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Understanding the Major Workplace Causes of Cancer in Canada

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In this webinar, Dr. Paul Demers, Director of the Occupational Cancer Research Centre and Professor with the University of Toronto, talked about the impact of the most common workplace carcinogens in Canada and how exposure can be prevented.
The webinar was followed by a question & answer session.

View the video:
https://youtu.be/3xVYsrHjE_U

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Understanding the Major Workplace Causes of Cancer in Canada

  1. 1. Understanding the Major Workplace Causes of Cancer in Canada Paul A. Demers, Ph.D. Director, Occupational Cancer Research Centre Professor, University of Toronto
  2. 2. Scrotal Cancer among Chimney Sweeps • Percival Pott (1775) linked scrotal cancer in chimney sweeps to the nature of their work and their exposure to cancer causing agents in soot • He was the first to identify an occupational carcinogen • Finally in 1840’s laws were passed prohibiting young boys from performing the work
  3. 3. International Agency for Research on Cancer Centre Internationale de Recerche sur le Cancer • IARC/CIRC: a specialized agency of the United Nations created in 1965 • In 1970 program conceived to provide advice on environmental carcinogens • First monograph on carcinogenic risks in 1972
  4. 4. International Agency for Research on Cancer IARC evaluate the carcinogenicity of: – Chemicals, metals, dust – Radiation – Biological agents – Pharmaceuticals – Personal habits – “exposure circumstances”
  5. 5. IARC Evaluation of Carcinogens • Group 1: Carcinogenic in humans (120 agents) – 57% can be found in workplaces • Group 2A: Probably carcinogenic in humans (82 agents) – 65% can be found in workplaces • Group 2B: Possibly carcinogenic in humans (311 agents) – 62% can be found in workplaces • Group 3: Not classifiable (502 agents) – 65% can be found in workplaces
  6. 6. Why are IARC Classifications Important? IARC’s classifications contribute to prevention by:  Stimulating regulations, guidelines, and policies (Occupational Exposure Limits (OELs), Rotterdam Convention, pesticide registration (by PMRA), labeling/WHMIS, toxic use reduction…)  Stimulating voluntary actions by employers and/or workers  Raising awareness
  7. 7. This report is available online at http://www.occupationalcancer.ca/2017/news -occupational-burden-ontario-report
  8. 8. The Burden of Occupational Cancer Project • A national team project funded by the Canadian Cancer Society • The objective was to identify how many cancers are caused by workplace exposures • The report also includes? – The number of people are currently exposed in Canada (from www.CAREXCanada.ca) – How can these cancers be prevented
  9. 9. Hierarchy of hazard controls (U.S. National Institute of Occupational Safety & Health)
  10. 10. The Impact of Asbestos in Canada • Mesothelioma: over 500 new cases each year (the numbers are still rising) • Lung cancer: estimates of approximately 1,900 new cases each year – Economic costs of mesothelioma and lung cancer alone: $2.35 billion annually • Other cancers: smaller numbers of larynx, ovary, stomach and colorectal • Asbestosis: 80 deaths per year, but likely 1000’s with some level of lung scarring
  11. 11. Number of mesothelioma cases by year of diagnosis and province (3-year rolling average) 0 50 100 150 200 250 1992 1993 1994 1995 1996 1997 1998 1999 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 Numberofmesotheliomacases Year of diagnosis Atlantic Provinces Quebec Ontario Manitoba Saskatchewan Alberta British Columbia
  12. 12. Asbestos Prevention • Approximately 150,000 Canadians are still regularly exposed – Majority are in construction and related occupations – Many more irregularly exposed • Canada banned asbestos January 1st this year, but much more is needed: – Removal of asbestos containing material from buildings – Create a public registry of all public buildings & workplaces that contain asbestos – Establish an inter-ministerial working group to address exposure & issues such as safe disposal, building renovation/abatement, public health…
  13. 13. Solar Ultraviolet (UV) Radiation • 4,600 non-melanoma skin cancers annually • 1,500,000 workers exposed • Greatest burden in construction & agricultural. Other groups, such as outdoor parks & recreation workers, gardeners…
  14. 14. Solar Ultraviolet (UV) Prevention Some prevention options: • Provide shade (either natural or shade structures) • Avoid outdoor sun exposure mid-day, 11:00-3:00 • Require all workplaces with workers that work outdoors for part or all of the day to develop a comprehensive, multi- component sun safety program (Sun Safety at Work Canada provides examples)
  15. 15. Diesel Engine Exhaust • 900,000 workers exposed • 560 lung and possibly, 200 bladder cancers annually • Greatest burden in transportation, construction & mining • Some prevention options: – Upgrade or replace old on-road and off-road trucks and diesel engines – Alternative fuels – No idling technology and rules – Exhaust treatment systems – Adopt occupational exposure limits
  16. 16. Crystalline Silica • 140,000 workers exposed • 570 lung cancers annually • Greatest burden in construction, mining, and mineral products processing • Some prevention options: – Replace silica with other substances – Ventilation and filtration systems – Use wet or vacuum methods for drilling, cutting, grinding and clean-up – Follow best practices for Occupational Exposure Limits
  17. 17. Shift Work at Night • Up to 1200 breast cancer suspected annually • 1.9 million working Canadians, depending on definition – Healthcare, hospitality industry, manufacturing, public safety Prevention is challenging • Optimizing work schedules to minimize circadian disruption
  18. 18. Welding Fumes • IARC upgraded all welding fumes from group 2B to Group 1, published in 2012 • Over 500,000 workers exposed ? • 310 lung cancers annually, in addition to eye cancer • Greatest burden in manufacturing & construction • Some prevention options: – Local exhaust ventilation – Appropriate Occupational Exposure Limits are needed
  19. 19. Environmental Tobacco Smoke at Work • Significant progress has been made over the past decades to reduce ETS in workplaces through legislation, supported by increased awareness • 130 lung, 35 pharynx, 20 larynx annually among never smokers • Some prevention options: – Build on successes by strengthening enforcement of smoke-free workplace legislation • According to the Canadian Tobacco Use Monitoring Survey many workers still report exposure to ETS at work and a lack of smoke-free policies
  20. 20. Radon • Approximately 190,000 workers exposed in underground work or poorly ventilated workplaces in high background regions • Approximately 190 lung cancers annually • Some prevention options: – Monitor for exposure! (radon is colourless & odourless) • Much is known about how to reduce exposure – Develop explicit and specific regulation of radon in indoor air (such as NORM (Naturally Occuring Radioactive Materials) Guidelines
  21. 21. Major Occupational Carcinogens in Canada Carcinogen Annual Cancers Current Exposure* Solar UV at Work 4600 non-melanoma skin 1.5 million Asbestos 1900 lung, 430 mesothelioma, 45 larynx, 15 ovarian, (? digestive) 152,000 Diesel Exhaust 560 lung, (200 bladder) 897,000 Crystalline Silica 570 lung 382,000 Welding Fumes 310 lung ? Nickel 170 lung 117,000 Chromium VI 50 lung 104,000 ETS at work 130 lung, 35 pharynx, 15 larynx** 125,000 Radon 190 lung 188,000 PAH’s (130 lung, 50 skin, 80 bladder) 350,000 Shiftwork (470-1200 breast) 1.9 million * People exposed, CAREX Canada ** Among never smokers (probable associations)
  22. 22. Recent IARC Pesticide Evaluations Glyphosate – Classified as Group 2A (NHL) Malathion – Upgraded to Group 2A (NHL, prostate) Diazinon – Upgraded to Group 2A (NHL, leukemia, lung) Lindane – Upgraded to Group 1 (NHL) DDT – Upgraded Group 2A (NHL testicular, liver) Pentachlorophenol – Upgraded Group 1 (NHL) Dieldrin & Aldrin – Upgraded to 2A (breast)
  23. 23. Conclusions • Occupational cancer is more common in Canada than most people think – There are many well-established causes of cancer in the workplace and many more that are suspected – There are thousands of cancers diagnosed every year that were caused by workplace exposures – Millions of Canadians, in a wide range of jobs, are exposed to carcinogens at work • These cancers can be prevented through actions taken at workplaces and government policies and regulations
  24. 24. Towards a cancer free workplace https://occupationalcancer.ca https://www.carexcanada.ca
  25. 25. Canadian Cancer Survivor Network Contact Info 1750 Courtwood Crescent, Suite 210 Ottawa, ON K2C 2B5 Telephone / Téléphone : 613-898-1871 E-mail: jmanthorne@survivornet.ca or info@survivornet.ca Website: www.survivornet.ca Twitter: @survivornetca Facebook: www.facebook.com/CanadianSurvivorNet Instagram: @survivornet_ca Pinterest: http://pinterest.com/survivornetwork/

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