A group of associations and professionals point to the absence of an environmental health component in the cancer strategy. Among them, the cardiologist Pierre Souvet, president of the Association Sant Environnement France. Interview.
Cardiologist – President of the Association Sant Environnement France
Actu-Environnement: The government presented a new strategy against cancer in February. Does it take the risks into account correctly?
Pierre Souvet: There are things about the individual factors but nothing about the collective factors. However, environmental pollution is a risk factor: cancer, cardiovascular or pulmonary diseases in particular. Whether you smoke is a risk factor, but being exposed to air pollution is another. The experience of Tokyo, which decided in 2000 to reduce particulate pollution, is extraordinary. After the ban on diesel in cities, particulate pollution fell by 44%. Mortality from lung cancer has fallen by 4.9%, lung mortality by 22% and cardiovascular mortality by more than 10%. I do not have a drug capable of reducing mortality at this point. It is therefore necessary to treat environmental risk factors as individual factors.
AE: What are the environmental risk factors?
PS: The three big factors are air pollution, pesticides and endocrine disruptors, knowing that there are growing links between them. There are also emerging risks: electromagnetic waves, nanoparticles, persistent pollutants, problems linked to climate change. These are risk factors that can add up to a pathology. The chemical contamination to which one is subjected participates in the outbreak of pathologies, in particular cancerous ones. If you are exposed to pesticides, you are more likely to get brain cancer or leukemia. With 5G, as with nanos, we are launching the technology without any hindsight. We have nothing to prove that it is dangerous but, at this stage, we cannot say either that it is not, because no reliable study is available.
AE: What are the drawbacks of not taking collective risks into account?
PS: For a real prevention policy, we must also take into account these risk factors and not just say it is not allowed to smoke . According to Health Insurance figures, reimbursement rose from 123 billion euros (€ bn) in 2012 to € 142 billion in 2018. Projections show that there will be 232,000 more cancer patients in 2023, not counting cardiovascular pathologies and other chronic illnesses. It is a colossal financial issue that cannot be solved with a care or prevention policy. a minima. Only 1 2% of France’s health budget is devoted to prevention. There is less than a full time equivalent dedicated to environmental health to the Minister of Health. We are faced with a real difficulty in ensuring that this prevention dimension is taken into account. However, young health professionals, who do not have a good grasp of the subject for lack of adequate training, wish to develop this aspect of health. Things should be able to change in the first cycle of medical studies via the fourth national environmental health plan.
AE: How do you explain that the public authorities do not give prevention the importance it should have?
PS: I don’t explain it. There is a total mismatch between the stakes and the means. If we do not want the green card to be replaced by the blue card, we must develop prevention to reduce human, financial and social costs. Because, often, environmental inequalities combine with social inequalities. It is clear that lobbies have slowed down evolution. But there is now an awareness, especially in cities, on the subject. We succeeded with the Crit’Air1 sticker to exclude diesels. These, even new, remain very polluting through the ultrafine particles.
AE: Doesn’t the lack of action of the public authorities come from the lack of information?
PS: Two years ago we asked with the Health to generalize and territorialize cancer registries. There are only about twenty registers and, oddly enough, there are none in the big cities. The risks are not the same in an industrial basin as in an agricultural or urban area. The minister replied that the registers were not designed to be warning or action tools, nor were they intended for surveillance. How to make a public health policy without data? It is essential to have an effective and responsive policy. There are places where more targeted actions are needed on pesticides, others on air pollution or elsewhere on endocrine disruptors.the Minister of
AE: Does this lack of data explain the absence of actions in areas where pediatric cancers have multiplied, such as Sainte-Pazanne in Loire-Atlantique?
PS: Yes, we react badly and too late. has been reported in this area for years. The public authorities have enlarged the territory so that the percentage of cancers appears to be lower. There is, however, a real problem. And there are some elsewhere but that we do not know, for lack of data.
AE: How can we territorialize environmental health?
PS: It is necessary to give the competence to the local collectivities. This will make it possible to carry out territorial health-environment diagnoses. A priori, we will get nothing more during this term. The challenge is to launch a discussion with the regions, metropolitan areas, EPCIs and municipalities to find out which level is the most appropriate. It is nevertheless already possible to act via local health contracts. Subsidized by regional health agencies (ARS), they allow cities to carry out diagnoses to adapt their policies and integrate this prevention dimension which is so lacking.
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New pesticides recognized as carcinogens by the WHO (article published on 03/23/2015) The international cancer research center has recently classified glyphosate, malathion and diazinon as probable carcinogens for humans.
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Article published on March 06, 2021