European Agency for Safety and Health at Work
Exposure to carcinogens and work-related cancer: A review of assessment methods
European Risk Observatory Report
15 december 2014
Table of Contents
List of tables and figures
Glossary
Introduction
Risk factors for cancer and occupational exposure to carcinogens
Sources of data on occupational exposure to carcinogens
Occupational exposure to carcinogens
Conventional and new approaches to the assessment and prevention of occupational cancer
Policies and strategies
Conclusions and recommendations
Conclusions
Recommendations
References
1. Introduction
2. Risk factors for work-related cancer and occupational exposure to carcinogens
2.1. Risk factors
2.1.1. Chemical risk factors
2.1.2. Environmental tobacco smoke
2.1.3. New and emerging chemical risks
2.1.4. Biological risk factors
2.1.5. Radiation
2.1.6. Emerging physical risks
2.1.7. Shift work that involves circadian disruption
2.1.8. Other work organisational factors
2.1.9. Sedentary work
2.1.10. Socioeconomic status
2.1.11. Summary: overview of cancer risk factors
2.2. Data sources for occupational exposure to carcinogens
2.2.1. National registers on occupational exposure to carcinogens
2.2.2. Exposure measurement databases
2.2.3. Information systems on carcinogen exposure
2.2.4. Other information systems including estimates on occupational exposure to carcinogens
2.2.5. Non-chemical carcinogens
2.2.6. Vulnerable groups
3. New approaches to the assessment and prevention of occupational cancer
3.1. Further developments and uses of exposure measurements and estimates.
3.1.1. Information on exposure trends and prediction of future exposures: the FINJEM-based trend study
3.1.2. Occupational exposure profiles based on job–exposure matrices
3.1.3. Distribution by exposure level: WOODEX – International information system on occupational exposure to wood dust
3.1.4. Identification and prevention of high exposures: Finnish ‘Dirty dozen’ project
3.1.5. Estimating exposure to occupational carcinogens in Australia (2011–12)
3.2. Identification of groups at risk through disease data
3.2.1. Identifying occupations at risk: Nordic Occupational Cancer Study
3.2.2. Occupational Cancer Monitoring (OCCAM)
3.2.3. Validating exposure histories and identifying vulnerable groups: the GISCOP study
4. Encouraging the principles of workplace prevention in legislation
4.1. International Labour Organisation conventions and recommendations
4.1.1. International Labour Organisation conventions
4.1.2. International Labour Organisation recommendation
4.2. European occupational safety and health legislation
4.2.1. Occupational exposure limit values
4.2.2. European Schedule of Occupational Diseases
4.3. European Union chemicals legislation: REACH
4.3.1. Registration under REACH
4.3.2. Authorisation and restriction under REACH
4.3.3. Derived no-effect levels required under REACH
4.4. Other regulations
4.4.1. Tobacco smoke
4.5. Principles of workplace prevention
4.5.1. The importance of the precautionary principle
4.5.2. Avoidance and substitution
4.5.3. Technical measures
4.5.4. Guidelines and tools
4.6. Back-to-work policies
5. Examples of national policies and strategies
5.1. France
5.2. Canada
5.2.1. Occupational cancer surveillance using the 1991–2006 Canadian census mortality and cancer cohort
5.2.2. Cross-Canada Study of Pesticides and Select Cancers
5.2.3. Estimating the burden of cancer linked to work in Canada
5.2.4. Activities related to shift work
5.2.5. Guidance and intervention programmes
5.3. Germany
5.3.1. Guidance for chemical agents
5.3.2. Guidance for biological agents.
5.3.3. Other information
6. Further activities of the European Agency for Safety and Health at Work
7. Discussion and conclusions
7.1. Benefits and limitations of exposure information systems
7.1.1. Validation of CAREX data
7.1.2. Sensitivity to vulnerable groups
8. Conclusions and recommendations
9. References
Annex I
List of figures and tables
Table 1: Overview of OSH-relevant carcinogenic factors
Table 2: Sources of exposure information on non-chemical carcinogenic factors and on vulnerable workers
Table 3: Findings and recommendations
Table 4: Number of carcinogens under the harmonised classification and labelling
Table 5: Overview of OSH-relevant carcinogenic factors
Table 6: Occupations or industries that have been evaluated by IARC as definitely (group 1), probably (group 2A) or possibly (group 2B) entailing excess risk of cancer among workers
Table 7: Description of major exposure information systems and reports dedicated to carcinogen exposure in the Member States of the European Union
Table 5: Numbers of workers (in thousands) exposed to agents covered in the CAREX project in 15 Member States of the European Union by country and by selected agents in 1990–3
Table 6: Numbers of exposures by agent (in thousands) in 15 Member States of the European Union in 1990–3 for all agents covered by CAREX
Table 7: Numbers of employed, exposures and exposed workers (in thousands) in 15 Member States of the European Union by industry in 1990–3
Table 11: The most common exposures by agent or factor in Canada
Table 9: Exposure to known and suspected carcinogens by exposure level, Canada, 2006
Table 13: Summary information on occupational exposure to agents associated with cancer in Finland in 2007–9
Table 14: Prevalence estimates (P, % of the employed aged 25–74) of exposure and of substantial exposure* in France in 2007 for selected agents assessed in the Matgéné programme
Table 15: Estimates of occupational exposure to carcinogens in France in 2003 and 2010 according to the SUMER surveys
Table 16: Exposure to chemicals and chemical carcinogens by gender in the public and private sector according to SUMER 2010
Table 17: Exposures to other cancer risk factors according to SUMER 2010
Table 18: Sources of exposure information on non-chemical factors associated with cancer
Table 19: The proportion (%) of the employed that worked in shifts or during the night at least once a month, including at least two hours between 22.00. and 05.00 in 27 Member States of the EU in 2000–10
Table 20: Sources of exposure information on carcinogen exposure of some vulnerable groups
Table 21: Numbers of workers exposed to inhalable wood dust, and distribution of exposed workers (%) by country and level of exposure in 25 Member States of the European Union (EU-25) in 2000–3
Table 22: Numbers of workers exposed to inhalable wood dust, the prevalence of exposure and distribution of exposed workers (%) by industry and level of exposure in 25 Member States of the EU (EU-25) in 2000–3
Table 23: Proportion of final sample and Australian working population estimated to be occupationally exposed, by carcinogenic agent, women
Table 24: Agents included and time periods covered by the job–exposure matrices of Denmark, Finland, Iceland, Norway and Sweden (NOCCA-JEMs)
Table 25: Proportion of exposed jobs by economic sector (GISCOP)
Table 26: Chemical agents and mixtures assessed in the SHEcan study
Table 27: Examples of preventive measures
Table 28: German technical rules (TRGS) with relevance to carcinogenic substances
Table 29: German technical rules for biological agents (TRBA) with relevance to carcinogenic substances
Figure 1: Exposure variables within MGU data acquisition
Figure 2: Most common agents covered by CAREX to which workers were exposed (numbers of exposed workers) in 15 Member States of the European Union in 1990–3
Figure 3: Results for baseline and intervention scenarios 1–6 (described in text) for breast cancer attributable to night shift work (women only), in terms of cancer registrations
Figure 4: Occupational inhalation exposure to crystalline silica (quartz dust) in Finland in 1950, 1970, 1990 and 2008 and predicted for 2020, as measured by four different metrics of exposure. Proportional values as compared with 1950 (baseline = 100).
Figure 5: Occupational exposure profile for welders and flame cutters in Finland in 2007–9; numbers of workers exposed to chemical agent and average level of exposure compared with the Finnish OEL in 2009*
Figure 6: Occupational exposure profile for formaldehyde in Finland in 2007–9; numbers of workers exposed to formaldehyde subdivided by occupation and the average level of exposure compared with the Finnish OEL in 2009 (0.3 ppm)*
Figure 7: Percentage of enterprises with a risk assessment that addressed CMRs, by size of enterprise (number of employees)
Figure 8: Survey on types of shift-work-related interventions. ‘Have any attempts been made to change shift patterns or in other ways to reduce the health impacts of shift work in your workplace? (Check all that apply)’ (n = 659)
© European Agency for Safety and Health at Work, 2014
Fonte: osha.europa.eu