The burden of occupational cancer in Great Britain
The aim of this project was to produce an updated estimate of the current burden of occupational cancer specifically for Great Britain. The primary measure of the burden of cancer used in this project was the attributable fraction (AF) ie the proportion of cases that would not have occurred in the absence of exposure; this was then used to estimate the attributable numbers. This involved obtaining data on the risk of the disease due to the exposure of interest, taking into account confounding factors and overlapping exposures, and the proportion of the target population exposed over the period in which relevant exposure occurred. Estimation was carried out for occupational exposures classified by the International Agency for Research on Cancer (IARC) as group 1 (established) and 2A carcinogens (probable).
5.3% (8023) cancer deaths were attributable to occupation in 2005 (men: 8.2% (6366); women 2.3% (1657)). Attributable estimates for total cancer registrations are 13694 (4.0%); and for men: 10074 (5.7%) and women 3620 (2.1%). Occupational attributable fractions are over 2% for mesothelioma, sinonasal, lung, nasopharynx, breast, non-melanoma skin cancer, bladder, oesophagus, soft tissue sarcoma and stomach cancers. Asbestos, shift work, mineral oils, solar radiation, silica, diesel engine exhaust, coal tars and pitches, occupation as a painter or welder, dioxins, environmental tobacco smoke, radon, tetrachloroethylene, arsenic and strong inorganic mists each contribute 100+ registrations. Industries/occupations with high cancer registrations include construction, metalworking, personal/household services, mining, land transport, printing/publishing, retail/hotels/restaurants, public administration/defence, farming and several manufacturing sectors. 56% of cancer registrations in men are attributable to work in the construction industry (mainly mesotheliomas, lung, bladder and non-melanoma skin cancers) and 54% of cancer registrations in women are attributable to shift work (breast cancer).
This project is the first to quantify in detail the burden of cancer due to occupation specifically for GB. There are several sources of uncertainty in the estimates, including exclusion of other potential carcinogenic agents, inaccurate or approximate data and methodological issues. On balance, the estimates are likely to be a conservative estimate of the total attributable burden. Forthcoming reports will present the results for; estimates of Disability-Adjusted Life Years; methods to predict future estimates of the occupational cancers with examples based on important hazards; and the results of sensitivity analysis of these estimates to sources of uncertainty and bias.
This report and the work it describes were funded by the Health and Safety Executive (HSE). Its contents, including any opinions and/or conclusions expressed, are those of the authors alone and do not necessarily reflect HSE policy.
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