A presentation given at the University of Aberdeen

1. WORKING FOR A HEALTHY FUTURE
INSTITUTE OF OCCUPATIONAL MEDICINE . Edinburgh . UK www.iom-world.org
How to eliminate occupational
cancer from chemicals
John Cherrie

2. Summary…
• UK occupational cancer burden
• then and now
• What do we mean by elimination of the
problem
• What evidence is there to help understand
exposure changes over time
• What are the priority substances
• Who is responsible for getting this done?

4. Doll and Peto (1981)

5. Occupational cancer burden in Britain
• Imperial College, Institute of Occupational Medicine
and others are undertaking this work for HSE
• Basic approach…
• Identify the number of people exposed, by industry, in
1980s
• Review the epidemiological literature to define the
appropriate relative risk
• Consider multiple exposures, male/female split, turnover
rates and some other complications
• Estimate the likely number of cases now from past
exposure

6. Cancers being considered…
• Lung cancer, bladder cancer, leukaemia,
mesothelioma, non-melanoma skin cancer, sinonasal
• Pharynx and nasopharynx, oesophagus, pancreas,
larynx, cervix, ovary, melanoma, stomach, GI tract
(stomach + colorectal), kidney, non-hodgkin’s
lymphoma, lymphohematopoietic system, multiple
myeloma, soft tissue sarcoma, all sites combined, liver
& bilary tract, liver (angiosarcoma), liver
(hepatocellular), bone, thyroid, CNS, brain, breast,
prostate

7. Results…
Cancer site Number deaths Attributable fraction
bladder 245 5.3%
breast 555 4.6%
larynx 20 2.6%
lung 4749 14.5%
melanoma (eye) 1 1.6%
mesothelioma 1937 95%
nasopharynx 8 8.2%
nhl 57 1.7%
nmsc 23 4.6%
oesophagus 184 2.5%
sinonasal 39 34%
Rushton et al. Occupation and cancer in Britain. British Journal of Cancer
(2010) vol. 102 (9) pp. 1428-1437.

8. Results…
Agent Lung cancer
registrations
Total registrations
Asbestos 2223 4216
Shift work (+ flight personnel) - 1969
Mineral oils 470 1730
Solar radiation - 1541
Silica 907 907
Diesel engine exhaust 695 801
PAHs from coal tars + pitch 282 545
Painters 215 359
TCDD (dioxins) 284 316
Environmental tobacco smoke
(non-smokers)
209 284
Rushton et al. Occupation and cancer in Britain. British Journal of
Cancer (2010) vol. 102 (9) pp. 1428-1437

9. Time trends in exposure…
Rubber - Crude Materials, Compounding and Mixing
0.0
2.0
4.0
6.0
8.0
10.0
12.0
14.0
16.0
18.0
mg/m3
Netherlands
United Kingdom
Poland
Germany
Sweden
Time trend
per year
UK : -6%
NL : -2%
PL : -6%
SW : -6%
GE : -7%
http://exasrub.iras.uu.nl/content.html
Agostini et al. Exposure to rubber process dust and fume since 1970s in the UK;
influence of origin of measurement data. J. Environ. Monit. (2010) vol. 12 (5) pp. 1170

10. Results from a review…
Year
1940 1950 1960 1970 1980 1990 2000 2010
%of1990exposurelevels
0
1000
2000
3000
4000
5000
ExposureNormalisedto100in1990
Aerosols
Creely et al. Trends in Inhalation Exposure - A Review of the Data in the Published
Scientific Literature. The Annals of Occupational Hygiene (2007) vol. 51 (8) pp. 665-678

11. Results from a review…
Year
1940 1950 1960 1970 1980 1990 2000 2010
%of1990exposurelevels
0
1000
2000
3000
4000
5000
ExposureNormalisedto100in1990
Gases and
vapours
Creely et al. Trends in Inhalation Exposure - A Review of the Data in the Published
Scientific Literature. The Annals of Occupational Hygiene (2007) vol. 51 (8) pp. 665-678

12. Crude projections of future burden…
Cherrie JW, Van Tongeren M, Semple S. Exposure to Occupational Carcinogens in
Great Britain. Ann Occup Hyg 2007 51: 653-664.

13. Elimination of occupational cancer….
• …elimination of the disease as a public health
problem (i.e. reduction of cases below what is
considered to be a public health risk)
• What might be “a public health risk” for
occupational cancer?
• Reduction of incidence to <<1% of all
cancers?
Cherrie. We can eliminate occupational cancer from chemicals. Occupational
Medicine (2008) vol. 58 (5) pp. 314-315

14. Possible problem agents…
• Radon and Crystalline silica
• Work to change attitudes and to follow advice on remediation/controls
• Diesel exhaust
• Filtered air in cabs
• Air conditioned refuges
• Respirators
• Welding
• Local ventilation and respirators
• Painting
• Wear respirator and protective clothing
• Improve general ventilation

15. Tracking progress…
• Periodic surveys of exposure by EU and
national authorities
• Intensity (including contextual information)
• Prevalence
• Updates of cancer burden estimates
• Routine reporting by health and safety
professionals through European associations

16. Who’s going to ensure elimination?
• H&S professionals
• Government
• Industry
• Trade unions
Slides available via www.OH-world.org