Investigating the Environmental Causes of Cancer: A Deep Dive into Carcinogens in Our Daily Lives

Earlier in April, Taipei’s Department of Health reported finding carcinogens in a batch of “Ah Lai White Curry Noodles” from Malaysia and a batch of “Indomie: Special Chicken Flavour” noodles from Indonesia, specifically ethylene oxide, a chemical compound associated with lymphoma and leukaemia^[1].

The Star on Thursday 25^th April reports that a spokesman for the Ah Lai brand said the firm has sent samples to be tested by a laboratory to check for carcinogens based on claims made by Taipei’s Department of Health^[1]. He says:

We have sent our samples to a lab and are awaiting the results. 

Prior to this, we have never had a problem nor has anyone made such claims against us since we started out in 2014.^[1]

And in 2021, the Hong Kong Consumer Council reported that 60 biscuit brands (including the popular Malaysian brands Jacob’s, Julie’s, and Hup Seng) contained carcinogens such as glycidol and acrylamide^[2]. As health director general Tan Sri Dr Noor Hisham Abdullah notes:

Acrylamide is a contaminant that can be produced during the processing or preparation of food. However, the contaminant can be controlled through the selection of raw materials and appropriate processes.

Learning that some of the foods we enjoy eating contain cancer-causing substances is terrifying, but that is far from the only source of carcinogens. The fact of the matter is that we are constantly exposed to carcinogens on a daily basis.

And although the amount may not be big enough to immediately cause problems, they will only continue to build up until it is too late.

That is why we must learn more about the environmental causes of cancer and the carcinogens we are exposed to in our everyday lives if we are to be better prepared against this affliction.

What Are Carcinogens?

In simple terms, a carcinogen is a substance that can cause you to have cancer. It may be a substance in the air, a product you use, or a chemical in foods and drinks (natural or artificial)^[4].

As mentioned above, exposure to carcinogens by themselves won’t necessarily cause cancer. Your chance of getting disease depends on other factors such as how long you’ve been exposed or how much you’ve accumulated in your body^[4].

From the food they eat to air they breathe in; people are getting exposed to more sources of carcinogens nowadays. Even too much exposure to direct sunlight is dangerous. Because of this, even healthy people are coming down with cancer, and treating cancer in Malaysia is not cheap.

How Carcinogens Cause Cancer

Carcinogens can cause cancer by damaging DNA, which carries genetic information in your cells. The damaged DNA will lead to mutations that can cause a disruption in the normal process of growth and cell division^[5].

Other times a carcinogen may cause damage and inflammation, which results in the cells dividing more rapidly. There is always a chance that a mutation will occur when this happens, which in turn increases the chance of developing cancer^[5].

What Other Foods Contain Carcinogens?

Biscuits and noodles aren’t the only foods that contain cancer-causing substances. In fact, chances are, nearly every food you’ve eaten contains carcinogens.

The rice and peanuts we use for our precious nasi lemak, for example, may contain aflatoxins. These chemicals are produced by parasitic molds that grow in soil, decaying vegetation, hay and grains and high concentrations of this substance has been linked with liver cancer and colon tumours^[6].

Although the number of aflatoxins found in rice or peanuts are not so high to be an immediate danger to us, researcher Sabran Mohd-Redzwan states:

Statistically, Malaysians consume rice about 289.68g/day (Ministry of Health [MOH], 2006). Thus it is assumed that dietary aflatoxin exposure from rice is somewhere between 55.04ng/day and 1.15μg/day [288.68g/day×0.19 or 3.96ng/g] for an adult of 60kg. Given that the aflatoxin-contaminated rice is consumed on a regular basis, this small amount of aflatoxin at the end will be accumulated in the body and can be detrimental to the health as previously reported.^[7]

Salted fish or ikan masin will also contain carcinogens in the form of N-nitroso compounds such as nitrosodimethylamine as a result of the salting process. Studies have linked N-nitroso compounds to cancers of liver, nasopharynx, stomach and oesophagus. And although most city-dwelling Malaysians don’t eat salted fish on a daily basis, this is an important foodstuff for fishing communities along rivers or coastlines^[6].

Even vegetables aren’t safe; dichlorodiphenyltrichloroethane (DDT) and other harmful pesticides are not only well-known to cause liver and breast cancer, but also other health problems. Although such pesticides are mostly banned in developed countries, it is still being used in some parts of the world due to how cheap and effective it is^[6].

In 2013, a UKM team led by Prof Dr Md Pauzi Abdullah from the School of Chemical Sciences and Food Technology found traces of endosulfan, edrine ketone, aldrin and DDE — a derivative of the dangerous DDT — six sampling sites across Cameron Highlands^[6].

Hidden In Plain Sight

Besides the food we eat, other carcinogens can be found elsewhere.

One such carcinogen, formaldehyde, can be found in composite wood products (hardwood plywood, particleboard, and medium-density fiberboard) as well as building and insulation materials. And in some circumstances, the chemical may be released into the air through a process called “off-gassing”, putting everyone in danger of exposure^[8].

Formaldehyde can also be found as a by-product in cigarettes and cigarette smoke. And while smokers are at the biggest risk of exposure due to directly inhaling this and other such chemicals, we mustn’t ignore the threat of second-hand smoking, where non-smokers indirectly inhale the carcinogens as they continue to waft around in the air around them. Second-hand smoke is, in fact, one of the most common ways non-smokers can receive lung cancer^[9].

All those tracts that have direct contact with tobacco smoke have a certain percentage linked to cancer. You are talking about mouth cancer, tongue cancer, oropharyngeal cancer, voice box cancer. It goes down to your stomach and intestines. Then it gets absorbed into the bloodstream and it can then go into different organs. You are talking about kidney, prostate, ovarian cancers. – Saunthari Somasundaram, president of the National Cancer Society of Malaysia (NCSM)^[10]

Not all carcinogens are chemical in nature. Ultraviolet (UV) radiation from the sun is a well-known cause of skin cancer^[11].

Melanoma (a mole that has become cancerous) is the deadliest of the skin cancers you can suffer from as it spreads (metastasises) more readily than the others, with sun exposure being the most important risk factor for developing melanoma^[11].

Finally, exposure to airborne pollutants can also lead to lung cancer. And in Malaysia, some of the common sources of air pollution include industrial factories, power plants and open-burning as well as seasonal haze resulting from biomass burning and forest fires in the country and in neighbouring countries like Indonesia and Thailand^[12].

Worryingly, the latest data demonstrates a lack of improvement in Kuala Lumpur’s air quality for four years. Although 2020 saw a 12% improvement from 2019, 2021 levels tell a different story as the city’s annual air pollution consistently hovers around the WHO recommended limit^[13].

Unfortunately, even staying indoors will not protect you from airborne carcinogens as such pollutants can originate from a variety of sources such as building materials, fire retardants, paint fumes, cleaning products, and even dust^[5].

Combatting Carcinogens

Cancer has been a major health problem for Malaysia in the past years. Worse still, the number of cancer cases has been rising over the years. According to data from the Malaysia National Cancer Registry Report (MNCRR) 2012-2016, there was an 11.3% increase in new cancer cases from 103,507 in 2007-2011 to 115,238 in 2012-2016^[14].

Disturbingly, the report also found that the percentage of cancer cases detected in Stages 3 and 4 rose from 58.7% between 2007 to 2011 to 63.7% between 2012 to 2016, despite the Health Ministry’s strategy of pushing for early screenings to prevent late detection that is linked with poorer survival^[14].

And according to Health Minister Khairy Jamaluddin, the number of people in Malaysia newly diagnosed with cancer is expected to rise to over 66,000 annually by 2030^[15].

This is an increase from the 49,000 people estimated to be newly diagnosed with cancer in 2020. – ex-Health Minister Khairy Jamaluddin^[15]

So far, Malaysia has only made little progress in properly regulating carcinogenic materials.

Just last year, the Malaysian government banned the use of the Highly Hazardous Pesticides (HHPs) chlorpyrifos and carbofuran in the agriculture sector effective May 1, 2023, with Agriculture and Food Industry Minister Datuk Seri Dr Ronald Kiandee revealing that many fruits and vegetables contain a disturbingly high amount of chlorpyrifos and carbofuran residue^[16].

Pesticide Action Network Asia Pacific (PANAP) warns that exposure to chlorpyrifos can lead to cancer of the lung and rectum among other detrimental health issues.

We welcome this regulatory action by the Malaysian government to ban chlorpyrifos and carbofuran in agriculture. Chlorpyrifos is linked to brain damage and is especially toxic to children. Exposure to even very low levels can cause losses in cognitive function, particularly in IQ and working memory, and lead to developmental disorders such as ADHD and autism. This ban is a decisive step that would protect innocent children from the devastating impacts of this pesticide. – Sarojeni Rengam, PANAP executive director^[16]

The Ministry of Health had also been working to get the Control of Tobacco Product and Smoking Bill 2022 passed in the hopes of regulating the sale of tobacco products and smoking devices to protect public health^[17].

The bill will ban the sale of cigarettes, tobacco and vape products to anyone born in the year 2007 and after^[17], and if approved, it will come into effect by 2025, giving ample time to create a smooth transition for our current tobacco regulations^[17].

Local anti-tobacco advocates assured that the main purpose of the bill was not to criminalise smokers or vapers, but to create a “normative” smoke-free culture, as pointed out by National Cancer Society of Malaysia (NCSM) managing director Dr Murallitharan Munisamy:

Nobody dares pick up a cigarette in the UK or smoke in public…and the joke is there is no police there, there is no policing, right? But society has evolved to that norm.^[19]

Khairy hoped that the bill will reduce smokers among Malaysians to less than five per cent by 2040, prevent children and teenagers from falling into the smoking habit, as well as to protect non-smokers^[17].

We do not bother smokers aged 18 and above as they can smoke until (the day) they die. This (law) is meant for the next generation as we want to put an end to the vicious cycle of smoking. – ex-Health Minister Khairy Jamaluddin^[17]

Why We Need To Do More

The presence of carcinogens in common and popular foodstuffs highlights a greater issue at hand:  a lack of regulation when it comes to such contaminants entering not just our food but also our water and breathing air.

As the Pasir Gudang disaster demonstrated, the lack of proper regulation on the kind of harmful chemicals we release into the environment will only lead to greater problems down the line.

While improving these regulations may help with this problem, far more important right now is raising awareness of the carcinogens we are exposed to on a daily basis. As the public becomes more educated on such issues, they will be better prepared and more willing to undergo early detection tests and have a better understanding of carcinogens and how such substances can eventually lead to cancer.

Remember, before we can change the laws, we must change the education system.

Explore our sources:

1. Malaysian instant noodle firm conducting tests after Taiwan health authorities find carcinogenic substances. (2023). Channel News Asia. Link.
2. S. Seng. (2021). Hup Seng Reportedly Among 60 Biscuit Types That Have Carcinogens, M’sia Health Ministry Investigating. Must Share News. Link.
3. S. Ong. (2021). Cancer-causing acrylamide in Malaysia-produced biscuits below EU Commission Regulation benchmark, says MOH. The Edge Markets. Link.
4. S. Booth. (2022). Common Carcinogens You Should Know. WebMD. Link.
5. L. Eldridge. (2021). What Is a Carcinogen? Very Well Health. Link.
6. A. Nasaruddin. (2017). Are Malaysians Getting Cancer By Eating? GetDoc. Link.
7. S. Mohd-Redzwan et al. (2013). A mini review on aflatoxin exposure in Malaysia: past, present and future. Front Microbiol. Link.
8. Facts About Formaldehyde. EPA. Link.
9. D. Leader. (2021). Health Risks of Secondhand Smoke. Very Well Health. Link.
10. R.S. Bedi. (2022). Malaysia’s smoking ban proposal aims to reduce cancer risk, but the Bill divides opinion. Channel News Asia. Link.
11. H.L. Brannon. (2022). The Effects of Sun on the Skin. Very Well Health. Link.
12. The State of Air Quality in Malaysia. (2022). Link.
13. P. Robertson. (2022). Kuala Lumpur Air Quality: 2022 Latest Pollution Readings. Smart Air. Link.
14. Cancer Cases Rise In Malaysia, Chinese Most Prone. (2020). CodeBlue. Link.
15. I.M. Iskandar & C.M. Theng. (2022). ‘Cancer cases to rise by 2030’. The Star. Link.
16. Malaysia commended for ban on chlorpyrifos and carbofuran. (2022). Pan Asia Pacific. Link.
17. N. Daim & V. Babulal. (2022). Control of Tobacco Product and Smoking Bill 2022 tabled for second reading in Parliament. New Straits Times. Link.
18. R.S. Bedi. (2022). Malaysia’s anti-smoking Bill referred to parliamentary committee for further deliberation. Channel News Asia. Link.
19. S. Pillai. (2022). How Legislation Paves The Way To A Smoke-Free Culture. Code Blue. Link.