When the state of California reported that it might label acetaminophen — the active ingredient in the common pain and fever medication Tylenol — as a carcinogen, it reupped discussion of the state’s long list (over 900 and growing) of carcinogen-labeled substances. These substances, found in everything from concrete parking lots to alcohol.
Warning labels are then required to be put on products containing these substances.Read More
Why California Has a Focus on Cancer
The law at the root of the carcinogen list is called Proposition 65 (also called the Safe Drinking Water and Toxic Enforcement Act). Passed in 1986, it requires all businesses to let consumers know about chemicals known to cause cancer, birth defects or other reproductive harm.
“Proposition 65 is a right-to-know law,” Sam Delson, deputy director for External and Legislative Affairs for the California Office of Environmental Health Hazard Assessment tells SurvivorNet. “Chemicals are put on the list [but] they are not banned. Their use is not restricted in any way. But it provides information that people can use to make their own informed decision.”
People nationwide might see these warnings on products they buy “because many companies put the labels on all items that contain these chemicals, even if they’re going to be sold in other states,” says the American Cancer Society.
The ACS explains that there are several ways a substance can be added to the OEHHA list: “If it’s considered by an ‘authoritative body’ to cause cancer in humans or lab animals. Organizations designated as authoritative bodies by the state of California include the International Agency for Research on Cancer (part of the World Health Organization), the US National Toxicology Program (NTP), and the US Environmental Protection Agency (EPA), among others.” The State of California can also make its own determinations.
What Does the Label Mean?
If a warning is placed on a product label or posted or distributed at the workplace, a business, or in rental housing, the business issuing the warning “is aware or believes that one or more listed chemicals is present,” according to ca.gov.
For chemicals that are listed as causing cancer, the “no significant risk level” is defined as the level of exposure “that would result in not more than one excess case of cancer in 100,000 individuals exposed to the chemical over a 70-year lifetime,” the site says. In other words, a person exposed to the chemical at the “no significant risk level” for 70 years would not have more than a “one in 100,000” chance of developing cancer as a result of that exposure.
Proposition 65’s Has Its Critics
Propositions 65 has its share of critics, with some saying that the list does more to create fear than it protects people from cancer.
After the committee decided coffee was a risk and businesses in the state began posting warnings, for instance, the U.S. Food and Drug Administration (FDA) issued a statement of disapproval, saying that the warnings would be “more likely to mislead consumers than to inform them.”
“The fact that the California Office of Environmental Health Hazard Assessment may end up slapping the drug with a warning label doesn’t mean it’s a proven killer,” writes the editorial board.
“In fact, the science on acetaminophen is far from settled.”https://t.co/nBHpD2aT8M
— L.A. Times Opinion (@latimesopinion) January 23, 2020
And the ACS points out that “not all of the cancer-related substances on the OEHHA list are considered to be known human carcinogens. … This means that not every chemical on the list has been proven to the worldwide scientific community to actually cause cancer in people.”
“We feel that proposition 65 has played a positive role in identifying carcinogens, and sometimes leading to their removal from products,” Delson says. “As a cancer survivor myself, I think it’s important work, and will be looking with interest to see what the committee does this spring.”
What’s Next for Acetaminophen
In 2011, the Carcinogen Identification Committee held a meeting in Sacramento to recommend that seven of the 39 chemicals referred to them be placed in a high priority, according to ca.gov. Among them: acetaminophen, which is also found in such common drugs such as Benadryl, Excedrin, Theraflu and Midol.
It’s been a long review process, but the panel is scheduled to have a public hearing on acetaminophen this spring after the public comment period closes Jan. 27.
Who Is on the Committee?
The committee includes experts from the fields of epidemiology, oncology, pathology, medicine, public health, statistics, biology and toxicology.
These experts include professors at California State University, University of Southern California, and University of California, Los Angeles, Berkeley, Riverside and San Francisco.
One member of the committee was the senior staff scientist at Bayer Healthcare Pharmaceuticals from 2008 to 2014.
A staff of about 130, mostly toxicologists and epidemiologists, helps compile research and data to be reported to the committee, according to Delson.