Potential Exposure to Environmental Toxic Emissions and Increased Cancer Risk in Puerto Rico

Abstract Background:Toxic environmental pollutants are a risk factor for some cancers. We conducted an ecological study to assess the cancer risk in Puerto Rico after 15 years of exposure. Methods:Cancer incidence data (2018-2022) were obtained from the Puerto Rico Central Cancer Registry. Contaminated areas were defined as municipalities with industrial facilities reporting on-site toxic chemical emissions to the Environmental Protection Agency's Toxic Release Inventory (TRI) from 2006 to 2020. We estimated cancer risk using the age-standardized incidence relative risk (RR) with 95% confidence intervals (95%CI) by cancer type and sex. This was repeated for the frequency of onsite TRI emissions (none, intermittent, and continuous). All were performed using SEER*Stat v8.4.4. Results:Between 2018 and 2022, 80,179 invasive cancer cases were diagnosed in Puerto Rico. Residents of contaminated municipalities had a 7% higher risk of all cancer types (RR: 1.07, 95%CI: 1.05-1.09) than those in non-contaminated municipalities, similar to females (RR: 1.05, 95%CI: 1.02-1.07) and males (RR: 1.10, 95%CI: 1.07-1.12). Risk was higher in highly contaminated municipalities, with a 5% increase in females (RR=1.05, 95%CI: 1.03-1.08) and 12% in males (RR=1.12, 95%CI: 1.09-1.15). Conclusions:The data suggest higher cancer rates in municipalities with TRI facilities, emphasizing the need for research, environmental interventions, and public health actions to mitigate toxic chemical exposure in Puerto Rico. Impact:This study contributes additional knowledge of Puerto Rico’s cancer burden by identifying the relationship that may exist between living in municipalities with industries reporting the emission of toxic chemicals and cancer risk.