The evidence is clear: Proximity to fossil fuel infrastructure poses a significant cancer risk to millions of Americans. Studies consistently link exposure to pollutants like benzene, polycyclic aromatic hydrocarbons (PAHs), and particulate matter from fossil fuel facilities to elevated rates of lung cancer, leukemia, and other malignancies.

Alarmingly, 17.6 million Americans live in close proximity to active oil and gas wells, transportation pipelines, and processing facilities, subjecting them to harmful air pollution. Children, pregnant women, older adults, communities of color, Indigenous populations, low-income groups, and immigrants are particularly vulnerable to the health impacts of these carcinogenic emissions.

A preventable public health crisis

The International Agency for Research on Cancer (IARC) has classified benzene, certain PAHs, and heavy metals like arsenic and cadmium as Group 1 carcinogens, solidifying the link between fossil fuel pollutants and cancer. These pollutants cause cancer through mechanisms such as direct DNA damage, oxidative stress, and chronic inflammation.

Exposure to particulate matter from fossil fuel emissions contributed to 18% of total global fatalities in 2018. Despite this overwhelming evidence, regulatory action to protect public health has been inadequate. While agencies like the EPA, CDC, and NASA monitor pollution levels and conduct research, stronger measures are urgently needed to mitigate the cancer risk posed by fossil fuel infrastructure.

A call for action

Physicians can help protect patients from these dangerous exposures by:

1. Educating patients and communities. Leverage their trusted position to raise awareness about the health hazards of fossil fuel pollution, especially among vulnerable populations. Provide educational materials, host community forums, and engage with local media to disseminate accurate information.

2. Advocating for stronger regulations. Use their professional expertise to advocate for stricter regulations and emission standards for fossil fuel facilities. Collaborate with medical associations, public health organizations, and environmental groups to lobby policymakers and regulatory agencies for more protective measures.

3. Supporting environmental justice initiatives. Partner with environmental justice organizations and community groups to address the disproportionate impact of fossil fuel pollution on marginalized communities. Advocate for equitable policies, community monitoring programs, and targeted interventions in high-risk areas.

4. Conducting research and surveillance. Participate in research studies, epidemiological investigations, and cancer surveillance efforts to enhance our understanding of the link between fossil fuel exposure and cancer risk. Collaborate with academic institutions, government agencies, and research organizations to generate robust data and evidence-based solutions.

5. Promoting preventive care and screening. Emphasize the importance of regular cancer screenings, early detection, and preventive measures for patients living in proximity to fossil fuel infrastructure. Develop tailored screening guidelines and educational campaigns to mitigate cancer risk in these communities.

6. Supporting clean energy transition. Endorse and advocate for policies that accelerate the transition to renewable energy sources, such as solar, wind, and geothermal power. Collaborate with energy companies, policymakers, and stakeholders to promote sustainable energy solutions that reduce fossil fuel dependence and associated health risks.

A moral imperative

The evidence is overwhelming: Fossil fuel infrastructure poses a significant and preventable cancer risk to millions of Americans, disproportionately impacting vulnerable communities. Ignoring this crisis is a moral failure. Health professionals have a responsibility to protect public health and prioritize the well-being of our patients.

Elissa Klein is a medical student.