We've all heard of breast cancer and seen the pink ribbons, but what do we really know about it? Surely you've heard about things like inherited genetic risk or lifestyle factors like smoking, alcohol use, and lack of exercise. But there are also a lot of environmental factors that increase the risk of breast cancer too (1,5). Some of these environmental factors come from things like toxic chemicals in our personal care products and cleaning solutions, endocrine disrupting chemicals that find their way into our food, processed foods, poor air quality, and much more. This means aspects of our home life and the outside world could make us more susceptible to breast cancer. It's not just the cocktails and our seemingly inability to get off the couch and go for a run! And yes, "us" really means all of us! Whether you're a man, woman, non binary, transgender, or you're over the age of 50 or are young enough to know how Tik Tok works, breast cancer affects us all. The way breast cancer develops and knowing the risks for it can be tricky and sometimes uncontrollable, but it doesn't mean there aren't ways to limit your exposure to these lesser-known environmental risks, so keep reading to find out how!

Environmental factors and breast cancer

In our daily life we come into contact with a lot of products that may contain chemicals that increase our risk for developing breast cancer. These chemicals may be in the cleaning products we use, cosmetics, our food, our air, and even our water. You may have even heard of some of them like heavy metals, PCBs, radiation, pesticides, and a whole host more. But to spare you about 8 hours, we will just mention a few!

Personal care and cleaning products

The usual suspects of harmful chemicals in our cosmetic and cleaning products are also the ones that are putting us at risk for breast cancer. Chemicals like BPA, phthalates, parabens, and PFAS have all been studied for their correlation with breast cancer (2). BPA and phthalates, which are often added to plastics, have been tested in a myriad of breast cancer studies for their endocrine disrupting abilities. Being exposed to these chemicals in utero or even in puberty can alter the development of mammary glands and increase an individual's risk for breast cancer later in life. While there is still ongoing research, laboratory studies show BPA alters mammary growth and development in rodents and other mammals and can increase the risk of tumor formation (3). And phthalates, which are also found in many fragrances, showed a high association with breast cancer and people who used cleaners and air fresheners frequently throughout their life (2).

Parabens, another group of endocrine disruptors, are often used in cosmetics as preservatives. Parabens have been found in biopsies of breast cancer tumors and have been shown to rapidly increase the numbers of human breast cancer cells (1). Then finally there is PFAS, a group of waterproofing chemicals found in many cosmetics that remains in our bodies and the environment for a very long time. PFAS has been found in amniotic fluid and placental cord blood samples and is linked with issues with mammary gland development during the prenatal and puberty stage. It has also been linked to delayed breast development in some studies (3). All of these chemicals have pretty serious effects over a long period of time and many of them are avoidable if we choose the right products!

Contaminated Food

Another risk factor we come into contact with everyday is our food. Some of the concerns include the use of pesticides and even the materials our food is packaged in. Many pesticides and herbicides used in agriculture are classified as endocrine disruptors and in animals studies have been shown to affect the development of mammary glands in both males and female rodents (1,6). Pesticides can often be found as residue on the food itself or in cases like fish, the pesticides can be found within the meat of the animal. Because pesticides are often found in water runoff, they leach into bodies of water and can be found in the fatty parts of fish (6).

Materials that come into contact with our food after it is grown can also potentially increase our risk. Contamination can be through packaging, processing, cooking, and food storage. For example, BPA is found in the lining of canned food and in many plastics. One study found that reducing intake of packaged foods decreased BPA levels in urine by 65% (1). Breast development is controlled by the endocrine system so being exposed to different endocrine disruptors in many forms can lead to altered breast development and an increased risk in breast cancer (7).

Poor air quality

Last up is all about what we breathe! There are many harmful air pollutants that come from a variety of sources like cars and industrial processes, but the one that has been correlated with breast cancer the most is nitrogen oxide. Nitrogen oxide (NOx) is considered to be a marker of traffic related air pollution because it comes from the burning of fuel in automobiles, trucks, and other equipment that run on combustion (5,8). This air pollutant has been linked to pre and postmenopusal breast cancer, as well as many other types of cancers. Air pollution is a tricky risk factor because we all have to breathe air, making it really hard to avoid, but it's often most concentrated in cities with high traffic and in communities of color (5,10,11).

Medical inequalities related to Breast Cancer

While explaining how all of these environmental risks affect us everyday, it's important to note that some groups of people are more at risk than others. In particular, Black women have a higher incidence of breast cancer before the age of 45 and are more likely to die from breast cancer at every age compared to White women. Many factors contribute to this including lack of insurance, fear of testing, delay in seeking care, barriers to early detection and care, and racial bias (9). A lot of the barriers minorities face comes directly from racism within the health care system as well as socioeconomic factors. One survey done at York State hospitals found that physicians have more negative perceptions towards African Americans and people of low or middle socioeconomic status. Another study found that 41% of Black women compared to 28% of White women had stated their doctor had never suggested mammography (9). So in many instances doctors are not recommending preventative care that could save a Black woman's life.

And not only are minority populations directly affected by the health care system, they are also disproportionately exposed to chemicals of concern for breast cancer, like the ones we discussed above. African Americans often have high body levels of many chemicals including PCB's, mercury, PAH's, and phthalates. And both African American and Hispanic populations have varying levels of BPA, PFAS, and triclosan compared to White populations (1). Beauty products marketed to Black and Brown women (such as skin lighteners, hair straighteners, and feminine hygiene products) contain harmful chemicals (12). In a time of ongoing social change these issues need to be addressed and brought to light. These barriers are not a choice, they are placed on these communities and put them at a disadvantage that is causing them to get sick.

Ways to avoid these environmental risks

It's almost impossible to know when, how, or if breast cancer might develop because of the many factors including environmental risks that are at play. But even though there isn't a definitive way to determine what might cause breast cancer, there are ways you can potentially reduce your exposure levels. Here are a few tangible ways to reduce your risk!

  1. First things first, do self breast exams and go in for regular mammograms with a licensed physician. You can do it yourself or have a partner help you! Here is a link on how to do a self breast exam!
  2. Reduce toxic cleaning products in your daily routine. Here are some natural cleaning alternatives we recommend for all purpose cleaners, floor cleaners, and laundry detergents. Check out our website for more alternatives!
  3. Also reduce the amount of toxic cosmetic products in your routine. Check out stores like Credo, Follian, Sephora clean, and Target clean to try some cleaner cosmetic products!
  4. Buy less fast food or even reduce the amount of times you go every week. Start by going one less day a week!
  5. Reduce the amount of packaged foods you consume to reduce your exposure to chemical additives in the plastic as well as the food!
  6. Buy organic fruits and vegetables if possible. Our secret for prioritizing organic produce is leafy greens, berries of all kinds, and things with skin you eat. If you prefer conventional produce make sure and wash the produce as much as possible to remove any possible residual pesticides!
  7. Buy an air purifier to keep the air you breathe in your home as clean as possible. Here are a few we recommend, but if you can't buy one here is how you can make your own!
  8. Drive less! It's easier said than done, but reducing vehicle emissions is a sure way to reduce the amount of air pollution we collectively breathe in!
  9. Donate to organizations that are fighting against medical racism and trying to reduce the health disparities for people of color. Some organizations are The Center for the study of Racism, Social Justice, and Health and the National Association for the Advancement of Colored People. Also check out are article on environmental justice and how to get involved!

When it comes to breast cancer there are risks all around us, but we are not completely powerless. While some things are hard to avoid, there are plenty of chemicals and products we can limit in order to minimize our exposure as much as possible. And as a young person you may not feel like any of this applies to you, but it's never too early to protect yourself against the risks of breast cancer.


Sources

  1. Gray, J. M., Rasanayagam, S., Engel, C., & Rizzo, J. (2017). State of the evidence 2017: An update on the connection between breast cancer and the environment. Environmental Health, 16(1), 94. https://doi.org/10.1186/s12940-017-0287-4
  2. Rodgers, K. M., Udesky, J. O., Rudel, R. A., & Brody, J. G. (2018). Environmental chemicals and breast cancer: An updated review of epidemiological literature informed by biological mechanisms. Environmental Research, 160, 152–182. https://doi.org/10.1016/j.envres.2017.08.045
  3. Buermeyer, N., Engel, C., Nudelman, J., Rasanayagam, S., & Sarantis, H. (2020). Paths to Prevention: California Breast Cancer Primary Prevention Plan. UC Office of the President: California Breast Cancer Research Program. Retrieved from https://escholarship.org/uc/item/1v2745z0
  4. Fiolet, T., Srour, B., Sellem, L., Kesse-Guyot, E., Allès, B., Méjean, C., Deschasaux, M., Fassier, P., Latino-Martel, P., Beslay, M., Hercberg, S., Lavalette, C., Monteiro, C. A., Julia, C., & Touvier, M. (2018). Consumption of ultra-processed foods and cancer risk: Results from NutriNet-Santé prospective cohort. BMJ, 360, k322. https://doi.org/10.1136/bmj.k322
  5. White, A. J., Bradshaw, P. T., & Hamra, G. B. (2018). Air pollution and Breast Cancer: A Review. Current Epidemiology Reports, 5(2), 92–100. https://doi.org/10.1007/s40471-018-0143-2
  6. Kass, L., Gomez, A. L., & Altamirano, G. A. (2020). Relationship between agrochemical compounds and mammary gland development and breast cancer. Molecular and Cellular Endocrinology, 508, 110789. https://doi.org/10.1016/j.mce.2020.110789
  7. Yang, K. J., Lee, J., & Park, H. L. (2020). Organophosphate Pesticide Exposure and Breast Cancer Risk: A Rapid Review of Human, Animal, and Cell-Based Studies. International Journal of Environmental Research and Public Health, 17(14), 5030. https://doi.org/10.3390/ijerph17145030
  8. https://www3.epa.gov/region1/airquality/nox.html
  9. Yedjou, C. G., Sims, J. N., Miele, L., Noubissi, F., Lowe, L., Fonseca, D. D., Alo, R. A., Payton, M., & Tchounwou, P. B. (2019). Health and Racial Disparity in Breast Cancer. Advances in Experimental Medicine and Biology, 1152, 31–49. https://doi.org/10.1007/978-3-030-20301-6_3
  10. Clark, L. P., Millet, D. B., & Marshall, J. D. (n.d.). Changes in Transportation-Related Air Pollution Exposures by Race-Ethnicity and Socioeconomic Status: Outdoor Nitrogen Dioxide in the United States in 2000 and 2010. Environmental Health Perspectives, 125(9), 097012. https://doi.org/10.1289/EHP959
  11. Tessum, C. W., Paolella, D. A., Chambliss, S. E., Apte, J. S., Hill, J. D., & Marshall, J. D. (n.d.). PM2.5 polluters disproportionately and systemically affect people of color in the United States. Science Advances, 7(18), eabf4491. https://doi.org/10.1126/sciadv.abf4491
  12. Zota, Ami R., and Bhavna Shamasunder. "The environmental injustice of beauty: framing chemical exposures from beauty products as a health disparities concern." American journal of obstetrics and gynecology 217.4 (2017): 418-e1.

https://doi.org/10.1016/j.ajog.2017.07.020

Science

What’s the Deal with Clean Beauty Regulations?

The current regulations in the cosmetics industry and some hope for cleaner products

When you walk into a cosmetics store what section do you go to first? The makeup, the skin care, maybe the hair care? By the time most of us are done and have gone through the entire store it's been two hours and our hands are full of different swatches of nude lipsticks, gold eyeshadows (somehow they are all slightly different), eyeliners, and maybe even a few perfumes on each arm. Cosmetics products are a staple in everyone's lives, but something most people might not be aware of is how many ingredients go into making our favorite cosmetics products like foundation or lip gloss. There's a lot of ingredients and magic that go into making foundation that gives you that perfect dewy skin look or lip gloss that is the perfect balance of sparkly and not too sticky. Due to the lack of government regulation of the ingredients in cosmetics products, there are all sorts of ingredients that are known to cause harm to humans in our makeup, lotions, deodorants, hair care, and the myriad of other cosmetic products. This issue on toxic ingredients has sparked a huge growth in cosmetic products that are labeled as "clean". Have you ever heard of clean beauty? Is it just a trend? Keep reading to explore what clean beauty is and some of the current and upcoming cosmetic regulations!

The problems with unregulated cosmetics

With the exception of hair dye, there are no laws that require cosmetic products or ingredients to be approved by the FDA before they go on the market. The FDA does not require specific safety tests to be done on a product or ingredient meaning only the individuals who manufacture and market the cosmetics have a legal responsibility to ensure the safety of their products. This is a major problem! Because manufacturers are not required to test for safety, consumers do not know if they did these tests at all or if the testing they did was adequate (4). To make matters worse, if a product eventually appears to have an adverse effect, the FDA has no authority under the current regulations to force the company to recall the product, the company must do so voluntarily (12). Between the years 2004-2016, an average of 396 adverse events per year were submitted to the FDA (11). If the objective is to keep people safe, this is too little too late!

Some common toxic ingredients in typical cosmetics products are heavy metals, PFAS (a group of Teflon-like chemicals), parabens, petroleum, phthalates, and fragrances. Heavy metals like lead, arsenic, mercury, zinc, chromium, and iron are often used for coloring purposes in cosmetics from lipstick to eyeliner. They can also accidentally end up in products due to contamination during the manufacturing and packaging processes (1,17). PFAS chemicals are often found in a lot of products like pressed powder makeup, foundation, anti-aging lotions, eyeliner, eyeshadow, mascara, and lipstick (1,16). PFAS gives cosmetics a waterproofing ability along with giving it a really smooth texture on the skin (2). Parabens are a synthetic preservative that is added to cosmetics to last longer, and petroleum, a byproduct of oil refining, has a really long shelf life and softens upon use making it a beneficial addition to cosmetics. The last two common ingredients are phthalates and fragrances which often go hand in hand. Fragrances are obviously placed in a product to make it smell better (1). They can be made from petroleum or natural materials, but most of the time the entire ingredient lists are not given due to it being proprietary information for the brand. Many fragrances then add in phthalates as a solvent to make the scent stick around longer. Phthalates are used mainly in cosmetics as skin moisturizers, skin softeners, skin penetration enhancers, and as anti-brittleness and anti-cracking agents for nail polish (18).

These ingredients are known to be endocrine disruptors, and are linked to reproductive and developmental harm, allergies, and even cancers (1,19). We should also keep in mind that we could be exposed to more than one toxic ingredient everyday depending on how many cosmetic products we use. When used repeatedly, ingredients like PFAS and the different heavy metals can accumulate in our bodies over time and increase our risk for illness (1).

In addition to being hazardous to our health, these same ingredients can also be toxic to our environment. Everytime you throw something away or wash it down the drain, those chemicals are going back into the environment polluting our soil and waterways (5). It's the same as chemicals coming off of your car and polluting the environment: a toxic chemical is a toxic chemical no matter where it came from!

What clean beauty means

The term "clean beauty" is pretty subjective, but it usually means that the products contain ingredients that have been evaluated for safety and the brands are transparent about the ingredients they are using. More and more brands have been coming out with clean cosmetic products because they realized that a lot of the everyday products people use have harmful and toxic chemicals in them. Some of these brands have a list of chemicals they refuse to use like parabens, synthetic fragrances, sulfates, phthalates, and more. There are even some clean beauty retailers that require brands to disclose all of their ingredients and check them against a do not use list before they are allowed to be sold. This all seems like progress, but all of these actions are voluntary and not required under law, meaning most brands don't go that extra mile which is why there's an urgent need for new government regulation and policies for the skincare industry.

Clean Beauty Regulations

The current federal regulations are pretty lackluster. For some context, the EU has prohibited the use of 1,378 substances in cosmetic products compared to the United States which has only banned 11 substances (13,14). Some of these banned chemicals include chloroform, mercury compounds, vinyl chloride, chlorofluorocarbons, and a few others (14). This abysmal effort by the federal government has forced states to come in to propose more comprehensive safety regulation for cosmetics. One particular bill recently passed in California, has established a ban of 25 toxic ingredients in cosmetics which could have major impacts on the cosmetics market as a whole. Because California is such a big market, with about 40 million people, it might force brands to start producing cleaner products. Most brands don't want to create two separate products, one cleaner version for people living in California, and another that is suitable for the rest of the U.S.! So there is hope that this bill in California could push brands to only create clean products. There are also a few other states including Connecticut, Colorado, Maine, Maryland, New York, Oregon, Vermont, Minnesota, and Wisconsin that have adopted policies to start cleaning up the cosmetics sold in their states (6).



Upcoming Clean Beauty Legislation

In the past few years there have been three big pieces of federal legislation that have been introduced into congress along with 9 state policies introduced by Maryland, New Jersey, and New York. Most of these state and federal policies focus heavily on removing the toxic ingredients and giving the FDA more authority to recall a product and to do their own safety reviews. These policies have not been passed or turned into law, but if all goes well they will be on their way to pass in the next few years!


Why switch to clean beauty?

Switching to clean beauty products can be a great way to start limiting our exposure to toxic chemicals. But as we previously mentioned, there is no universal clean beauty standard, or list of ingredients brands need to avoid. There is very little regulation on ingredients across the entire cosmetics industry, meaning products can claim they are safe but that could mean entirely different things depending on the brand. For the most part switching to clean beauty products is likely to reduce your overall exposure to toxic ingredients because these brands have tried to reduce the number of chemicals in their products. Brands like Sephora and Target now have clean beauty sections that people can shop from, along with stores and brands like Detox Market, Follian, Credo, BeautyCounter, Ursa Major, and Biossance to name a few. These stores and brands have made it so we don't have to wait around for government regulation to get cleaner cosmetics products. If you can, try to support more clean beauty brands to show the world that there is a market and a need for cosmetic products that don't put us at risk!

Resources to support and keep updated on clean beauty legislation

We created a list of letter writing campaigns, clean beauty news sources, and information pages on current and upcoming clean beauty legislation. If you want to stay updated on clean beauty legislation and find ways to support the different state and federal policies, click on the links below!

  1. This link allows you to send a message to your congressional representative to support the Safe Cosmetics and Personal Care Products Act of 2019 (H.R. 4296)!
  2. The Campaign for Safe Cosmetics has an action alert page with multiple letter writing campaigns to tell your cosmetics companies, the FDA, and elected officials that safe cosmetics are important to you. Click the link here!
  3. The Environmental Working Group has a page dedicated to clean cosmetics legislation, news and reports, and where to support clean cosmetics companies.
  4. The Campaign for Safe Cosmetics tracks upcoming and adopted state policies in regard to cosmetics and cleaning products.



Sources

  1. https://www.safecosmetics.org/get-the-facts/chem-of-concern/
  2. https://www.ewg.org/skindeep/contents/is-teflon-in...
  3. https://www.law.cornell.edu/uscode/text/21/chapter-9/subchapter-VI
  4. https://www.fda.gov/cosmetics/cosmetics-laws-regulations/fda-authority-over-cosmetics-how-cosmetics-are-not-fda-approved-are-fda-regulated
  5. Juliano, C., & Magrini, G. A. (2017). Cosmetic Ingredients as Emerging Pollutants of Environmental and Health Concern. A Mini-Review. Cosmetics, 4(2), 11. https://doi.org/10.3390/cosmetics4020011
  6. https://www.saferstates.org/toxic-chemicals/cleaning-cosmetics-and-construction/
  7. https://leginfo.legislature.ca.gov/faces/billTextClient.xhtml?bill_id=201920200AB2762
  8. https://energycommerce.house.gov/committee-activity/hearings/hearing-on-building-consumer-confidence-by-empowering-fda-to-improve
  9. https://energycommerce.house.gov/sites/democrats.energycommerce.house.gov/files/documents/COSMETICS_DRAFT%20112719.pdf
  10. https://www.feinstein.senate.gov/public/index.cfm/2019/3/feinstein-collins-introduce-bill-to-strengthen-oversight-of-personal-care-products
  11. Kwa, M., Welty, L. J., & Xu, S. (2017). Adverse Events Reported to the US Food and Drug Administration for Cosmetics and Personal Care Products. JAMA Internal Medicine, 177(8), 1202–1204. https://doi.org/10.1001/jamainternmed.2017.2762
  12. https://www.fda.gov/cosmetics/cosmetics-recalls-alerts/fda-recall-policy-cosmetics
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