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Cancer arising from workplace exposure has a long history. The earliest recognised form of occupational cancer in the world is Chimney sweep’s carcinoma, cancer of the skin of the scrotum, first described in England in 1775.
In many workplaces people are exposed to the carcinogenic effects of dust, fumes, gases, vapours, in addition to harmful chemicals and volatile contaminants. Some of the substances, such as paints, inks, varnishes, glues, lubricants, detergents and certain beauty products, cause long-term harm following contact or inhalation.
The harm these toxic substances cause is largely preventable, but the picture is complicated by the amount of time between exposure and development of the cancer – ranging from many years or even decades.
While the EU’s plans to revise the Carcinogen and Mutagens Directive seem unlikely to get much attention in the media, the bold proposals could lead to a significant reduction in work-related cancer should they come to fruition. Half of work-related deaths in Europe are from cancer.1 In the UK 8,000 cancer deaths and 13,500 new cases of cancer each year are due to occupational exposure.2 In the U.S. there are 20,000 deaths and 40,000 new cases annually.3
The greatest risk of cancer through work exposure lies within the construction and mining industries, due to the wide range of trades and multiple hazardous carcinogens. Jobs in agriculture, work with vehicles and roles in some service industries can also lead to excessive exposure to sunlight and pesticides, in addition to diesel fumes and second-hand smoke. The circadian disruption caused by shift work at night probably increases the risk of breast cancer, according to the International Agency for Research into Cancer (IARC). However, more research is needed to help cement any links between working at night and developing cancer.
The U.S. National Institute for Occupational Safety and Health (NIOSH) estimates that only 2% of chemicals used in commerce have actually been tested for carcinogenicity.4 Some diseases take years to develop even when exposure levels are high. Asbestos remains the most recognised hazard. Existing controls are predicted to lower cases of mesothelioma; for example, the lung cancer caused by exposure to asbestos falling 90% in the UK by 2060.5
The IARC has identified nearly 500 agents that definitely, probably or possibly cause cancer. However, the EU has only imposed an Occupational Exposure Limit (OEL)6 on just three agents: benzene, hardwood dust and vinyl chloride monomer.7
The Carcinogen and Mutagens Directive will introduce or revise OELs for 13 more chemicals.8 By reducing the hardwood dust OEL (from 5 to 3 mg/m³), a monetized health benefit, ranging between EUR 12 and 54 million, will be derived from the reduction in sino-nasal tumours.9 An estimated 3.5 million workers across the EU are exposed to respirable crystalline silica (RCS), putting them at risk of silicosis and lung cancer. Setting an OEL of 0.1 mg/m³ for RCS could prevent 100,000 cancer cases in the next 50 years.10 In the U.S., the Occupational Safety and Health Administration (OSHA) proposes an even lower safe limit for RCS of 0.05mg/m³. For those exposed, this level represents an excess lifetime risk of 19/1000 for lung cancer mortality and 54/100 for lung disease other than cancer.11
Steps like these will improve workers’ health protection by reducing their exposure to carcinogens. But cancers from exposure to asbestos, for example, will continue, and workers are at risk from other cancer-causing agents even at lower levels of exposure. However, although it may take many years to establish the effects of these measures, a review of occupational rates could be in order in some sectors due to a significant risk reduction for some workers.
