Safety and Health at Work Vol. 13 Supplement 2022
Occupational cancer: Future opportunities and challenges

Safety and Health at Work Vol. 13 Supplement 2022
Occupational cancer: Future opportunities and challenges

Occupational cancer, Future opportunities,challenges

Occupational cancer is estimated to cause 350 000 deaths and 7 million DALYS worldwide every year. These numbers, from the Global Burden of Disease project, are the best estimate we have. However, they are almost certainly underestimates, as they only include a limited number of carcinogens and are based on prevalence data from the early 1990s. This presentation is therefore focused on these two issues: the
identification of occupational carcinogens; and determining who is
exposed to those carcinogens. Identifying carcinogens is a difficult and time-consuming process. Thousands of new chemicals are introduced every year, and only a very small proportion have been assessed by any of the major international organizations. The biggest challenge to speeding up the process is the reliance on traditional epidemiological studies in humans, which need long time periods (often decades), high-
quality records and measurements, and a very large stable workforce. Other approaches such as rodent and mechanistic studies, while more rapid, still require a huge investment of resources. Challenges also arise from the lack of co-ordination between the different regulatory and scientific organizations meaning that the same agents can (confusingly) be assigned different carcinogenicity ratings. An exciting opportunity in this area is the recent development of in silico or computational methods, and the push to develop internationally accepted protocols to use these tools. Determining exposure to established carcinogens is necessary not only for identifying who is exposed to carcinogens, but also where inspection and education campaigns should be focused. Exposure assessments are traditionally in the form of individual workplace measurements by highly trained specialists using customized
equipment and well-equipped laboratories. These assessments are
typically conducted in large companies with in-house expertise or the funds for consultants. In the past, national bodies conducted large-scale surveys or collected measurements from representative samples of the workforce. However, with nearly two-thirds of the workforce in high income countries now working in small and medium sized enterprises, national surveys a thing of the past, and the move of many dirty industries to low-income countries, the likelihood that representative data are being collected is minimal. These challenges need to be met by a change of approach, from expert measurements to new opportunities including the development of low-cost real-time wearable devices, online applications which assess work practices of individuals, and the opportunity to collect anonymous data to provide a more comprehensive understanding of exposure patterns in the community.
There are exciting developments in the areas of identifying carcinogens and determining exposure to those carcinogens which we hope can be taken up in not only the high income countries, but also in low income countries, where the need is much greater.

Lin Fritschi and Renee Carey

Elsevier Korea LLC

January 2022

Sri Wahyuni

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Safety and Health at Work Vol. 13 Supplement 2022