noted that the cancer burden continues to grow globally, exerting tremendous physical, emotional, and financial strain on individuals, families, communities, and health systems. Many health systems in low- and middle-income countries are least prepared to manage the burden, and large numbers of cancer patients globally do not have access to timely quality diagnosis and treatment.
The National Cancer Institute of the United States stated that cancer is caused by changes to certain genes that alter cellular function some of which occur naturally when DNA is replicated during the process of cell division. But others are the result of environmental exposures that damage DNA.
The US NCI noted that people can avoid some cancer-causing exposures, such as tobacco smoke and the sun’s rays. But other ones are harder to avoid, especially if they are present in the air, water, food, or in materials people use in their daily jobs. Understanding which exposures are harmful, and where they are found may help people to avoid them.
A recent study by the programme collaborators for Environmental Influences on Child Health Outcomes in the United States of America disclosed that pregnant women were at risk of cancer when exposed to chemicals from plastics, cleaning products (bleaching agents), clothing, and cookware/dishware among other household items.
Pregnant women are not only prone to cancer through exposure but they can as well transfer toxicants/diseases from the placenta to the unborn child.
Findings from the research provided important public health implications by estimating exposure levels of widespread chemicals that are not well-characterised during pregnancy and not routinely bio-monitored and exploring their socio-demographic predictors.
The report stated, “The ubiquitous detection of both melamine and cyanuric acid in our pregnant population is concerning since kidney toxicities have been reported at varying exposure levels and there is potential for developmental effects.
“Additionally, our population is exposed during the prenatal period which could increase the risk for developmental effects in the children due to unique or heightened periods of developmental susceptibility and the potential for maternal-foetal transfer via the placenta and breast milk. Populations residing within proximity to hazardous waste sites may also be exposed to toxicants which have been identified in groundwater and soil samples.”
The researchers opined that epidemiologic investigations of pregnancy exposures were limited and called for assessments of combined exposures to toxicants in the pregnant population, and their potential links to adverse health outcomes in children.
They urged continuous identification of environmental factors that can play an important role in maternal and child health.
Experts opined that preventive measures and adequate biomonitoring were the solutions to the deterrence of carcinogenesis and developmental effects on maternal and child health.
Commenting on the issue, a professor of nutritional biochemistry and toxicology at the Federal University of Technology, Akure, Ondo State, Afolabi Akindahunsi, stated that carcinogens were ubiquitous due to technological advancement and industrialisation.
He noted that carcinogens were present in air, food, and water with one of the major sources being plastics, stating that waste treatment disposal in the environment was poor which he noted increased the presence of carcinogens and predisposed individuals to them.
He added that food products both cooked and uncooked including water were stored in plastic materials. He explained that certain water quantities went through a cycle of freezing and thawing thereby increasing the rate at which carcinogens get into the food.
The toxicology expert stated that there were carcinogens that could be prevented, noting that those found in the air or water cannot be averted because they were a result of environmental pollution and waste. According to him, some laboratory investigations such as X-rays which can convert non-carcinogens to carcinogens also contribute to increased exposure to unsafe agents.
He further stated that when pregnant women were exposed to those chemicals, their immunity would be compromised thus affecting the status of the developing foetus.
Akindahunsi also said that the chemicals could be transferred from the mother to her unborn child and cause complications such as low birth weight or pregnancy loss.
He however stated that with issues that pertained to health, prevention was more effective and less expensive than cure. He advised that avoiding identified sources of cancer-causing agents and creating awareness regarding the reduction of plastic use would reduce the risk of the onset of carcinogenesis.
He also noted that drinking water from plastic bottles left in the car which had been heated and cooled down was dangerous.
On the use of biomonitoring to curb exposure to carcinogens, Akindahunsi said that biomonitoring was limited to biomarkers for specific cancers, noting that more could be achieved through prevention.
He added, “The golden rule is to be careful and conscious of what you eat or drink and avoid industrial areas where the air pollution is visible though other areas could have some pollution too. Pollutants in the air are numerous, even in areas where it seems the air is odourless. Potable water must be analysed and plastic use should be avoided. A pregnant woman should be more careful because her immunity is compromised and the developing foetus can be affected by the chemicals.’’
On his part, a professor of toxicology at the Usmanu Danfodiyo University, Sokoto State, Mu’azu Abubakar, noted that pregnant women were part of the vulnerable group in terms of exposure to toxicants, stating that once the toxicants got into circulation it was difficult to stop them.
He explained that pregnant women exposed to cancerous agents could transfer the toxicants to the child through the placenta, which can get into the embryo and affect the developing foetus, adding that the child could be born with some postnatal defects.
He stated, “The tendency is there. They are more vulnerable because the effect is not only on them but on their babies. Anything classified as carcinogenic can affect the mother and the baby. That is how dangerous it can be for them. The only way out is to reduce exposure to the substances. If polythene bags are being burnt in their vicinity, they should avoid it or stop the use of substances that could predispose them to toxicants.”
He noted that preventing exposure to toxicants was tantamount to preventing exposure to cancer and other attendant developmental issues. He further said that routine tests were far-fetched as research was on selective issues, noting that the healthcare system lacked the facility to test for the carcinogenic agents.
He said, “Plastics and other toxicants are all over and exposure is unavoidable. Biomonitoring is to be done to ascertain environmental impacts but it is not done. It is only done in academics during research. The Environmental Protection Agency does not have the capacity to biomonitor.
“The environment is polluted but biomonitoring will help us ascertain the extent of damage and then communities can be advised. Without adequate biomonitoring, we can only advise a reduction in the use of the substances. If an area has a history of neonatal deaths then we can start monitoring, do analysis and advise appropriately but now we can only generalise.”
He advised the intake of antioxidants or nutrients to guide against exposure to toxicants.
In his contribution, a professor of Obstetrics and Gynaecology at the University of Benin, Edo State, Friday Okonofua, said that awareness and adequate information on the risks of exposure to cancer-causing chemicals would help pregnant women reduce the usage of materials linked to the agents.
He said, “If pregnant women know these chemicals are harmful they will begin to reduce their use. The chemicals are found in everything we use. The water we drink is in plastics and the chemicals can leak into the water. The fish we eat are exposed to the chemicals. Some of the chemicals are used as pesticides and fertilisers. They get into our food and we eat them.”
He urged women to reduce their intake of artificially processed foods, use of dyes, and other chemicals, especially during pregnancy.
Okonofua, however, noted that the risk of congenital malformation was low in Nigeria compared to developed countries because Nigeria had yet to be industrialised.
He stated that pregnant women were usually advised to take folic acid acting as an antioxidant against such chemicals.
The don said, “We advise women to take folic acid three months prior to pregnancy and should continue even after the first trimester until they give birth. We recommend an ultrasound scan at the beginning and during the second trimester of the pregnancy to detect any sort of malformations in the baby. There are also other procedures between 12 and 14 weeks of pregnancy to help detect such malformations.
“Women who have a family history of cancer should ensure to go for routine checks and procedures. If they limit exposure to the chemicals and take supplements such as folic acid regularly, the risk level will be nominal.”
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