Occupational cancer

Occupational cancer
Other names: Workplace cancer[1]
Label for substances dangerous to human health.
Specialty	Oncology, occupational safety
Usual onset	>10 yrs from exposure[2]
Causes	Chemicals, radiation, shift work[1][3]
Prevention	Decreased use of certain chemicals, limiting exposure[4][2]
Frequency	2 to 8% of cancers[5]
Deaths	350,000 in 2016[4]

Occupational cancers are cancers at least partly caused by exposures at work.^[1][4] Types commonly include lung cancer including mesothelioma, bladder cancer, and leukemia.^[6] The period between exposure and onset of cancer is often more than 10 years.^[2]

Risk factors include certain chemicals, radiation, and possibly shift work.^[1][3] Chemicals include asbestos, second hand smoke, silica dust, arsenic, radon, benzene, and diesel fumes.^[7][4][6] Other factors include frequency, amount, duration, and how the exposure occurs.^[8] Professions more commonly affected include farmers, miners, painters, firefighters, and manufacturers of aluminium and rubber.^[1][5]

Prevention involves decreasing the use of certain chemicals and if this is not possible limiting exposure to these substances, a process known as hierarchy of controls.^[4][2][9] This often involves regulation and protective equipment.^[2] Agencies often specify maximum allowed exposures and may put in place routine monitoring.^[8] International Agency for Research on Cancer (IARC) and American Conference of Governmental Industrial Hygienists (ACGIH) have classifications for a substances risk.^[8]

Occupational cancer represents 2 to 8% of cancers^[5] and are responsible for about 3.5 to 5% of cancer deaths (350,000 in 2016).^[10][4] Males are more commonly affected than females.^[10] In the developed world they represent just over half of work related deaths.^[11] They were first identified in the 1700s by Percivall Pott among people who clean chimneys.^[4]

Risks

Occupational exposure to chemicals, dusts, radiation, and certain industrial processes have been tied to occupational cancer. Exposure to cancer-causing chemicals (carcinogens) may cause mutations that allow cells to grow out of control, causing cancer. Carcinogens in the workplace may include chemicals like anilines, chromates, dinitrotoluenes, arsenic and inorganic arsenic compounds, beryllium and beryllium compounds, cadmium compounds, and nickel compounds.^[12] Dusts that can cause cancer leather or wood dusts, asbestos,^[13] crystalline forms of silica, coal tar pitch volatiles, coke oven emissions, diesel exhaust and environmental tobacco smoke.^[12] sunlight; radon gas; and industrial, medical, or other exposure to ionizing radiation can all cause cancer in the workplace. Industrial processes associated with cancer include aluminum production; iron and steel founding; and underground mining with exposure to uranium or radon. Shift work, which can disturb the circadian rhythm, has also been identified as a risk factor for some forms of cancer, in particular for breast cancer. ^[14][15][16]

Other risk factors for cancer include:^[17][18][19]

• Personal characteristics such as age, sex, and race
• Family history of cancer
• Being overweight or having obesity
• Diet and personal habits such as tobacco use and alcohol consumption
• The presence of certain medical conditions or past medical treatments, including chemotherapy, radiation treatment, or some immune-system suppressing drugs
• Certain infectious agents (viruses, bacteria, parasites) including human papillomaviruses, Epstein–Barr virus, hepatitis B virus, hepatitis C virus, and helicobacter pylori
• Exposure to cancer-causing agents in the environment (for example, sunlight, radon gas, air pollution)

Firefighting

Firefighters have shown higher rates of certain types of cancer (respiratory, digestive, and urinary systems), and of all cancers combined, when compared to the general U.S. population.^[20] This is linked to many aspects of the firefighting occupation such as exposure to smoke and other products of combustion that are known carcinogens, as well as being exposed to chemicals in the gear worn to protect the firefighter. ^[21]

Due to the lack of central and comprehensive sources of data, research on cancer rates amongst firefighters has been challenging.^{[22][23][24][25]} On July 7, 2018, Congress passed the Firefighter Cancer Registry Act of 2018 requiring the National Institute for Occupational Safety and Health of the Centers for Disease Control and Prevention to create the National Firefighter Registry designed to collect data on cancer rates among U.S. firefighters.^[26][27][28]

Construction

Construction workers are at a higher risk of developing cancer from exposures at work compared to other occupations.^[29][30][31]

The increased levels of dust and chemicals like asbestos at construction sites leads to workers being exposed. These long term exposures have been linked to the development of lung cancer.^[30] Other factors related to construction work can also put the workers at an elevated risk of cancer such as sun exposure. Construction workers are often required to spend long hours working in the sun. Long periods of exposure to radiation from the sun can cause skin cancer.^[31][32]

Agriculture

Agricultural workers face higher rates of cancer development due to exposures on the job.^[33]

Similar to construction workers, agricultural workers are exposed too many chemicals including known carcinogens. Workers in the agricultural field are also subject to long periods of exposure to radiation from the sun. All of these factors combine put the workers at and increased risk of developing cancers such as prostate cancer, multiple myeloma, and melanoma of the skin.^[33]

Types

Common cancers due to work:^[13]

Prevention

Many occupational cancers are preventable. Personal protective gear, workplace controls, and worker education can prevent exposure to carcinogens in the workplace. Tobacco smoking has also been shown to increase the risk of work-related cancers; decreasing or abstaining from smoking can decrease cancer risk.^[13]

Agencies like the US Food and Drug Administration, Environmental Protection Agency, the International Agency for Research on Cancer (IARC) and Occupational Safety and Health Administration have developed safety standards and limits for chemical and radiation exposure.^[13] International Labour Organization has also adopted Occupation Cancer Convention (C139) in 1979 for improvement of workplace safety conditions.

Epidemiology

An estimated 48,000 cancers are diagnosed yearly in the US that come from occupational causes; this represents approximately 4-10% of total cancer in the United States.^[34] It is estimated that 19% of cancers globally are attributed to environmental exposures (including work-related exposures).^[35] It is estimated that there are approximately 120,000 work-related cancer cases annually in the EU due to exposure to carcinogens at work.^[36]

References

External links

• Firefighters and Cancer Archived 2024-09-14 at the Wayback Machine, National Firefighter Protection Association.
• Firefighters Cancer Foundation Australia Archived 2024-07-20 at the Wayback Machine.

• Firefighter Cancer Support Network Archived 2024-09-14 at the Wayback Machine (FCSN).
• Occupational Cancer in the Fire Service Archived 2024-02-22 at the Wayback Machine, Commonwealth of Massachusetts.

• National Firefighter Registry Archived 2022-10-17 at the Wayback Machine (NFR) for Cancer, National Institute for Occupational Safety and Health (NIOSH), USA
• Stop carcinogens at work Archived 2024-09-14 at the Wayback Machine, EU OSHA. The site shares information to help prevent workers from being exposed to carcinogens in the workplace.
• Occupational Cancer Archived 2024-09-14 at the Wayback Machine, NIOSH.
• NIOSH Pocket guide to chemical hazards, Appendix A- NIOSH Potential Occupational Carcinogens Archived 2024-05-20 at the Wayback Machine.