Never underestimate the risk of occupational cancer

Around 5% of all cancer deaths annually in the UK are caused by occupation-related disease. So what steps can employers take to help make sure their staff will not be the ones who are suffering?

Occupational cancers have been underestimated in the past by both employers and employees.

Recent research, “The burden of occupational cancer in Great Britain” by Rushton L et al (2012), concludes that 8,000 cancer deaths in Britain each year are linked to occupations – especially those where asbestos, diesel engine fumes or shift work are involved. This equates to around 5% of all cancer deaths in Britain.

The research identified the construction industry, with more than two million workers (7% of the working population), as a high-priority sector for reducing work-related cancer risks.

Just under half of occupation-related cancer deaths are among male construction workers who are likely to come into contact with asbestos and other carcinogens, such as silica and diesel engine fumes.

In addition to deaths, the study shows that around 13,600 new cancer cases are caused by risk factors related to work each year.

After asbestos, the main work-related risk factors that were highlighted include: night-shift work, linked to around 1,960 female breast cancer cases; mineral oils from metal and printing industries, linked to around 1,730 cases of bladder, lung and non-melanoma skin cancers; sun exposure, linked to around 1,540 skin cancer cases; silica exposure, linked to 910 cancer cases; and diesel engine fumes, linked to 800 cancer cases.

These figures could be even higher, as new work-related risk factors are identified or the understanding of potential risk factors becomes more definite.

In addition, there are now more cases of cancer generally than there were back in 2004, when the figures the research was based on were produced.

Prevention is key

There is a clear connection between the jobs we do and our risk of developing cancer; unless measures are taken to reduce exposures, work-related cancers will continue to occur at the same rate.

The cancer with the greatest number of cases and deaths linked to work is lung cancer – a disease that is extremely hard to detect early and has poor survival rates. More than 30 occupational exposures have been identified as risks.

One of the best ways to beat cancer is to prevent it in the first instance. While smoking has the single biggest impact on lung cancer risk, workplace risks are also having a significant effect.

Employers need to ensure they are doing all they can to protect their workforce, putting preventative methods in place.

Asbestos will remain the most important occupational risk factor in the future, as even though it is no longer used in construction, maintenance on old buildings can still be a risk for workers today.

The number of asbestos-related cancers will continue to rise as it can take a long time to develop. The manufacturing industry also remains of concern, with more than 4,000 work-related cancers identified.

Similar numbers were found in the service industries – many caused by night work affecting women, with other cancers being caused by large numbers experiencing relatively low levels of exposure.

Small businesses need help

My research has demonstrated that not only is it important to think about reducing statutory workplace limits, but that considerable reduction in occupational cancers could be achieved by improving the compliance to limits already in place.

Particular encouragement is needed for small companies and self-employed workers.

Measures such as water suppression of dust, improved ventilation, regular maintenance of machinery and use of appropriate personal protective equipment, where necessary, have all been shown to be effective in reducing exposure, and could be considered for many of the cancer-causing substances highlighted by this research.

Shift work is now an essential part of working and is important for industry and the economy as a whole, providing flexible working patterns for staff. However, shift work – particularly night-shift work – has been shown to be associated with increased numbers of accidents and sickness absence, in addition to breast cancer in women.

Getting the balance right between the advantages of shift work and the potential social and health disturbances remains a challenge. This is especially difficult given the many different types of shift-work patterns that exist – there is currently ongoing research exploring this.

One of the cancers highlighted in this British study was the non-fatal type of skin cancer. This can be unsightly, and treatments – although usually straightforward – cause inconvenience to sufferers and cost the NHS a considerable amount as there are so many cases.

The main cause is exposure to sunlight, and this study picked out the construction industry and other outdoor workers such as farmers as those most likely to be affected.

Encouraging employers to provide sunscreen and workers to use it would do a lot to reduce this common cancer.

Reducing the risks

Unfortunately, many of the industries of most concern are part of the “macho culture” in which non-fatal skin cancer would be seen as a trivial problem. We need a change of attitude that treats the use of sunscreen on the same level as that of wearing hard hats, safety boots and goggles.

Workers and employers need to identify the potential causes of cancer in their workplaces and develop and apply measures to reduce the risks. This will lead to better working conditions and an increase in the life expectancy of the working population.

Dr Lesley Rushton is a medical statistician and epidemiologist with a special interest in occupational cancers. She will be speaking on day one (Tuesday 26 February) of the Institution of Occupational Safety and Health’s 2013 annual conference in London.

Reference

Rushton L et al (2012). “The burden of occupational cancer in Great Britain”. Health and Safety Executive RR931.

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