There is now a global effort to prevent cancers caused by work. IOSH’s SIMON BUTT-BETHLENDY* discusses occupational cancer, what causes it and why there is no time to lose in the fight to tackle it.
Worldwide, accidents or occupational diseases kill an estimated 2.78 million people every year. According to the International Labour Organisation (ILO): “By far the greatest proportion of current work-related deaths — 86 per cent — come from disease. In the region of 6500 people a day die from occupational diseases, compared to 1000 from fatal occupational accidents.” Occupational cancers are linked to at least 26% of deaths caused by work — just behind the main cause, circulatory disease (31%). The real figure for cancer could actually be much higher because of how data on work-related ill-health are currently reported. Effective prevention is vital.
What is occupational cancer?
The term ‘occupational cancer’ describes all cancers instigated by exposure at work to a cancer-causing agent or carcinogen. Some, like skin or eye damage due to sun exposure, may result from cumulative long-term exposures. Others, such as the inhalation or ingestion of asbestos fibres, may be triggered by short-term, high-intensity dosages.
The International Agency for Research on Cancer (IARC), part of the World Health Organization (WHO), has classified asbestos fibres, solar radiation, diesel engine exhaust emissions, silica dust and over 45 other agents as occupational carcinogens. Everything from welding fumes and metalworking fluids to coal tars and soot (a tumour known as ‘soot wart’ — the first work cancer — was recognised in chimney sweeps in 1775) to wood dust and mineral oils is included.
Other factors ranging from whether workers smoke to family health history can influence if cancer develops after occupational exposure, but it is widely accepted that exposure has a strong impact on the likelihood of getting a work-caused cancer, even without ‘lifestyle’ factors. Many of these occupational cancers are ‘long latency’, taking 10, 20, 30, 40 or more years to develop. Tracing work-related causes when a person has changed career or retired can be difficult.
According to a 2017 ILO report on the latest, best estimates of accidents and diseases: “The proportion of work-related cancer (malignant neoplasm) dominated the fatal work-related diseases in high income countries. This is a continuously growing problem that needs better preventive measures. Practically, all such cancers can be avoided by eliminating the exposures to carcinogenic agents and minimizing exposures at related jobs, settings and procedures.”
Groundbreaking UK studies in the last 10 years by Lesley Rushton and Sally Hutchings of Imperial College London and John Cherrie at the Institute of Occupational Medicine have highlighted the true picture of occupational cancer in Britain. There are on average 8000 work-related cancer deaths a year with 14,000 new registrations attributable to occupational exposures.
Recent extensive research included two million people over a 50-year period, looking at Group 1 carcinogens (the agent is carcinogenic to humans) and Group 2A carcinogens (the agent is probably carcinogenic to humans) as defined by the International Agency for Research on Cancer.
In Australia, one estimate of the burden of occupational cancer by Fritschi and Driscoll suggested that 40% of current Australian workers could be exposed to carcinogens in their workplaces; highest among farmers, drivers, miners and transport workers, leading to tens of thousands of work-caused cancers developing this century. All this research helps target prevention efforts on carcinogens, industries and behaviours where they are needed.
What can be done to tackle it?
Cancer caused by work isn’t inevitable — it’s avoidable. Put simply, cutting exposure to carcinogens stops cancers developing. Spotting the signs of cancer early on means it can be treated, and even cured in some cases.
In many countries, controlling exposure to carcinogens is a legal requirement — either under explicit laws or under general health and safety protection legislation. Employers who do not get it right could be prosecuted and fined and see their reputation hit too. And there is also a strong moral argument for ensuring workers are not exposed to dangerous substances as part of what they do for a living.
There are many proven, successful control measures for tackling occupational cancer as well as behavioural changes that reduce risks. In developed economies we already do much of what is required. We just need to do more of it. That is where health and safety professionals have powerful roles to play, managing good interventions, sharing knowledge and influencing improvements.
If you can avoid using a carcinogen by substituting it for a less harmful substance or modifying the process so there is less exposure, then do it. Ventilation in various forms can be used to reduce exposure. Using safe operating procedures can also help reduce exposure, and as a last resort issue personal protective equipment. These are all simple and effective tactics.
We must also make sure those individuals who are handling or exposed to carcinogenic substances or processes are aware of the proper controls and why they should be followed, as well as what health effects they should look out for.
All this advice, free practical resources and a wealth of case studies form a campaign called ‘No Time to Lose — Working Together to Tackle Occupational Cancer’, which has now launched in Australia thanks to support from the National Safety Council of Australia (NSCA) Foundation.
How you can use No Time to Lose to tackle occupational cancer
The Institution of Occupational and Safety Health (IOSH) developed and launched No Time to Lose (NTTL) to collaborate worldwide on tackling and preventing cancers caused by work.
Over 350 supporter organisations have signed up, including 130 who completed detailed pledges demonstrating how their policies and work practices reduce exposure to occupational carcinogens.
NSCA Foundation is an influential new ally making available to its members and stakeholders a full suite of NTTL resources adapted and updated for Australia and New Zealand.
Access to and use of NTTL fact sheets, infographics, leaflets, posters, presentations, films and more is free. Everything businesses need to educate and inform the workforce: www.nscafoundation.org.au/no-time-to-lose.
Show that your organisation is part of our campaign to tackle occupational cancer by signing up as a supporter online. It is free, easy to do and helps us all achieve greater impact.
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