About the research
The working environment should not be a place where there is a risk of disease or injury, yet many thousands of workers worldwide are exposed to hazardous substances at work every day. The detection of occupational hazards should therefore have a high priority in any programme of cancer prevention.
By estimating the burden of disease, we can more easily identify major risk factors and those populations that are more likely to get the disease. We can also make more informed decisions on priorities for reducing risk and better understand the nature of health inequalities.
This project is the first to quantify in detail the burden of cancer due to occupation specifically for Britain. It includes estimates for 23 cancer sites, over 40 occupational carcinogens and more than 60 industrial sectors. The results are being used by the Health and Safety Executive, employees and employers to inform and prioritise risk reduction strategies. The methods are being adapted in other countries and extended to include socio-economic impact evaluation.
More specifically, the project estimated the current burden of cancer for Britain due to occupational exposure to carcinogenic agents and/or exposure circumstances classified by the International Agency for Research on Cancer as definite (Group 1) or probable (Group 2A) human carcinogens; it also predicted the future burden under scenarios of exposure reduction. The results inform prioritisation of health and safety strategic planning.
Overall, 8010 cancer deaths (5.3 per cent of all deaths by cancer) and 13,598 cancer registrations could be attributed to occupational carcinogens or circumstances in 2005 and 2004. Important cancer sites are mesothelioma, sino-nasal, lung, naso-pharynx, breast, non-melanoma skin cancer and bladder. Key work-related carcinogens are asbestos, shift work, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, occupation as a painter or welder and dioxins. Approximately 56 per cent of cancer registrations in men occurred in the construction industry and 54 per cent of cancer registrations in women were due to shift (night) work. Without intervention, occupational attributable cancers are forecast to be over 10,000 annually by 2060.
Methodology
The measures of the burden of cancer used were the attributable fraction and numbers of deaths and cancer registrations. For each cancer/exposure pair, risk estimates (adjusted for confounders) were obtained from key industry-based studies, meta-analyses or reviews. The period of exposure relevant to the development of the cancer was assumed to be 10 to 50 years for solid tumours and 0 to 20 years for haematopoietic neoplasms before the year of estimation.
National data were used to derive the proportion of the population ever exposed to each carcinogenic agent or occupation, adjusting for staff turnover, life expectancy and industry-employment trends over this period. The future burden of occupational cancer was estimated by projecting risk exposure periods accounting for cancer latencies of up to 50 years forward in time for a series of forecast target years given past and projected exposure trends and under-targeted reduction scenarios.
Publications
This research has been published in the following journals:
Hutchings, S.J., Cherrie, J.W., Van Tongeren, M. and Rushton, L. (2012) ‘Intervening to reduce the future burden of occupationally-related cancers in Britain: what could work?’, Cancer Prevention Research, 5(10), pp. 1213-1222. doi: 10.1158/1940-6207.CAPR-12-0070
Hutchings, S.J. and Rushton, L. (2011) ‘Towards risk reduction: Predicting the future burden of occupational cancer’, American Journal of Epidemiology 173(9), pp. 1069-1077. doi: 10.1093/aje/kwq434
Rushton, L., Bagga, S., Bevan, R., Brown, T.P., Cherrie, J.W., Fortunato, L., Holmes, P., Slack, R., Van Tongeren, M., Young, C. and Hutchings, S.J. (2010) ‘Occupation and cancer in Britain’, British Journal of Cancer, 102(9), pp. 1428-1437. doi: 10.1038/sj.bjc.6605637
Rushton, L., Brown, T.P., Cherrie, J.W., Fortunato, L., Van Tongeren, M. and Hutchings, S.J. (2010) ‘How much does benzene contribute to the overall burden of cancer due to occupation?’, Chemico-Biological Interactions, 184(1-2), pp. 290-292. doi: 10.1016/j.cbi.2009.11.007
Rushton, L., Hutchings, S. and Brown, T. (2008) ‘The burden of cancer at work: Estimation as the first step to prevention’, Occupational and Environmental Medicine, 65, pp. 789-800. doi:10.1136/oem.2007.037002