Asbestos and shift work boost work-related cancer deaths to over 8,000 a year

British Journal of Cancer

Around 8,000 cancer deaths in Britain each year are linked to occupations - especially those where asbestos, diesel engine fumes or shift work is involved - a new study shows today. This equates to around 5 per cent of all cancer deaths in Britain.

The study1, funded by the Health and Safety Executive and published in the British Journal of Cancer, also found that just under half of these deaths were among male construction workers who are most likely to come into contact with asbestos as well as other important carcinogens such as silica and diesel engine exhaust.2

Researchers used a list of work-related cancer causing substances identified by the International Agency for Research on Cancer (IARC) to calculate the impact of work on cancer cases and deaths. And they found that around 13,600 new cancer cases are caused by risk factors related to work each year.

After asbestos, the main work-related risk factors were night shift-work – linked to around 1,960 female breast cancer cases, mineral oil from metal and printing industries – linked to around 1730 cases of bladder, lung and non-melanoma skin cancers, sun exposure – linked to around 1540 skin cancer cases, silica exposure – linked to 910 cancer cases and diesel engine exhaust – linked to 800 cases.3

And researchers warned that these estimates of cancer cases and deaths linked to occupation are likely to be conservative and could be even higher as new work-related risk factors are identified or the understanding of potential risk factors becomes more definite.4

In addition there are now more cases of cancer than there were back in 2004.

Lead author Dr Lesley Rushton, an occupational epidemiologist based at Imperial College London, said: “This study gives us a clear insight into how the jobs people do affect their risk of cancer.

“We hope these findings will help develop ways of reducing health risks caused by exposure to carcinogens in the workplace.

“The cancer with the greatest number of cases and deaths linked to work is lung – a disease which is hard to detect early and has poor survival. Over 30 occupational exposures have been identified by IARC as definite or probable lung cancer causing substances.

“One of the best ways we can beat the disease is by preventing it in the first place. Smoking has the single biggest impact on lung cancer risk, but work-place risks are also having a significant effect.”

Asbestos remains the most important occupational risk factor. Even though it is no longer used in construction, maintenance on old buildings can still be a risk for workers today. And the number of asbestos-related cancers will continue to rise as they can take a long time to develop.

Researchers said that some of the risk factors had an effect on cancer beyond the workplace – for example, asbestos can be found in some households and diesel engine exhaust contributes to air pollution.

Sara Hiom, director of information at Cancer Research UK, said: “It’s very worrying to see so many people developing and dying from occupation-related cancers. A large proportion of the deaths are a result of exposure to asbestos in past decades and improved safety measures should mean that in the next generation or so we will see this number tail off dramatically.

“The Health and Safety Executive has commissioned a review of the evidence on shift work and cancer – at the moment it’s still only classified as a probable cause of cancer. Once the review is complete in 2015, we will have a more definite understanding of the role it may play in influencing cancer risk.

“At this point, we expect the government and employers to take fast and appropriate action to minimise the risks faced by workers and Cancer Research UK will be watching this closely.

“Not smoking is the single most important thing that can reduce the likelihood of developing cancer - to put this in perspective, there are around 43,000 cancer deaths due to smoking in the UK each year. Maintaining a healthy weight, cutting back on alcohol and taking plenty of exercise can also have a big impact on reducing the risk of cancer.”

ENDS

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References

1. Rushton, L et al., Occupation and cancer in Britain, British Journal of Cancer Supplement, (2012).

Notes to Editor

2. The burden of occupation on cancer is calculated on 2005 figures for cancer deaths and 2004 figures for cancer incidence. Four per cent of all cancer cases registered in Britain in 2004 were linked to occupational carcinogens.

  • In contrast to cancer deaths linked to occupational risks, the study showed that there were 212 deaths in 2005/06 due to workplace injuries.
  • Around eight per cent of deaths in men are linked to occupation, compared with just over two per cent in women.

Four in ten of all occupation-related cancer cases (41 per cent, 5,408 cases) and just under half of occupation-related cancer deaths (48 per cent, 3,668 deaths) in Britain were in construction workers, particularly men.

The construction industry has over two million workers and makes up around seven per cent of the total working population. Researchers identified this as a high priority sector for reducing work-related cancer risks.

Around 70 per cent of the occupation-related deaths in construction workers were linked to asbestos.

The most recent estimate on occupation and cancer was released last year (D. M. Parkin, The fraction of cancer attributable to lifestyle and environmental factors in the UK in 2010, British Journal of Cancer Supplement, (2011).)

This study also found that around four per cent of all cancer cases in the UK were down to occupation. But the latest research provides more detail on specific risk factors, job sectors and cancer types and also gives figures on cancer deaths.

Previous estimates on occupation and cancer were based on research by Doll and Peto (1981) which found between two and eight per cent of cancer deaths – around 3,000 – 12,000 a year – were caused by occupation.

3. Asbestos was responsible for 4,216 cancer cases in Britain in 2004; of these eight were cancer of the larynx, 47 stomach cancers, 2,223 lung cancers and 1,937 cases of mesothelioma.

  • Asbestos was linked to 3,909 cancer deaths in Britain in 2005 (1,937 of these were from lung cancer, a further 1,937 from mesothelioma, 32 from stomach cancer and three from laryngeal cancer).
  • Shift work was linked to 552 breast cancer deaths.
  • Diesel engine exhaust was linked to 652 deaths from bladder and lung cancer combined.
  • Mineral oils were linked to 1,730 cancers in Britain in 2004 – 296 bladder cancers, 470 lung cancers, 902 non-melanoma skin cancers and 55 sinonasal cancers.
  • Mineral oils were linked to 563 cancer deaths in Britain in 2005.
  • Solar radiation was linked to 1,541 non-melanoma skin cancers and 13 Non-Melanoma Skin Cancer deaths.
  • Another key risk factor was tobacco smoke encountered at work by non-smokers – responsible for 284 lung cancer cases.

4. Since this study, IARC has re-evaluated all group one definite human carcinogens – giving overall classifications but also for specific cancer sites. For instance, in addition to the cancer types linked to asbestos analysed by this study, ovarian, colorectal and pharyngeal cancers have also been linked to this risk. So the asbestos estimates for cancer cases are under-estimated.