Just more than 5% of deaths caused by cancer in 2005 would not have occurred if the individuals concerned had not been exposed to carcinogens at work, according to the first detailed review of the burden of occupational cancer in Britain.
The review estimated that 8,019 deaths in 2005 were attributable to occupational exposure. Lung cancer contributed the largest number of attributable deaths for men and women, followed by mesothelioma, bladder, oesophageal and stomach cancers for men, and breast cancer, mesothelioma, bladder and oesophageal cancers for women. Industries contributing substantially to occupational cancers include construction, land transport and other heavy industries, together with personal and household services (including hairdressing and dry cleaning) and retailing. Many carcinogenic exposures in the workplace affect multiple cancer sites – asbestos contributes the most to total attributable deaths and cancer registrations.
The authors said the estimates of the current burden are based on exposures in the past, many of which would have been higher than today. However, they also suggest that, for many carcinogens, a major contribution to the overall burden was made by a large number of workers being exposed at low levels and low risk.
The burden of occupational cancer in Great Britain, HSE, April 2010
Self-reported ill health
Latest figures from the Labour Force Survey for 2008-09 show that 1.2 million people (3.9% of the working population) who worked during this period reported an illness that they believe was caused or made worse by work. Musculoskeletal disorders (MSDs) were by far the most common condition reported, and together with stress, depression and anxiety, accounted for a large proportion of new cases of work-related ill health.
Two public sector areas had higher-than-average prevalence rates of work-related illness – health and social work, and public administration and defence – while teachers and caring personal service occupations were among those with higher-than-average prevalence. Each person reporting a work-related illness took an average 20.8 days off sick as a result.
Trends in the incidence rate of work-related illness have fluctuated recently – falling from 2001-02 to 2005-06, rising sharply in 2006-07, before falling back in 2007-08 and remaining stable last year. Statisticians suggest that falls in the early part of the decade were driven by a sharp decline in stress, depression and anxiety, but that this decline was reversed the following year, matched by a big rise in MSDs. Both incidence rates reverted back to the long-term downward trend in 2007-08 and 2008-09. Days lost per worker because of ill health and injury in 2008-09 were lower than in earlier surveys (with the exception of 2005-06, where the rate in the latest survey was similar).
Self-reported work-related illness and workplace injuries in 2008-09, HSE, April 2010
Women and heart disease
High levels of work pressure are a significant risk factor for heart disease in women, according to a study of Danish female nurses. In total, 12,116 nurses were examined in 1993 using a questionnaire, and their health was tracked to the beginning of 2008. Of these women, 580 were hospitalised with ischaemic heart disease (IHD) in the period, and those who reported high work pressure had a 1.4-fold increased risk of heart disease compared with female nurses who reported “suitable” work pressure. No association was found between job influence and IHD.
The authors said the study added to the previous body of evidence for the harmful effects of excessive psychological demands at work on cardiac health, but went further by demonstrating a specific effect among women.
Psychological work environment and risk of ischaemic heart disease in women: the Danish nurse cohort study, Allesoe K et al, Occupational and Environmental Medicine 2010; 67: pp318-322.
Sleeplessness and work
Employees who wake up at least three times during the night have poorer work productivity and performance than those experiencing fewer sleep interruptions, according to a US study. Just more than 4,000 workers at four US companies described their sleep patterns and completed a work limitation survey questionnaire. Of the sample, 31% averaged three or more awakenings and had the greatest work and productivity impairments across a range of dimensions.
Impact of night-time awakenings on worker productivity and performance, Zammit G K et al, Journal of Occupational and Environmental Medicine 2010, vol. 52, issue 5, pp513-518.
Workplace interventions and rehabilitation
Participatory workplace interventions only help people off sick because of distress return to work if they are motivated to do so at an early stage in their absence. This finding prompted the authors of a Dutch study to suggest that other approaches needed to be considered for this sub-group of long-term absentees.
Employees off sick with distress for between two and eight weeks took part in a stepped intervention involving talking with supervisors about overcoming obstacles to return-to-work. The intervention significantly reduced this group’s time off sick compared with a control group receiving usual care. However, this effect was only noted among those who stated they intended to return to work at the beginning of the study despite symptoms – these workers returned after 55 days on average, compared with 120 days in the case of the usual care group. No such effect was measured for employees without a baseline intention to return to work.
A workplace intervention for sick-listed employees with distress: results of a randomised controlled trial, Occupational and Environmental Medicine 2010, published online first.
Legal news round-up…
Director banned for lead exposure breaches
A director of a fuel tank manufacturing business has been banned from directing any company for five years after breaching a raft of health and safety regulations, and was also fined £17,000. Workers at Transtore (UK) Ltd were exposed to lead and other harmful chemicals while paint was sprayed at the plant without correct safety measures in place. Brian Nixon, managing director of the firm, was also ordered to pay £8,169 costs, and the company was fined £70,000 with costs of £27,507 for eight separate breaches, including contravening three prohibition notices.
During the investigation, blood and urine samples taken from workers showed higher levels of lead than those present in the UK population. The company was condemned for allowing workers to spray paint containing toxic lead chromate without adequate controls in place, meaning the workers were breathing in harmful fumes.
Health and Safety Executive inspector Peter Snelgrove agreed with the district judge who described the situation at the site as “lamentable”, adding: “Mr Nixon deliberately flouted health and safety laws and paid scant regard to the safety of his employees”.
by Sarah Silcox