Occupational cancer in the United Kingdom

Our plain-English summary of Occupational cancer in the United Kingdom, by D. Coggon (Environmental Health Perspectives, 1999).

The study

• Author: D. Coggon
• Journal: Environmental Health Perspectives
• Published: 1999;107 Suppl 2(Suppl 2):239-44
• Type of article: Review
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Most of the known occupational hazards of cancer have occurred in the United Kingdom. Over recent decades a contraction of manufacturing industry and legal controls on carcinogens have led to reductions in exposure, but cases continue to occur, often as a consequence of exposures 20 or more years ago. By far the most important occupational cause of cancer in the United Kingdom is asbestos, which currently accounts for some 600 cases of mesothelioma and perhaps 100 cases of bronchial carcinoma per year. Recent trends suggest that the number of mesothelioma cases attributable to asbestos will increase over the next few decades. Exposure to sunlight in outdoor work may cause several hundred cases of nonmelanomatous skin cancer per year, and occupational exposure to polycyclic aromatic hydrocarbons could be responsible for a similar number of skin and lung tumors. Other known occupational hazards of cancer are unlikely to account for more than 100 cases per year in total.

In plain English

This article was a review, part of a monograph on occupational cancer in Europe, that estimated how many cancers in the United Kingdom are caused by work. The author wrote that crocidolite, amosite and chrysotile asbestos had all been used extensively in the UK, and that asbestos was by far the most important occupational cause of cancer there. The author estimated that some 600 mesothelioma cases a year may be attributable to workplace asbestos, a number likely to rise over the next two decades. The author also estimated perhaps 100 cases a year of bronchial carcinoma (lung cancer). A table from the author's earlier death-certificate analysis of men aged 20 to 74 in England and Wales showed more than 850 excess deaths from pleural or peritoneal cancer in asbestos-linked jobs over 11 years. The author noted that the true total was likely substantially higher. The author cited projections by Peto and colleagues that male mesothelioma deaths would peak around 2020 at 2700 to 3300 a year. Overall, the author estimated that occupational exposures may cause 1000 to 2000 of the more than 250,000 cancers occurring each year in the UK.

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: Review (overview of occupational cancer in the United Kingdom, part of a monograph on occupational cancer in Europe); not a new study
• Who was studied: The UK working population in general. The asbestos table draws on the author's earlier proportional mortality analysis of men aged 20 to 74 in England and Wales, 1979-1980 and 1982-1990.
• Exposure: Asbestos (crocidolite, amosite and chrysotile) at work. The review also covered other occupational carcinogens, including polycyclic aromatic hydrocarbons, sunlight, ionizing radiation, aromatic amines, chromates, wood dust and benzene.
• Main results:
  • The author estimated that some 600 mesothelioma cases per year in the UK may be attributable to workplace asbestos, and that this number is likely to increase over the next two decades.
  • The author estimated that occupational asbestos exposure is responsible for perhaps 100 cases of bronchial carcinoma a year.
  • In the table drawn from the earlier analysis (men aged 20 to 74, England and Wales), more than 850 excess deaths from pleural or peritoneal cancer were recorded over the 11-year period in occupations associated with asbestos exposure.
  • Among construction workers not elsewhere classified (a group that includes laggers), there were 77 deaths from pleural cancer and 64 from peritoneal tumors. Carpenters had more pleural cancer deaths (167) but only 6 deaths from peritoneal cancer. The author suggested this may reflect differences in exposure-response relationships for the two tumors.
  • Each year more than 500 new mesothelioma cases are awarded compensation under the government's industrial injuries scheme.
  • The author cited an estimate by Peto and colleagues (a separate study) that male mesothelioma mortality in Britain will peak in about 2020, at between 2700 and 3300 deaths a year.
  • The author estimated that occupational exposures overall may be responsible for between 1000 and 2000 of the more than 250,000 cancers occurring each year in the UK.
• The authors' conclusion: The author concluded that asbestos is by far the most important occupational cause of cancer in the United Kingdom.
• Limitations the authors state:
  • The death-certificate analysis used only the most recent occupation, which may not be the job most relevant to the death given the long induction period for mesothelioma. The author therefore expected the total number of occupational cases to be substantially higher.
  • The link between asbestos and bronchial carcinoma is less specific than for mesothelioma, and comparisons between occupations are confounded by smoking. This makes the occupational impact harder to assess.
  • Cohort studies relating lung cancer to mesothelioma excess focused on highly exposed workers. The author noted the relation may differ at the lower exposures more common in the working population.
  • Links between asbestos and other cancers, such as carcinomas of the larynx and gastrointestinal tract, are not firmly established.
  • The estimates for skin cancer from sunlight and for skin and lung tumors from polycyclic aromatic hydrocarbons are subject to considerable uncertainty.

Topics

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

Related studies

• Mortality of employees of the United Kingdom Atomic Energy Authority, 1946-97 — W.D. Atkinson, D.V. Law, et al. (2004)
• Risk of cancer from occupational exposure to ionising radiation: retrospective cohort study of workers in France, the United Kingdom, and the United States (INWORKS) — D.B. Richardson, E. Cardis, et al. (2015)
• Work-related respiratory disease in the United Kingdom, 1989-1992: report on the SWORD project — S.K. Meredith, J.C. McDonald (1994)
• Asbestos lung fibre analysis in the United Kingdom, 1976-96 — G. Berry (2002)
• Mortality among United Kingdom servicemen who served abroad in the 1950s and 1960s — S.C. Darby, C.R. Muirhead, et al. (1990)
• Occupational cancer in Italy — E. Merler, P. Vineis, et al. (1999)

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