When Thomas Varghese relocated from Seattle to take a job at the University of Utah, his colleagues warned him he wouldn’t make much use of his expertise in lung cancer in his new post.
“You’re going to go there and never see any lung cancer,” the cardiothoracic surgeon said his co-workers told him as he arrived in 2015. “And I get here and, you know what, we’re busy.”
Utah is one of five states where more than 1 percent of lung cancers are likely caused by exposure to air pollution, according to the latest version of an annual report by the American Thoracic Society on the health effects of air pollution.
“This report sort of justifies that [air pollution] is a concern, and defines what those concerns might be leading to,” said Gary Ewart, an official with the American Thoracic Society and one of the report’s co-authors. “It doesn’t just make you cough. For some unfortunate people, it may actually trigger lung cancer.”
The Thoracic Society estimated that four to 29 Utahns develop lung cancer each year because of their exposure to small particulate pollution, which accumulates on the Wasatch Front during wintertime inversions.
Though the absolute number of cases was relatively low, it represents a sizable portion of all lung cancers that occur in Utah, where the most common cause of lung cancer — smoking — isn’t particularly prevalent.
Ewart noted that the number was also large compared with Utah’s overall population. Air pollution in California, for example, was estimated to cause about 610 cases of lung cancer each year, according to the report — but California’s population is far larger.
While the number of people who develop lung cancer as a result of air pollution is relatively small, Ewart said, the Thoracic Society was still concerned about the results, because lung cancer is a particularly deadly disease, even among cancers.
“It’s a pretty serious condition to be triggered by air pollution,” he said. “This is not a trivial finding.”
Overall, the report estimated that 110 Utahns die each year as a result of exposure to either small particulate pollution or ozone, a chemical that typically forms in the air in the summer. Utah currently does not meet federal standards for either of those pollutants — standards the American Thoracic Society does not believe are adequate to protect human health.
Varghese, who oversees general thoracic surgery at the U. in Salt Lake City and is also the co-director of the thoracic oncology program at the Huntsman Cancer Institute, said he, too, found the report disturbing.
Lung cancer is generally associated with smoking, Varghese said, and only rarely runs in families.
When you see a patient with lung cancer “who’s never touched a cigarette before and has not been exposed to [secondhand smoke],” he said, “right there you have to know something is going on in the environment.”
Varghese said he has operated on Utahns who, despite having never smoked, still had the carbon deposits and black lungs typically associated with cigarette use.
Unlike some other organs, Varghese said, the lungs aren’t able to regenerate or repair themselves. Damage from cigarette smoke or air pollution is likely permanent, he said, and may trigger cancers that develop even 20 years after the original injury occurred.
Maintaining a healthy diet and getting regular exercise may be Utahns’ best lines of defense, Varghese said.
While it may not reduce the risk associated with breathing polluted air, he said, people in good health overall typically have better treatment outcomes in the event they do develop lung cancer.
