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Markowitz S, Ringen K, Dement JM, Straif K, Christine Oliver L, Algranti E, Nowak D, Ehrlich R, McDiarmid MA, Miller A. Occupational lung cancer screening: A Collegium Ramazzini statement. Am J Ind Med 2024; 67:289-303. [PMID: 38440821 DOI: 10.1002/ajim.23572] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2024] [Accepted: 02/01/2024] [Indexed: 03/06/2024]
Affiliation(s)
- Steven Markowitz
- Barry Commoner Center for Health & the Environment, Queens College, City University of New York, New York, New York State, USA
| | - Knut Ringen
- CPWR-The Center for Construction Research and Training, Silver Spring, Maryland, USA
| | - John M Dement
- Duke University School of Medicine, Division of Occupational & Environmental Medicine, Durham, North Carolina, USA
| | - Kurt Straif
- ISGlobal, Barcelona, Spain
- Boston College, Chestnut Hill, Massachusetts, USA
| | - L Christine Oliver
- Dalla Lana School of Public Health, Division of Occupational and Environmental Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Dennis Nowak
- Institute and Clinic for Occupational, Social and Environmental Medicine, LMU Klinikum, LMU Munich, CPC Munich, Comprehensive Pneumology Center Munich, #DZL, Deutsches Zentrum für Lungenforschung, Munich, Germany
| | - Rodney Ehrlich
- Division of occupational Medicine, School of Public Health, University of Cape Town, Cape Town, South Africa
| | - Melissa A McDiarmid
- Division of Occupational & Environmental Medicine, University of Maryland School of Medicine, USA
| | - Albert Miller
- Barry Commoner Center for Health & the Environment, Queens College, City University of New York, New York, New York State, USA
- Department of Medicine, Mount Sinai School of Medicine, New York, New York State, USA
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Chen-Xu J, Jakobsen LS, Pires SM, Viegas S. Burden of lung cancer and predicted costs of occupational exposure to hexavalent chromium in the EU - The impact of different occupational exposure limits. ENVIRONMENTAL RESEARCH 2023; 228:115797. [PMID: 37001847 DOI: 10.1016/j.envres.2023.115797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/24/2023] [Revised: 03/28/2023] [Accepted: 03/28/2023] [Indexed: 05/16/2023]
Abstract
BACKGROUND Exposure to hexavalent chromium [Cr(VI)] occurs widely in occupational settings across the EU and is associated with lung cancer. In 2025, the occupational exposure limit is set to change to 5 μg/m3. Current exposure limits are higher, with 10 μg/m3 as a general limit and 25 μg/m3 for the welding industry. We aimed to assess the current burden of lung cancer caused by occupational exposure to Cr(VI) and to evaluate the impact of the recently established EU regulation by analysing different occupational exposure limits. METHODS Data were extracted from the literature, the Global Burden of Disease 2019) study, and Eurostat. We estimated the cases of cancer attributable to workplace exposure to Cr(VI) by combining exposure-effect relationships with exposure data, and calculated related DALYs and health costs in scenarios with different occupational exposure limits. RESULTS With current EU regulations, 253 cases (95%UI 250.96-255.71) of lung cancer were estimated to be caused by Cr(VI) in 2019, resulting in 4684 DALYs (95%UI 4683.57-4704.08). In case the welding industry adopted 10 μg/m3, a decrease of 43 cases and 797 DALYs from current values is expected. The predicted application of a 5 μg/m3 limit would cause a decrease of 148 cases and 2746 DALYs. Current costs are estimated to amount to 12.47 million euros/year (95%UI 10.19-453.82), corresponding to 39.97 million euros (95%UI 22.75-70.10) when considering costs per DALY. The limits implemented in 2025 would lead to a decrease of 23.35 million euros when considering DALYs, with benefits of introducing a limit value occurring after many decades. Adopting a 1 μg/m3 limit would lower costs to 1.04 million euros (95%UI 0.85-37.67) and to 3.33 million euros for DALYs (95%UI 1.89-5.84). DISCUSSION Assessing different scenarios with different Cr(VI) occupational exposure limits allowed to understand the impact of EU regulatory actions. These findings make a strong case for adapting even stricter exposure limits to protect workers' health and avoid associated costs.
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Affiliation(s)
- José Chen-Xu
- NOVA National School of Public Health, Public Health Research Centre, NOVA University Lisbon, Lisbon, Portugal; Public Health Unit, Primary Healthcare Cluster Baixo Mondego, Coimbra, Portugal.
| | | | | | - Susana Viegas
- NOVA National School of Public Health, Public Health Research Centre, Comprehensive Health Research Center, CHRC, NOVA University Lisbon, Lisbon, Portugal
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Abstract
Selected occupational populations are at the highest risk of lung cancer, because they smoke at increased rates and are concurrently exposed to workplace lung carcinogens. Low-dose computed tomography (CT)-based lung cancer screening has an enormous potential to reduce lung cancer mortality in these populations, as shown both in the lung cancer screening studies in the general population and in studies of workers at high risk of lung cancer. Pulmonologists can play a key role in identifying workers at high risk of lung cancer and ensuring that they are offered annual low-dose CT scans for early lung cancer detection.
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Affiliation(s)
- Steven B Markowitz
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, 65-30 Kissena Boulevard, Remsen Hall, Queens, NY 11367, USA.
| | - Brittany Dickens
- Barry Commoner Center for Health and the Environment, Queens College, City University of New York, 65-30 Kissena Boulevard, Remsen Hall, Queens, NY 11367, USA
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Abstract
Background: In Indonesia, many occupations and industries involve a variety of hazardous and toxic materials. The ILO estimates that about 21.1% of the tracheal, bronchial, and lung cancer deaths among men were attributable to workplace hazardous substances. This study investigated the relationship between occupations or workplace exposure and the risk of lung cancer in the country. The results will help determine how Indonesia can best mitigate the risk for its workers. Objectives: This case-control study utilizes the Indonesian Standard of Industrial Classification (IndSIC) 2015 with the aim of exploring the risk of lung cancer among Indonesian workers. Methods: The study included patients aged 35 years old or older receiving thoracic CT at the radiology department of Persahabatan Hospital. The cases were histological-confirmed primary lung cancers, while the controls were negative thoracic CT scan for lung cancer. The subjects’ job titles and industries were classified according to IndSIC 2015 and blind to the patient’s grouping as a case or control. Logistic regression was used to determine the odds ratios for lung cancer among all sections and some divisions or groups of IndSIC 2015. Findings: The mean age was 58.1 (±10.23) years for lung cancer patients and 54.5 (±10.23) years for controls. The majority of subjects (19.6%) worked in Section G (Wholesale and retail trade; repair of motor vehicles and motorcycle). After adjusting for age, gender, level of education, and smoking habit, the risk of lung cancer was nearly three-times higher (OR = 2.8, 95% CI = 1.11–7.02) in workers of Division A01 (crop, animal production, and hunting) and two-times higher (OR = 1.9, 95% CI = 1.05–3.46) in workers of Section F (construction) compared to the workers in other sections or divisions. Conclusions: The excess risk of lung cancer among certain categories of workers confirms the need for improved policy, monitoring, and control of occupational exposure for primary cancer prevention and workers’ compensation purposes.
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Lightfoot N, MacEwan L, Tufford L, Holness DL, Mayer C, Kramer DM. Who cares? The impact on caregivers of suspected mining-related lung cancer. ACTA ACUST UNITED AC 2019; 26:e494-e502. [PMID: 31548817 DOI: 10.3747/co.26.4635] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Background In the present study, we investigated the emotional, physical, financial, occupational, practical, and quality-of-life impacts on caregivers of patients with mining-related lung cancer. Methods This concurrent, embedded, mixed-methods study used individual in-depth qualitative interviews and the 36-item Short Form Health Survey (version 2: RAND Corporation, Santa Monica, CA, U.S.A.) quality-of-life measure with 8 caregivers of patients with suspected mining-related lung cancer who had worked in Sudbury or Elliot Lake (or both), and sometimes elsewhere. Individuals who assist workers in filing compensation claims were also interviewed in Sudbury and Elliot Lake. Interviews (n = 11) were transcribed and analyzed thematically. Results Caregiver themes focused on the long time to, and the shock of, diagnosis and dealing with lung cancer; not much of a life for caregivers; strong views about potential cancer causes; concerns about financial impacts; compensation experiences and long time to compensation; and suggestions for additional support. Quality-of-life scores were below the norm for most measures. Individuals who assist workers in preparing claims were passionate about challenges in the compensation journey; the requirement for more and better family support; the need to focus on compensation compared with cost control; the need for better exposure monitoring, controls, resources, and research; and job challenges, barriers, and satisfaction. Conclusions Caregivers expressed a need for more education about the compensation process and for greater support. Worker representatives required persistence, additional workplace monitoring and controls, additional research, and a focus on compensation compared with cost control. They also emphasized the need for more family support.
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Affiliation(s)
- N Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, ON
| | - L MacEwan
- School of Social Work, Laurentian University, Sudbury, ON
| | - L Tufford
- School of Social Work, Laurentian University, Sudbury, ON
| | - D L Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, and Division of Occupational Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael's Hospital, Toronto, ON
| | - C Mayer
- Supportive Care Oncology Research Unit, Health Sciences North, Sudbury, ON
| | - D M Kramer
- School of Occupational and Public Health, Ryerson University, Toronto, ON
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Lee K, Lee S, Min J, Kim I. Occupational cancer claims in Korea from 2010 to 2016. Ann Occup Environ Med 2018; 30:64. [PMID: 30410771 PMCID: PMC6211432 DOI: 10.1186/s40557-018-0272-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Accepted: 09/21/2018] [Indexed: 11/14/2022] Open
Abstract
Background Research on carcinogens causing occupational cancer has been updated. Further, social interest in occupational cancer has increased. In addition, the standard for recognizing cancer as a work-related disease has also been revised. The present study aims to describe the distribution of occupational cancer claims or its approval rate and their association with work-related variables. Methods We analyzed 1299 claim cases for occupational cancer from 2010 to 2016 provided by the Korea Workers’ Compensation and Welfare Service (KCOMWEL). The status of approval rate was shown by year, sex, industry, occupation, age of diagnosis, duration from employment to diagnosis, and cancer site. Results The approval rate was 39.0% from 2010 to 2016 and tended to increase annually since 2011. Both the number of claims and the approval rate were higher in men. Mining and quarrying showed the highest approval rate (78.4%). The approval rates by age of diagnosis and duration from employment to diagnosis increased as the time periods increased. Respiratory organ had the highest number of claims and the highest approval rate by cancer site. Conclusions The approval rate of occupational cancer has shown an increasing trend since 2011. The increase of occupational carcinogens and cancer sites and the improvement of social awareness about occupational cancer could have resulted in this trend. The present study provides unique, and the latest and most accurate findings on occupational cancer data of recent 7 years that could be helpful to researchers or policy makers on occupational cancer.
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Affiliation(s)
- Kyungjoon Lee
- 1Department of Occupational and Environmental Medicine, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Republic of Korea
| | - Sujin Lee
- 1Department of Occupational and Environmental Medicine, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Republic of Korea
| | - Jeehee Min
- 1Department of Occupational and Environmental Medicine, Hanyang University Hospital, 222-1 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Republic of Korea
| | - Inah Kim
- 2Department of Occupational and Environmental Medicine, College of Medicine, Hanyang University, 222 Wangsimni-ro, Seongdong-gu, Seoul, 04763 Republic of Korea
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Kushner R, Kramer DM, Holness DL. Feasibility of clinicians asking patients about their exposure to occupational hazards: An intervention at five primary care health centres. Work 2018; 60:365-384. [DOI: 10.3233/wor-182750] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Rivka Kushner
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada
| | - Desre M. Kramer
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada
| | - D. Linn Holness
- Dalla Lana School of Public Health and Department of Medicine, University of Toronto, Toronto, ON, Canada
- Division of Occupational Medicine and Centre for Urban Health Solutions, Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, ON, Canada
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Kramer DM, Holness DL, Haynes E, McMillan K, Berriault C, Kalenge S, Lightfoot N. From awareness to action: Sudbury, mining and occupational disease in a time of change. Work 2018; 58:149-162. [PMID: 29036859 PMCID: PMC5676845 DOI: 10.3233/wor-172610] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
BACKGROUND: Miners work in highly hazardous environments, but surprisingly, there are more fatalities from occupational diseases, including cancers, than from fatalities from injuries. Over the last few decades, the mining environment has become safer with fewer injuries and less exposure to the toxins that lead to occupational disease. There have been improvements in working conditions, and a reduction in the number of workers exposed, together with an overall improvement in the health of miners. OBJECTIVES: This study attempted to gain a deeper understanding of the impetus for change to reduce occupational exposures or toxins at the industry level. It focuses on one mining community in Sudbury, Ontario, with a high cancer rate, and its reduction in occupational exposures. It explored the level of awareness of occupational exposures from the perspective of industry and worker representatives in some of the deepest mines in the world. Although awareness may be necessary, it is often not a sufficient impetus for change, and it is this gap between awareness and change that this study explored. It examined the awareness of occupational disease as an impetus to reducing toxic exposures in the mining sector, and explores other forces of change at the industrial and global levels that have led to an impact on occupational exposures in mining. METHODS: From 2014 and 2016, 60 interviews were conducted with individuals who were part of, or witness to the changes in mining in Sudbury. From these, 12 labour and 10 industry interviews and four focus groups were chosen for further analysis to gain a deeper understanding of industry and labour’s views on the changes in mining and the impact on miners’ health from occupational exposures. The results from this subsection of the data is the focus for this paper. RESULTS: The themes that emerged told a story about Sudbury. There is awareness of occupational exposures, but this awareness is dwarfed in comparison to the attention that is given to the tragic fatal injuries from injuries and accidents. The mines are now owned by foreign multinationals with a change from an engaged, albeit paternalistic sense of responsibility for the health of the miners, to a less responsive or sympathetic workplace culture. Modernization has led to the elimination, substitution, or reduction of some of the worst toxins, and hence present-day miners are less exposed to hazards that lead to occupational disease than they were in the past. However, modernization and the drop in the price of nickel has also led to a precipitous reduction in the number of unionized miners, a decline in union power, a decline in the monitoring of present-day exposures, and an increase in non-unionized contract workers. The impact has been that miners have lost their solidarity and power to investigate, monitor or object to present-day exposures. CONCLUSIONS: Although an increase in the awareness of occupational hazards has made a contribution to the reduction in occupational exposures, the improvement in health of miners may be considered more as a “collateral benefit” of the changes in the mining sector. Multiple forces at the industrial and global level have differentially led to an improvement in the working and living environment. However, with the loss of union power, the miners have lost their major advocate for miner health.
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Affiliation(s)
- Desre M Kramer
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada
| | - D Linn Holness
- Centre of Research Expertise for Occupational Disease, St. Michael's Hospital, Toronto, ON, Canada, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Emily Haynes
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada
| | - Keith McMillan
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada
| | - Colin Berriault
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada
| | - Sheila Kalenge
- Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada
| | - Nancy Lightfoot
- School of Rural and Northern Health, Laurentian University, Sudbury, ON, Canada
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Wranik WD, Muir A, Hu M. Costs of productivity loss due to occupational cancer in Canada: estimation using claims data from Workers' Compensation Boards. HEALTH ECONOMICS REVIEW 2017; 7:9. [PMID: 28188606 PMCID: PMC5307412 DOI: 10.1186/s13561-017-0145-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 01/20/2017] [Indexed: 06/06/2023]
Abstract
INTRODUCTION Cancer is a leading cause of illness globally, yet our understanding of the financial implications of cancer caused by working conditions and environments is limited. The goal of this study is to estimate the costs of productivity losses due to occupational cancer in Canada, and to evaluate the factors associated with these costs. METHODS Two sources of data are used: (i) Individual level administrative claims data from the Workers Compensation Board of Nova Scotia; and (ii) provincial aggregated cancer claims statistics from the Association of Workers Compensation Boards of Canada. Benefits paid to claimants are based on actuarial estimates of wage-loss, but do not include medical costs that are covered by the Canadian publicly funded healthcare system. Regional claims level data are used to estimate the total and average (per claim) cost of occupational cancer to the insurance system, and to assess which characteristics of the claim/claimant influence costs. Cost estimates from one region are weighted using regional multipliers to adjust for system differences between regions, and extrapolated to estimate national costs of occupational cancer. RESULTS/DISCUSSION We estimate that the total cost of occupational cancer to the Workers' Compensation system in Canada between 1996 and 2013 was $1.2 billion. The average annual cost was $68 million. The cancer being identified as asbestos related were significantly positively associated with costs, whereas the age of the claimant was significantly negatively associated with costs. The industry type/region, injury type or part of body affected by cancer were not significant cost determinants. CONCLUSION Given the severity of the cancer burden, it is important to understand the financial implications of the disease on workers. Our study shows that productivity losses associated with cancer in the workplace are not negligible, particularly for workers exposed to asbestos.
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Affiliation(s)
- W Dominika Wranik
- School of Public Administration, Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada.
| | - Adam Muir
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, NS, Canada
| | - Min Hu
- Department of Economics, Dalhousie University, Halifax, NS, Canada
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Tompa E, Kalcevich C, McLeod C, Lebeau M, Song C, McLeod K, Kim J, Demers PA. The economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure. Occup Environ Med 2017; 74:816-822. [PMID: 28756416 PMCID: PMC5740539 DOI: 10.1136/oemed-2016-104173] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2016] [Revised: 05/10/2017] [Accepted: 05/20/2017] [Indexed: 01/15/2023]
Abstract
OBJECTIVES To estimate the economic burden of lung cancer and mesothelioma due to occupational and para-occupational asbestos exposure in Canada. METHODS We estimate the lifetime cost of newly diagnosed lung cancer and mesothelioma cases associated with occupational and para-occupational asbestos exposure for calendar year 2011 based on the societal perspective. The key cost components considered are healthcare costs, productivity and output costs, and quality of life costs. RESULTS There were 427 cases of newly diagnosed mesothelioma cases and 1904 lung cancer cases attributable to asbestos exposure in 2011 for a total of 2331 cases. Our estimate of the economic burden is $C831 million in direct and indirect costs for newly identified cases of mesothelioma and lung cancer and $C1.5 billion in quality of life costs based on a value of $C100 000 per quality-adjusted life year. This amounts to $C356 429 and $C652 369 per case, respectively. CONCLUSIONS The economic burden of lung cancer and mesothelioma associated with occupational and para-occupational asbestos exposure is substantial. The estimate identified is for 2331 newly diagnosed, occupational and para-occupational exposure cases in 2011, so it is only a portion of the burden of existing cases in that year. Our findings provide important information for policy decision makers for priority setting, in particular the merits of banning the mining of asbestos and use of products containing asbestos in countries where they are still allowed and also the merits of asbestos removal in older buildings with asbestos insulation.
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Affiliation(s)
- Emile Tompa
- Institute for Work and Health, Toronto, Ontario, Canada.,Department of Economics, McMaster University, Hamilton, Ontario, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | | | - Chris McLeod
- Institute for Work and Health, Toronto, Ontario, Canada.,School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Martin Lebeau
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
| | - Chaojie Song
- Occupation Cancer Research Centre, Toronto, Ontario, Canada
| | - Kim McLeod
- School of Population and Public Health, Faculty of Medicine, University of British Columbia, Vancouver, British Columbia, Canada
| | - Joanne Kim
- Occupation Cancer Research Centre, Toronto, Ontario, Canada
| | - Paul A Demers
- Occupation Cancer Research Centre, Toronto, Ontario, Canada
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Arrandale VH, Bornstein S, King A, Takaro TK, Demers PA. Designing exposure registries for improved tracking of occupational exposure and disease. Canadian Journal of Public Health 2016; 107:e119-e125. [PMID: 27348098 DOI: 10.17269/cjph.107.5039] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2015] [Revised: 01/21/2016] [Accepted: 10/27/2015] [Indexed: 11/17/2022]
Abstract
OBJECTIVES Registries are one strategy for collecting information on occupational exposure and disease in populations. Recently leaders in the Canadian occupational health and safety community have shown an interest in the use of occupational exposure registries. The primary goal of this study was to review a series of Canadian exposure registries to identify their strengths and weaknesses as a tool for tracking occupational exposure and disease in Canada. A secondary goal was to identify the features of an exposure registry needed to specifically contribute to prevention, including the identification of new exposure-disease relationships. METHODS A documentary review of five exposure registries from Canada was completed. Strengths and limitations of the registries were compared and key considerations for designing new registries were identified. RESULTS The goals and structure of the exposure registries varied considerably. Most of the reviewed registries had voluntary registration, which presents challenges for the use of the data for either surveillance or epidemiology. It is recommended that eight key issues be addressed when planning new registries: clear registry goal(s), a definition of exposure, data to be collected (and how it will be used), whether enrolment will be mandatory, as well as ethical, privacy and logistical considerations. CONCLUSIONS When well constructed, an exposure registry can be a valuable tool for surveillance, epidemiology and ultimately the prevention of occupational disease. However, exposure registries also have a number of actual and potential limitations that need to be considered.
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Affiliation(s)
- Victoria H Arrandale
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue (3-010), ON, M5G 1X3, Canada. .,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| | - Stephen Bornstein
- Centre of Applied Health Research, Memorial University, St. John's, NL, Canada
| | - Andrew King
- School of Labour Studies, McMaster University, Hamilton, ON, Canada
| | - Timothy K Takaro
- Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada
| | - Paul A Demers
- Occupational Cancer Research Centre, Cancer Care Ontario, 525 University Avenue (3-010), ON, M5G 1X3, Canada.,Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
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Labrèche F, Duguay P, Boucher A, Arcand R. But other than mesothelioma? An estimate of the proportion of work-related cancers in Quebec. ACTA ACUST UNITED AC 2016; 23:e144-9. [PMID: 27122983 DOI: 10.3747/co.23.2812] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
BACKGROUND More than 30 exposures in the workplace are proven carcinogens. In the present study, we aimed to estimate the burden of occupational cancer in Quebec so as to increase awareness among stakeholders and to prioritize research activities. METHODS Work-attributable fractions-that is, the proportions of cancers attributable to work-as published in Finland and the United Kingdom were applied to Quebec 2002-2006 cancer incidence and mortality data to estimate the number of work-related cases for 28 cancer sites. RESULTS Overall, 6.0% of incident cancers (men: 9.1%; women: 2.7%) and 7.6% of cancer deaths (men: 11.8%; women: 2.8%) could be attributable to work, resulting annually in an average of 2160 new cancer diagnoses and 1190 cancer deaths in Quebec. Incident cancers of the lung, prostate, skin, bladder, and (female) breast were the most numerous; cancer sites resulting in more deaths were lung, (female) breast, and pleura. During the same period, compensation statistics reported annual averages of 94.3 incident cancers and 61.9 cancer deaths, mostly involving mesothelioma (64% of compensated incident cancers) and lung cancer (30% of compensated incident cancers). CONCLUSIONS Increased recognition of workplace cancers by all stakeholders, from workers and employers to treating physicians, will foster appropriate preventive measures for safer workplaces.
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Affiliation(s)
- F Labrèche
- Chemical and Biological Hazards Prevention, Institut de recherche Robert-Sauvé en santé et en sécurité du travail (irsst), Montreal, QC;; Departments of Environmental and Occupational Health and of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, QC
| | - P Duguay
- Scientific Division, irsst , Montreal, QC
| | - A Boucher
- Scientific Division, irsst , Montreal, QC
| | - R Arcand
- Occupational Health Unit, Institut national de santé publique du Québec, Montreal, QC
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