Estimates of work-related cancers in workers exposed to carcinogens

Our plain-English summary of Estimates of work-related cancers in workers exposed to carcinogens, by F. Deschamps, M. Barouh, G. Deslee, et al (Occupational Medicine, 2006).

The study

• Authors: F. Deschamps, M. Barouh, G. Deslee, A. Prevost, J.N. Munck
• Journal: Occupational Medicine
• Published: 2006;56(3):204-9
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Aim: To evaluate the proportion of work-related cancers.

Methods: A descriptive study of incident cases of cancer during 3 years in a French county. All people with cancer having a current or past working history were included in the studied population which was recruited from local hospitals. A working history was obtained from each subject by interview. The different organ cancers were linked using well-defined criteria, to specific occupational carcinogenic exposures. The results obtained were compared to international data on work-related cancer incidences.

Results: A total of 2009 cases were included and 3.18% (64) met the criteria for work-related cancer as defined. Asbestos and polycyclic hydrocarbons were the main occupational carcinogens identified. Construction and fabricated metal products sectors were linked to almost two-thirds of work-related cancers. The percentage of the studied population with attributable risk for occupational cancer was relatively close to international data (mean 4%) and organ cancer distribution percentages did not vary significantly from international published validated data.

Conclusion: Work-related cancers tend to be concentrated in relatively small groups of people among whom the risk of developing the disease may be quite large. The detection of occupational hazards should therefore have a higher priority in any programme of cancer prevention. Well-defined criteria to identify specifically cancers with an occupational origin should be specified by the scientific international community.

In plain English

This descriptive study covered people newly diagnosed with a first cancer from September 1995 to September 1998 at a cancer centre and a university hospital in Champagne-Ardenne, France. It included 2009 patients (1092 men and 917 women) with a current or past job. Housewives and permanently unemployed people were excluded. Patients were interviewed about their work histories. A cancer counted as work-related if it occurred at a body site linked to one of 13 known workplace carcinogens and the person had potential contact with that agent at least 5 weeks a year for at least 3 years. By these criteria, 64 cancers (3.18%) were work-related: 5.67% in men and 0.22% in women. Nine of 12 mesotheliomas (listed under pleura) and 49 of 303 lung cancers were counted as work-related. Asbestos accounted for 43 of 68 carcinogen exposures, more than any other agent. The authors made no adjustment for smoking. The authors concluded that work-related cancers tend to be concentrated in relatively small groups of people whose risk may be quite large.

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: Descriptive study of incident (newly diagnosed) cancer cases over 3 years in one French county
• Who was studied: 2009 patients (1092 males, 917 females) with newly diagnosed first cancers from 15 September 1995 to 15 September 1998, seen at the Regional Comprehensive Cancer Centre and University Hospital in Champagne-Ardenne, France. Housewives and permanently unemployed people were excluded. 93 people refused to take part and 18 could not be interviewed.
• Exposure: 13 known occupational carcinogens or groups of carcinogens, including asbestos (linked in the study to lung cancer and mesotheliomas) and polycyclic hydrocarbons (PAHs). Exposure was judged from interview-based job histories. A case counted as work-related if contact was likely and lasted at least 5 weeks a year for not less than 3 years. Exposure intensity was not assessed.
• Main results:
  • 64 of 2009 cancers (3.18%) met the criteria for work-related cancer: 5.67% in men and 0.22% in women.
  • Mesothelioma (listed under pleura): 9 of 12 cases (75%) were attributed to work-related exposure.
  • Lung cancer: 49 of 303 cases (16.2%) were attributed to occupational exposure.
  • Asbestos was the most common exposure, at 43 of 68 carcinogen exposures (63%) among the 64 work-related cases; four cases had both asbestos and PAH exposure. Asbestos accounted for both female cases.
  • Work-related lung cancers and mesotheliomas made up almost 90% of the cases related to asbestos and PAH exposures.
  • Construction, fabricated metal products and manufacturing machinery together accounted for 67% of work-related cases. Asbestos exposure in construction accounted for 17 of the 68 exposures (25%).
  • Applying the highest and lowest published international percentages to the study's cancer counts gave a range of 1.5% (30 cases) to 10% (213 cases), compared with the study's own estimate of around 3% (64 cases).
  • Extrapolating to France as a whole, the authors suggested that about 8400 work-related cancer cases a year (3% of 280 000 new cancers) could deserve compensation, compared with around 500 currently compensated.
• The authors' conclusion: The authors concluded that work-related cancers tend to be concentrated in relatively small groups of people whose risk of developing the disease may be quite large. They also concluded that their estimates were close to international research, and that detecting occupational hazards should have higher priority in cancer prevention.
• Limitations the authors state:
  • No adjustment was made for tobacco use, diet or other environmental factors, so the authors could not assume that lung cancers were not partly due to smoking.
  • Exposure intensity could not be obtained in most cases and was left out.
  • Several common current workplace carcinogens were not included, which the authors said could make the proportion of work-related cancers look smaller.
  • The authors acknowledged that their criteria for counting a cancer as work-related can be debated.

Topics

Medical terms in this study, explained in our Lexicon: Carcinogenic, Attributable Risk.

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• Occupational exposures and cancer: a review of agents and relative risk estimates — C. Marant Micallef, K.D. Shield, et al. (2018)
• Investigating cancer risks related to asbestos and other occupational carcinogens — J. Siemiatycki (2007)
• The long-lasting legacy of industrial carcinogens: the lesson of asbestos. Irving J. Selikoff Memorial Lecture, 1995 — C. Maltoni (1997)
• Carcinogens and the workplace — R. Hawkins (1996)

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