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WATER GREMLIN PUBLIC HEALTH ASSESSMENT While little is known about the causes of some typesof.canper (e.g., brain tumors), for many types of cancer; specific risk factors have been identified. For some cancers, these known risk factors account for a significant proporti6ii of cancer occurrence (e.g., 85- 90% of lung cancer: is attributable -to smoking; 95%-of cervical cancer is due to the Human Npilloma Virus). Communities and counties can vary widely in terms of known risk factors for cancers contributing to the variability of cancer rates. While age and gender distributions in a. community can routinely be accounted for, lack of information about other known determinants. of cancer incidence (such as smoking histories) in a given population makes it diff€euitto.attribute any observed excess or deficit in cancer rates to a given cause. y Well -designed epidemiolpgical studies; In addition to -toxicological research, are necessary to answer questions about the extent to which an envirohmental.exposure may-be..contribufingto the occurrence -of cancers in human populations. Indeed, most known human carcinogens have been identified through epldemlologic studies of occupational groups. Cancer risks.are much more likely to be detected in the workplace rather than in a community settingsince (1) occupational exposures are generally much greater than community exposures; (2) it-is.frequently possible to estimate past exposures in a workplace.using industrial hygiene data, job histories, and other data; and (3) it is.usual.ly possible to identify:all the people who worked at a workplace fora. particular tlme period using personnel records. •: State and federal. regulatory standards. and guidelines are intended to limit. exposures to potential carcinogens to very low risks; for example, ohe additional cancer in 100,000 people with lifetime exposure. This level of cancer risk is purposefully many thousands of tittles lower than cancer risks that can be detected by epidemiologic studies. or examination of community cancer rates. 82