Counting the cost of occupational cancer

Exposure to diesel exhaust fumes can be a risk factor for occupational cancer

The Institution of Occupational Safety and Health’s (IOSH) “No Time to Lose” campaign has been working since 2014 to reduce the terrible toll of work-related cancer. Dr Lesley Rushton, of Imperial College London, looks at the risks posed to workers and how they can be controlled

It is a fact that ought to be better known than it is: employees are much more likely to die from cancer caused by work than they are in a workplace accident.

Across industry as a whole, there has been a huge amount of effort put in to ensuring that workplaces are safe, to prevent accidents and protect workers. This, of course, should be applauded.

However, can the same be said for preventing exposure to harmful substances? Are employers doing everything they can to manage the risks that these substances pose? Can employees return home after every shift knowing that their health hasn’t been harmed?

Author details

Dr Lesley Rushton is emeritus reader of occupational epidemiology at Imperial College London’s Faculty of Medicine and is chair of the Industrial Injuries Advisory Council

Many of the substances found in workplaces – more than 50 of them, in fact – can cause cancer.

The extent of these exposures was revealed recently when new global figures showed that 742,000 people die every day from cancer which can be traced back to work activities. This is 2,033 every day. Or 43 every second.

When you take into consideration that 380,000 die every year in workplace accidents – also too many, it must be added – then it is only too easy to see how vital it is that exposure to these substances is controlled.

Extent on occupational cancer

I recently worked with teams from the Health and Safety Laboratory, the Institute of Environment and Health, the Institute of Occupational Medicine and Imperial College London on research into the extent of this issue in Great Britain.

Our findings were published in The Burden of Occupational Cancer in Great Britain. They showed that almost 14,000 new cases of cancer caused by work were being registered each year, while there were around 8,000 deaths annually from occupational cancer.

It was with the Great Britain and international figures in mind that the Institution of Occupational Safety and Health (IOSH) launched its “No Time to Lose” campaign back in November 2014.

While there are over 50 carcinogens that are known to cause cancer found in workplaces, this campaign concentrates on some of the main ones: diesel exhaust fumes; solar radiation; and silica dust.

The campaign calls on organisations to put in place measures to control employee exposure to these carcinogens. It also provides free, practical guidance on how this can be done. In this article I will in more depth at some of these carcinogens and what employers can be to manage and mitigate risk more effectively.

Diesel exhaust fumes

Diesel engine exhaust fumes are a mixture of gases, vapours, liquid aerosols and particles created by burning diesel fuels.

Diesel fumes may contain more than 10 times the amount of soot particles than in petrol exhaust fumes, and the mixture includes several carcinogenic substances, meaning they have the potential to cause cancer.

Our research showed that it is linked to about 650 deaths annually in Great Britain.

Anyone therefore working with or around diesel-powered equipment or vehicles is at risk. Emissions from diesel vehicles like forklifts, lorries, buses, trains and tractors – particularly in enclosed spaces such as garages, warehouses and workshops – can cause a problem. People working with fixed power sources like compressors, generators or power plants in sectors like tunnelling, mining or construction could also be at risk.

There are many types of action that organisations can take to prevent employees from significant exposure to these harmful fumes. These include:

  • switching to other forms of fuel where possible, for example gas or electric;
  • replacing old engines with newer versions with lower emissions;
  • making sure that engines are maintained properly;
  • making sure diesel engine exhausts have filters;
  • using “local exhaust ventilation” and good general ventilation in fixed or enclosed workplaces; and
  • rotating jobs between different employees to minimise exposure.

Solar radiation

The effects of exposure to the sun’s rays have been widely publicised. But how many people really consider how much they are exposed while they are working outdoors?

In Great Britain, there are at least 1,500 new cases of non-melanoma skin cancer and 240 new cases of malignant melanoma diagnosed every year which are linked to solar radiation exposure at work. Work-related skin cancer kills 60 people every year.

There are many sectors where workers are at risk. Construction is certainly one of the most common, but any outdoor worker is vulnerable.

Of course, in such sectors outdoor work is necessary, but there are many ways that people can manage the risks they face. Five of the most effective are:

  • wearing long, loose-fitting clothing to keep the sun off the skin;
  • ensuring the head, face, ears and neck are protected by wearing wide-brimmed hats and sunglasses with UV protection;
  • seeking shade whenever possible, especially during break times and in the middle of the day;
  • regularly applying high-factor sunscreen; and
  • checking your body regularly for any mole changes and other possible skin cancer signs.

Don’t forget, too, it is not just outdoor workers that may be at risk. An office worker who, say, throws themselves down in the park for an hour at lunchtime, without any protection or sunscreen on, could also be doing themselves significant damage.

Silica dust

Every year in Great Britain, nearly 800 people die from lung cancer caused by breathing in silica dust at work.

Silica dust is created when the “crystalline silica” in materials such as stone, mortar or tiles is broken down and released. It happens when you drill, saw, cut, grind or sand the products – or work on them in any way that disturbs the natural silica content.

There is a wide variety of different job roles where people could be at risk. These include bricklayers, ceramics and pottery workers, demolition workers, foundry operatives, furnace workers, mining machine operators, quarry workers, rock drillers and sandblasters.

As with the other carcinogens, however, the No Time to Lose campaign highlights how organisations can take a few simple steps to safeguard their employees.

The main aim should be to stop silica dust getting into the air in the first place. You may be able to select a process that avoids or cuts down the dust being released, for example, taking into account silica dust control at the design stage of a construction project by planning buildings with pre-built recesses for plumbing, gas and electric wiring so there is less need to cut or drill masonry and concrete.

Other ways of managing exposure include removing or substituting materials containing crystalline silica from the work process.

If it is not possible to protect operatives from silica dust at the design stage or by changing processes or materials, then organisations should seek to monitor or assess the exposure and identify the jobs and tasks that need better controls.

In a factory or workshop environment, the best strategy is to use engineering controls like enclosures or hoods and local exhaust ventilation to extract the contaminated air at the point it is produced, or to use water suppression on fixed machinery.

Where work with hand-held power tools generates dust, for example on construction sites, the best strategies are to use localised ventilation on the tool or suppress the dust using water spray systems.

As with the other carcinogens, IOSH’s campaign materials provide more information on managing the risks.

Campaign support

Three years on from the launch of the campaign, I’m delighted to say it has been a major success.

More than 100 organisations from different parts of the world have made a pledge to the campaign. This means they agree to investigate what activities could expose employees to a potentially harmful carcinogen and, once identified, put measures in place to manage the risks.

Meanwhile, a further 200-plus organisations have endorsed No Time to Lose, demonstrating that there is a real will to raise awareness of and take action on occupational cancer.

The campaign has been exhibited at events around the world. I can say from personal experience at some of these exhibitions that it has garnered a huge level of interest.

What we cannot say is whether this level of support has led to a fall in people being diagnosed with work-related cancer.

This is because of the long latency period that exists – many people do not show symptoms or are not diagnosed for years, or even decades.

It is likely that the level of people suffering from cancer caused by work will remain high for some time because of this.

However, this does and should not prevent us from putting measures in place now to protect future the current generation and future generations of workers.

Just as organisations look to keep workplace accidents to a minimum, they must also continue to strive to ensure that people are not exposed carcinogens which could lead to ill health.

All workers, no matter what the industry, should be covered by a culture of care. They have a right to return home at the end of every day’s work in the knowledge they haven’t been exposed to something that could harm their health.

Organisations can take a major step towards doing that today. By making a pledge to the IOSH campaign they can make a real signal of intent about how seriously they view the health of employees and help to ensure that in the future rates of work-related cancer will be reduced.

There really is no time to lose.

For more information, visit www.notimetolose.org.uk. The papers for the research The Burden of Occupational Cancer in Great Britain can be found on the British Journal of Cancer’s website at www.nature.com/bjc/index.html

One Response to Counting the cost of occupational cancer

  1. Robert Olcott 11 Jul 2018 at 8:00 pm #

    In 1975, the Tool & Die Shop I worked at, was bought by a self-proclaimed ‘Millionaire’… who had a new project for us to do (rather than using an existing ‘hermetically sealed room with a Jig Bore already in it, he had me use the milling machine at the foot of the stairs to the office–so all employees could be exposed to the dust…after it sometimes mixed with cutting oil fumes…and when I asked what the material was [I had a pretty good idea what it was], he asked why I was asking, and I explained that I wanted to set my machine speeds/feed rates to the material (I only had a 1903 Machinery’s Handbook), and he said it was “Trialite”. Trialite was not listed in my Machinery’s Handbook, so I went to the blueprints in the back room, to check the ‘Materials List’, and Trialite was spelled: “ASBESTOS” on the blueprints. … When I asked if we could have “3M” Paper Masks…he indicated he couldn’t afford that expenditure, much less respirators….

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