Californians see cancer warning signs everywhere. But does drinking coffee, staying at a hotel, or using a parking lot really cause cancer?
In California, it seems you're never far from a reminder about cancer.
You can't park a car indoors or order a cup of coffee in the Golden State without seeing a warning about the various ways your cancer risk might spike.
That's thanks to a state law that dates back to 1986, called Proposition 65, which was enacted to protect California's drinking water supply from toxic, potentially cancer-causing chemicals. But the law also mandates that the state keep a master list of all chemicals known to be toxins, and requires manufacturers and businesses to warn people about these chemicals if they're present in products or buildings (even in extremely small doses).
There are more than 1,000 chemicals on California's cancer-warning list, which grows every year. Some chemicals on the list have been proven to cause cancer, but not all. A chemical only needs to have a 1 in 100,000 chance of upping your risk for cancer in order to merit a written warning to consumers.
However, because the way cancer develops in the body is extremely complex, one's cancer risk isn't just about what we put in our mouths, cars, and lungs. Cancer has a lot to do with the genes in our body and our family history, too.
For those and other reasons, many Californians and cancer experts lament that the warnings, as written, aren't all that helpful.
As the American Cancer Society says on its website, "the Prop 65 labels only tell you that a product has something in it that might cause cancer or affect reproduction. They don’t say what the substance is, where it is in the product, how you might be exposed to it, what the level of risk is, or how to reduce your exposure."
Here are a few of the strangest things that carry cancer warnings in California.
A concrete parking lot is not the best place for a casual, cancer-risk-free hang.
"Breathing the air in this parking garage can expose you to chemicals including carbon monoxide and gasoline or diesel engine exhaust," California says on its parking lot warning. "Do not stay in this area longer than necessary."
The state insists that phrase be printed on signs in indoor parking decks, or just about anywhere that people park inside.
The International Agency for Research on Cancer agrees with California on this one: diesel oil has more than 30 known components that can cause cancer, though in a well-ventilated parking deck, there shouldn't be too many fumes.
California now warns all residents that a cup of joe might cause cancer, but scientists aren't so sure.
Researchers who've studied coffee drinkers for years think that those people probably aren't at any higher risk of getting cancer. Instead, caffeine addicts may actively lower their risk of developing some kinds of cancers, including oral, prostate, and liver cancer.
But those findings didn't stop a California judge from recently ruling that coffee might be associated with a risk of cancer because it contains a tiny dose of a chemical called acrylamide. The compound can form when food is cooked at high temperatures, through processes like frying, baking and roasting. Acrylamide has been linked to cancer in mice and rats when it's put in their drinking water, but only in very high doses.
Acrylamide is in all kinds of cooked food we regularly eat, like french fries, potato chips, cookies, and cereal. There's no evidence yet that the amount of acrylamide in a cup of coffee has any detrimental health effects. In fact, you'd have to drink in thousands of times the amount of acrylamide in a cup of coffee to get to those levels. It's much more likely that acrylamide in cigarettes could be worrisome for people.
Still, places like Starbucks (pictured above) have started pinning up signs to comply with the new California regulation.
Phones aren't chemicals, so they're not on the official Prop 65 list, but the California Department of Health still warns that the radio frequency energy they emit might cause cancer.
Scientific studies haven't demonstrated that cell phone radiation levels are anything to worry about.
Nevertheless, California residents are told not keep their phones in their pockets, and store them away from the bed at night. The health department also suggests consumers use wired headphones, wireless headsets, and speakerphone capabilities instead of holding their phone up to their ear, and opt to send more texts to avoid keeping phones close to their heads.
Even spending a little time as a tourist in California can up your cancer risk, the state says.
"When you check in at a hotel, look for a Proposition 65 warning sign at the hotel’s check-in desk, or a warning printed on the registration form," the state suggests, adding, "if you have any questions about the warning, ask hotel representatives."
Not all hotels have the cancer warnings — much of the danger the state is worried about in hotels comes from toxins in substances like secondhand smoke or alcohol.
Even getting your teeth worked on can be risky, according to California's warning system: some chemicals on the state's list are used in common dental procedures.
"These include sedation with nitrous oxide; some root canals, crown placements or removals, dental bridge placements; tooth restorations with fillings that contain mercury; and the use of some dental appliances," California's warning reads.
Going out to eat is not a cancer risk-free activity either, according to California.
Any place that serves fries, alcohol, or some balsamic vinegars that may contain lead must also serve up this warning to customers:
"Certain foods and beverages sold or served here can expose you to chemicals including acrylamide in many fried or baked foods, and mercury in fish, which are known to the State of California to cause cancer and birth defects or other reproductive harm."
Acrylamide (the same chemical California's worried about in coffee) is found in some foods cooked at high temperatures. But again, the FDA says the levels of the chemical in foods like fries or crackers are much lower than acrylamide levels linked to cancer in animal studies.
The state suggests residents also limit their consumption of grilled foods, since we know those cooking processes can contribute to cancer risk, too.
Amusement parks aren't all fun and games, according to Prop 65.
The state cautions that exhaust from rides, lead in railings, secondhand smoke from fellow park-goers, and greasy food could all raise cancer risk.
It's true that the chemicals in all of those things have been shown to be linked with higher rates of cancer, but you'll find all of them outside of amusement parks, too.
Even if some of California's cancer warnings seem silly, others are very sound.
Scientists have known for years that the more alcohol you drink, the higher your risk may be of developing cancers like throat, liver, breast, and colon.
Cancer doctors in the US say even as little as one glass a day of an alcoholic drink can contribute to your risk of developing cancer.
The Los Angeles Times editorial board outlined how useless the state's warnings can be in a September opinion piece.
"The signs they post don't provide the context to help people make educated decisions about the risk they face," the board wrote. "Many don't even identify which chemical or chemicals are at issue."
That leaves consumers who are inundated with cancer warnings at a loss about to how to reduce their risk.
But later this year, California is expected to tweak its policies.
New rules set to be in place by August 30, 2018 will require companies to name at least one risky chemical in any product that comes with a cancer warning. Warnings will also have to include a note telling consumers the URL of the state's website, where people can find more information about how to reduce their exposure to toxic chemicals.
With those changes, California's ubiquitous cancer warnings may at least get a bit more helpful and specific.