Advancing environmental epidemiologic methods to conform the cancer burden.

Even though many environmental carcinogens have been identified, studying their effects on specific cancers has been challenging in non-occupational settings where exposures may be chronic but at lower levels. Although exposure measurement methods have improved considerably, along with key opportunities to integrate multi-omic platforms, there remain challenges that need to be considered particularly around the design of studies. Cancer studies typically exclude individuals with prior cancers and start recruitment in midlife. This translates into a failure to capture individuals who may have been most susceptible because of both germline susceptibility and higher early life exposures that lead to premature mortality from cancer and/or other environmentally caused diseases like lung diseases. Using the example of breast cancer, we demonstrate how integration of susceptibility, both for cancer risk and exposure windows, may provide a more complete picture regarding the harm of many different environmental exposures. Choice of study design is critical to examine the effects of environmental exposures, and it will not be enough to just rely on the availability of existing cohorts and samples within these cohorts. In contrast, new, diverse, early onset case-control studies may provide many benefits to understanding the impact of environmental exposures on cancer risk and mortality.

Cancer Risk Reduction Through Education of Adolescents: Development of a Tailored Cancer Risk-Reduction Educational Tool.

Growing evidence links adolescent exposures to cancer risk later in life, particularly for common cancers like breast. The adolescent time period is also important for cancer risk reduction as many individual lifestyle behaviors are initiated including smoking and alcohol use. We developed a cancer risk-reduction educational tool tailored for adolescents that focused on five modifiable cancer risk factors. To contextualize risk factors in adolescents' social and physical environments, the intervention also focused on structural barriers to individual- and community-level change, with an emphasis on environmental justice or the fair treatment and meaningful involvement of all people regardless of race, color, national origin, or income with respect to the development, implementation, and enforcement of environmental laws, regulations, and policies. The educational tool consisted of a 50-min module that included an introduction to cancer biology including genetic susceptibility and environmental interactions, cancer burden in the local community, and risk reduction strategies. The module also included an interactive activity in which adolescent students identify cancer risk factors and brainstorm strategies for risk reduction at both the individual and community level. We administered the module to 12 classes of over 280 high school and college students in New York City. Cancer risk reduction strategies identified by the students included family- or peer-level strategies such as team physical activity and community-level action including improving parks and taxing sugary foods. We developed a novel and interactive cancer risk-reduction education tool focused on multiple cancers that can be adopted by other communities and educational institutions.

Development and validation of a method to quantify benefits of clean-air taxi legislation.

Air pollution from motor vehicle traffic remains a significant threat to public health. Using taxi inspection and trip data, we assessed changes in New York City's taxi fleet following Clean Air Taxi legislation enacted in 2005-2006. Inspection and trip data between 2004 and 2015 were used to assess changes in New York's taxi fleet and to estimate and spatially apportion annual taxi-related exhaust emissions of nitric oxide (NO) and total particulate matter (PMT). These emissions changes were used to predict reductions in NO and fine particulate matter (PM2.5) concentrations estimates using data from the New York City Community Air Survey (NYCCAS) in 2009-2015. Efficiency trends among other for-hire vehicles and spatial variation in traffic intensity were also considered. The city fuel efficiency of the medallion taxi fleet increased from 15.7 MPG to 33.1 MPG, and corresponding NO and PMT exhaust emissions estimates declined by 82 and 49%, respectively. These emissions reductions were associated with changes in NYCCAS-modeled NO and PM2.5 concentrations (p < 0.001). New York's clean air taxi legislation was effective at increasing fuel efficiency of the medallion taxi fleet, and reductions in estimated taxi emissions were associated with decreases in NO and PM2.5 concentrations.