Cancers in France in 2015 attributable to occupational exposures

Our plain-English summary of Cancers in France in 2015 attributable to occupational exposures, by C. Marant Micallef, K.D. Shield, J. Vignat, et al (International Journal of Hygiene and Environmental Health, 2019).

The study

• Authors: C. Marant Micallef, K.D. Shield, J. Vignat, I. Baldi, B. Charbotel, B. Fervers, A. Gilg Soit Ilg, P. Guénel, A. Olsson, L. Rushton, S.J. Hutchings, E. Cléro, D. Laurier, P. Scanff, F. Bray, K. Straif, I. Soerjomataram
• Journal: International Journal of Hygiene and Environmental Health
• Published: 2019;222(1):22-29
• Cited by: 38 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Background: Recent and comprehensive estimates for the number of new cancer cases in France attributable to occupational exposures are lacking.

Objectives: To estimate the number of new cancer cases attributable to occupational exposures, using a newly developed methodology and the most recent data, for a comprehensive set of occupational carcinogens in France in 2015.

Methods: Surveys among employees, the national labor force data, a cohort of agricultural workers, national monitoring of workers exposed to ionizing radiation and job-exposure matrix in France were used. The number and proportion of new cancer cases attributable to established occupational carcinogens (Group 1) was estimated using estimation of lifetime exposure and risk estimates from cohort studies. Cancer data were obtained from the French Cancer Registries Network.

Results: In France in 2015, an estimated 7905 new cancer cases, 7336 among men and 569 among women, were attributable to occupational exposures, representing 2.3% of all new cancer cases (3.9% and 0.4% among men and women respectively). Among men and women, lung cancer was impacted the most, followed by mesothelioma and bladder cancer in men, and by mesothelioma and ovary in women. These cancers contributed to 89% of the total cancers attributable to occupational carcinogens in men, and to 80% in women. The main contributing occupational agent was asbestos among men (45%) and women (60%).

Conclusions: Currently, occupational exposures contribute to a substantial burden of cancer in France. Enhanced monitoring and implementation of protective labor policies could potentially prevent a large proportion of these cancers.

Copyright © 2018. Published by Elsevier GmbH.

In plain English

This study estimated how many new cancer cases in France in 2015 could be attributed to past workplace exposure to established cancer-causing agents. The authors combined estimates of how much of the French population had ever been exposed with relative risks taken from published studies. These sources included national surveys, a farmers' cohort and a job-exposure matrix. For mesothelioma, the share due to asbestos came from a national surveillance program and counted occupational exposure only. Of 346,000 new cancer cases, an estimated 7905 (2.3%) were attributable to work: 7336 in men (3.9%) and 569 in women (0.4%). Asbestos accounted for the largest number, 3489 cases in men and 344 in women. An estimated 83.1% of mesothelioma in men and 41.7% in women was attributed to occupational asbestos. So were 2715 lung cancers in men and 147 in women. An estimated 23.5% of men had ever been exposed to asbestos over 1965 to 2005. The authors concluded that occupational exposures continue to contribute to a substantial number of new cancers in France. They noted that the results largely reflect historical exposure.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Population-attributable fraction estimation (modeling) study combining exposure prevalence data with relative risks from published studies
• Who was studied: Projected new cancer cases in France in 2015 (346,000 in total), estimated from 2013 French Cancer Registries Network (FRANCIM) incidence rates applied to the 2015 population; exposure data came from French surveys, a farmers' cohort, radiation monitoring and a job-exposure matrix
• Exposure: 25 occupational agents in the main analysis, including asbestos (fiber types not specified). Asbestos was grouped among agents very little used after 2000. The mesothelioma fraction counted occupational asbestos exposure only, not para-occupational exposure such as living with an exposed relative.
• Main results:
  • An estimated 7905 of 346,000 new cancer cases in France in 2015 (2.3%) were attributable to occupational exposures
  • Men: 7336 attributable cases (3.9% of all cases in men); women: 569 (0.4% of all cases in women)
  • Asbestos accounted for the largest number of attributable cases: 3489 in men and 344 in women
  • Mesothelioma: 83.1% of cases in men and 41.7% in women were attributed to occupational asbestos exposure
  • Lung cancer attributed to asbestos: 2715 cases in men (PAF 9.3%), 147 in women (PAF 1.3%), 2862 in total (PAF 7.1%)
  • Estimated prevalence of ever exposure to asbestos over 1965 to 2005: 23.54% of men and 2.47% of women
  • In a secondary analysis including agent and cancer pairs with only limited evidence, asbestos added 758 attributable colorectal cancer cases in men and 70 in women
• The authors' conclusion: The authors concluded that occupational exposures continue to contribute to a substantial number of new cancer cases in France, and that many of these carcinogens are still present in French workplaces
• Limitations the authors state:
  • 2013 incidence rates were applied to the 2015 population, because detailed 2015 cancer data were not available
  • Exposure data for some carcinogens were not available
  • The adjustment factors for historical exposure were set by broad category and may not fit each agent, which may over- or under-estimate past exposure prevalence
  • Most exposures used a single ever-exposed versus never-exposed risk estimate, which does not account for different exposure levels
  • The results largely reflect historical exposure, not the burden from current exposures

Topics

Medical terms in this study, explained in our Lexicon: Occupational Exposure, Lung Cancer, Mesothelioma.

Related studies

• Occupational exposures and cancer: a review of agents and relative risk estimates — C. Marant Micallef, K.D. Shield, et al. (2018)
• An estimate of cancers attributable to occupational exposures in France — P. Boffetta, P. Autier, et al. (2010)
• Estimated number of cancers attributable to occupational exposures in France in 2017: an update using a new method for improved estimates — C. Marant Micallef, H. Charvat, et al. (2023)
• The current burden of cancer attributable to occupational exposures in Canada — F. Labrèche, J. Kim, et al. (2019)
• Estimating the social cost of respiratory cancer cases attributable to occupational exposures in France — H. Serrier, H. Sultan-Taieb, et al. (2014)
• Application of Pattern Mining Methods to Assess Exposures to Multiple Airborne Chemical Agents in Two Large Occupational Exposure Databases from France — J.F. Sauvé, A. Emili, et al. (2022)

Browse more research in International Journal of Hygiene and Environmental Health, or return to medical research.