Occupational cancer in a Paris suburb: first results of a proactive research study in Seine Saint-Denis

Our plain-English summary of Occupational cancer in a Paris suburb: first results of a proactive research study in Seine Saint-Denis, by Reseau "Surveiller les Cancers D'origine Professionnelle en Seine, Saint-Denis" Reseau SCOP 93 (International Journal of Occupational and Environmental Health, 2005).

The study

• Authors: Reseau "Surveiller les Cancers D'origine Professionnelle en Seine, Saint-Denis" Reseau SCOP 93
• Journal: International Journal of Occupational and Environmental Health
• Published: 2005;11(3):263-75
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A multidisciplinary network, SCOP 93, investigated cancer patients in three hospitals in a Paris suburb that has an unusually high incidence of cancers, to identify those who had been exposed to occupational carcinogens, assess the adequacy of the French system for their compensation, and help develop priorities for prevention. In 2002-2003, 175 patients were interviewed, of whom 127 provided job histories. Of these, 74% of 107 men and 70% of 20 women were deemed likely to have occupational cancers, half of them following exposures to at least three different carcinogens. The network team prepared claims for the 26 patients whose cancers were potentially compensable by the rigid rules of the system; 21 of them, most of whom had cancers attributable to asbestos, received compensation. Suggestions for improving the system for compensation of occupational cancer victims in France are offered.

In plain English

This article reported the first year of SCOP 93, a network studying the work histories of cancer patients in Seine Saint-Denis, a Paris suburb. From March 1, 2002, to February 28, 2003, it registered 175 new patients (140 men, 35 women) at three hospitals. Of these, 77% had lung cancer and 5.1% had mesothelioma or other pleural cancers. Experts used interview-based job histories, obtained for 127 patients, to judge exposure to 46 listed carcinogens. Among men with job histories, 74% had been exposed to at least one, and half to three or more. Among women, the figure was 70%. Asbestos was the carcinogen most often identified for both sexes. Of 94 exposed patients, 59 received a medical certificate of occupational disease, but only 26, all men, filed claims. Of those claims, 21 were accepted for cancer linked to occupational asbestos exposure, 4 were rejected and 1 was pending. The authors said the project did not aim to examine causal links between exposures and cancer. They tied the dominance of asbestos claims to the higher rewards of France's asbestos compensation fund.

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 hospital cancer patients registered over one year, with sociologist interviews to build job histories and expert assessment of occupational carcinogen exposure and of eligibility for compensation (first-year report of an ongoing network)
• Who was studied: 175 new cancer patients resident in Seine Saint-Denis (140 men, 35 women) admitted to three hospitals there, registered March 1, 2002 to February 28, 2003. Average age was 63 (range 31-94). Lung cancer accounted for 77%, bladder 12%, mesothelioma and other pleural cancers 5.1%, leukemias 2.4% and sinus cancer 0.6%. Job histories were obtained for 127 (107 men, 20 women).
• Exposure: Occupational exposure to a list of 46 carcinogens based on the International Agency for Research on Cancer list, including asbestos (fiber types not specified). Exposure was scored as probability times intensity and classed as weak (scores 1-5), average (6-9) or strong (10-15).
• Main results:
  • Among male patients with job histories, 74% had been exposed to one or more listed carcinogens, and half had been exposed to three or more. Among women, the proportion was 70%.
  • Asbestos was the carcinogen most often implicated for both men and women. In Table 1, asbestos exposure was identified in 184 men's jobs (52%; 76.1% of these scored average or strong) and 7 women's jobs (35%; 42.9% scored average or strong).
  • Of the 94 exposed patients, 11 women (of 14) and 24 men (of 80) were judged by the experts not eligible for compensation.
  • 59 exposed patients (56 men and three women) received an initial medical certificate of occupational disease. The study's summary chart notes that 32 of these 59 died. 33 of the 59 (30 men and three women) did not submit claims.
  • Three out of four exposed women did not receive a medical certificate, and none of the women submitted a claim.
  • 26 claims were submitted, all by men. Of these, 21 were accepted for cancer linked to occupational asbestos exposure, although all 21 had been exposed to several carcinogens. Four were rejected, and one patient was still waiting for a decision.
  • For comparison, 27 cancer cases were compensated by the occupational compensation board in the whole district during 2001. The three study hospitals' patients represent a fourth of the district's cancer patients.
• The authors' conclusion: The authors concluded that the first year's results emphasize the gravity of the situation and show that exposures to occupational carcinogens persist. They attributed the predominance of asbestos-linked claims to the higher rewards of the French asbestos compensation fund, and argued this hides other carcinogen exposures.
• Limitations the authors state:
  • There is no regional cancer register, so the study patients could not be compared with the district's overall population.
  • There were no workplace records of chemical and dust levels, so exposures were estimated from patients' accounts and expert judgment.
  • The study's carcinogen list included only some of the best-known occupational carcinogens.
  • Women's exposures were difficult to assess because of a lack of epidemiologic studies, for example on cleaning work.
  • The project did not aim to examine causal links between exposures and the patients' cancers.

Related studies

• Low dose exposure to natural and man made fibres and the risk of cancer: towards a collaborative European epidemiology. Report of a workshop held in Paris , 10-12 June, 1991 — A.J. Valleron, J. Bignon, et al. (1992)
• The silence: the asbestos industry and early occupational cancer research--a case study — D.E. Lilienfeld (1991)
• The carcinogenicity of dietary acrylamide intake: a comparative discussion of epidemiological and experimental animal research — J.G. Hogervorst, B.J. Baars, et al. (2010)
• After a Century of Research into Environmental Mutagens and Carcinogens, Where Do We Stand? — J.D. Vitorino, P.M. Costa (2023)
• The burden of cancer at work: estimation as the first step to prevention — L. Rushton, S. Hutchings, et al. (2008)
• Phase II study of first-line bortezomib and cisplatin in malignant pleural mesothelioma and prospective validation of progression free survival rate as a primary end-point for mesothelioma clinical trials (European Organisation for Research and Treatment of Cancer 08052) — M.E. O'Brien, R.M. Gaafar, et al. (2013)

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