Reducing Occupational Exposure to Chemical Carcinogens

A new IOM paper published in the journal 'Occupational Medicine' identifies that most occupational cancer deaths in the UK are preventable. 7000 people in the UK die from work related cancer each year - far more than the 3000 people who lose their lives in road traffic accidents or the 240 who die as a consequence of accidents at work. Many of these lives could be saved by raising awareness of the substances at work that can cause cancer, the potential risks and reducing exposure to these harmful chemicals.

Over a million people in the UK are exposed to cancer causing substances in their workplaces. The evidence review identified approximately 250 different carcinogens, ranging from the well documented asbestos to Zidovudine, a drug used in HIV that was classified as potential cause of cancer in 2000. The research in the Society of Occupational Medicine's journal then goes on to identify which of these require priority action and which barriers need to be overcome to ensure exposure is controlled.

John Cherrie (the paper's author) argues that in many situations, workers such as those from the construction industry, painters and decorators and workers who are exposed to diesel exhaust fumes from motor vehicles, are simply unaware of the risks and because of this, appropriate controls are not put in place.

"There is a social inequality in occupational cancer risk, which is concentrated in manual workers and lower employment grades. This means that many of the industries with workers at risk don't have access to good occupational health advice so proper risk assessments are not undertaken" said Dr Tony Stevens, President of the Society of Occupational Medicine "The missed opportunity is that we know the culprits and how to control them. It's simply a case of getting the right expertise into the right workplaces."

The study identifies the top 10 chemical or exposure circumstances that contribute to the current cancer burden in Great Britain. Whilst asbestos comes out top, other substances such as crystalline silica found in construction and other industrial processes, particles from diesel engine exhausts, paints and mineral oils were all found to present a serious public health risk. Five of the top ten on the list are all commonly found in construction and we need to target the message for improved control to this sector in particular.

There are currently no steps taken to reduce the risk for most people who are exposed to diesel exhaust emissions such as drivers and tollbooth assistants and this area is not prioritised by regulatory bodies.

The study argues that in almost all cases simple practical steps can be taken to reduce exposure. It provides practical examples to show how effective controls can be easily implemented. In the case of the tollbooth worker - the room can be over pressurised and fresh filtered air can be pumped into the cabin. Painters and decorators need to be educated to use brush or roller applications, wear protective equipment and maximise ventilation. However, in both of these examples there needs to be a considerable shift in attitude before these types of strategies are adopted. Communication on its own will not change attitudes and there needs to be regulatory change, technical innovations and training interventions to ensure the risks for workers from these harmful cancer causing agents is reduced.

The review calls for a series of national surveys to be undertaken so that we have a much better understanding of the number of people exposed to cancer causing chemicals in the workplace and the levels of exposures in different jobs and industries.

The article may be viewed via the following link:

http://occmed.oxfordjournals.org/cgi/content/abstract/59/2/96