Use of exposure registration in the prevention of occupational cancer in Finland

Our plain-English summary of Use of exposure registration in the prevention of occupational cancer in Finland, by J. Alho, T. Kauppinen, E. Sundquist (American Journal of Industrial Medicine, 1988).

The study

• Authors: J. Alho, T. Kauppinen, E. Sundquist
• Journal: American Journal of Industrial Medicine
• Published: 1988;13(5):581-92
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

A nationwide system for monitoring occupational exposure to a wide range of carcinogens has been in operation in Finland since 1979. The primary aim of the system is to lead to the identification, evaluation, and eventual elimination of the exposures. The number of exposed workers reported to the register was about 20,000 out of the work force of 2.3 million in 1979-1984. The most common exposures were chromates, nickel and its inorganic compounds, and asbestos. Data are presented to show that the system has been at least partially successful in decreasing exposures at work places. As an example, we discuss the decrease in the use of hydrazine, which was previously widely used as an anticorrosive agent at power plants. The statistical quality of the system is discussed, and possibilities for future research uses of the computerized data base are outlined.

In plain English

This article was the authors' critical appraisal of the first six years (1979 to 1984) of Finland's national Register of Occupational Exposure to Carcinogens (ASA). Workplaces reported workers exposed to listed carcinogens; 50 were listed between 1979 and 1985. In 1984, 10,815 workers (0.5% of the working population) were listed, and 19,603 people had been in the register at some point in 1979 to 1984. Chromium and nickel had the most registered exposures every year. Among 1984 newcomers, the most common exposures were chromates, nickel, asbestos, benzene and PAHs. The authors reported that most exposed machine and engine mechanics were car mechanics, whose exposures occurred during brake maintenance. They said asbestos strippers appeared under-reported through negligence. They estimated the register covered perhaps only one-sixth to one-third of exposed workers. In a survey of work departments that left the register, 38% reported some decrease in exposure, about half through substitution. Hydrazine use at power plants fell after 1979, which the authors said did not prove an effect of the register. The authors concluded there was some evidence the system may initiate substitution and stimulate preventive measures.

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 appraisal of a national occupational carcinogen exposure register, including surveys of departing work departments and of hydrazine use in power plants
• Who was studied: Workers reported to Finland's ASA register, 1979 to 1984: 10,815 workers in 1984 (0.5% of the working population) from 1,275 work departments; cumulative 19,603 people over 1979 to 1984
• Exposure: 50 listed carcinogens (1979 to 1985), most commonly chromates, nickel and asbestos; asbestos exposure among car mechanics during brake maintenance; hydrazine used as an anticorrosive agent at power plants
• Main results:
  • Among workers entering the register for the first time in 1984, the most common exposures were chromates, nickel, asbestos, benzene and PAHs
  • The cumulative register population over 1979 to 1984 was 19,603 people
  • About one-third of exposed employees were exposed to at least two carcinogens
  • Most exposed machine and engine mechanics were car mechanics; their exposures occurred during brake maintenance of vehicles (asbestos is the exposure the authors link to brake maintenance)
  • Lack of reports from asbestos strippers (and chimney sweeps) appeared to be due to negligence; brake maintenance work had more reported exposures than earlier estimates
  • The authors estimated register coverage may be as low as one-sixth to one-third of exposed workers; for hydrazine in power plants, about one-third
  • Among work departments leaving the register, 11% of exits were due to organizational changes, 38% involved some decrease in exposure (about half through substitution), and 20% to 30% appeared due to negligence
  • Hydrazine imports peaked at about 290 tons/year in 1979 and fell below 100 tons/year in 1985; the authors said this coincided with, but did not prove, an effect of the register
• The authors' conclusion: The authors concluded that a nationwide exposure register is feasible and that there is some evidence it may initiate substitution and stimulate preventive measures
• Limitations the authors state:
  • Register coverage was low, and enforcing reporting can remedy this only to a limited extent
  • The carcinogen list is subject to political negotiation, which reduces its research usefulness
  • Industry and occupation categories are often inaccurate stand-ins for actual exposure
  • Linking the register to cancer data was not yet considered useful because of the population's small size and young mean age (35 years)
  • Rules are still needed on which light exposures should be reported

Topics

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

Related studies

• Occupational exposure to carcinogens in Finland — P. Heikkilä, T. Kauppinen (1992)
• Finnish Institute of Occupational Health (FIOH): prevention and detection of asbestos-related diseases, 1987-2005 — M.S. Huuskonen, J. Rantanen (2006)
• Breast cancer and occupational exposures in women in Finland — E. Weiderpass, E. Pukkala, et al. (1999)
• Women's occupation and cancer: preliminary analysis of cancer registrations in England and Wales, 1971-1990 — J. Simpson, E. Roman, et al. (1999)
• Retrospective exposure assessment for carcinogenic agents in bitumen waterproofing industry in Finland and denmark — P. Anttila, P. Heikkilä, et al. (2009)
• Trends of occupational exposure to chemical agents in Finland in 1950-2020 — T. Kauppinen, S. Uuksulainen, et al. (2013)

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