Occupation and cancer in the UK - statistics

Table 7.1 12,13 shows a summary of what we know about occupational exposure to carcinogens and the cancers they are related to.

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The International Agency for Research on Cancer (IARC) classifies more than 100 exposures as cancer causing and more than 60 as probably cancer causing. Some of these exposures take place in occupational settings (Table 7.2).10

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Studies of occupational exposures and cancer have been carried out for the British population in the year 2005 and the French and Nordic populations in the year 2000. 1-3

The British study estimated that 8% of cancer deaths in men were caused by occupation and 2% of cancer deaths in women, reflecting their lower exposure to occupational carcinogens (Table 7.3). In addition, an estimated 2,900 cases of non-melanoma skin cancer - which is rarely fatal - were attributed to occupational exposure to solar radiation, mineral oils and polycyclic aromatic hydrocarbons (PAH). 1

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The Nordic and French studies made somewhat lower estimates of the proportion of total cancer cases/deaths attributable to occupational exposures: The Nordic study estimated that 3% of all cancer cases in men in the year 2000 were attributable to occupation and the French study estimated that 2.5% of all cancer cases and 3.7% of all cancer deaths in men in the year 2000 were due to occupation. The estimate for the atttibutable proportion for women was lower than 1% in the French study, and lower than 0.1% in the Nordic study. 2, 3

An analysis that scaled up the findings of the British study to the UK population estimated that nearly 4% of all cancers (or around 11,500 cases of cancer) in 2010 were linked to occupation .14

The cancer most strongly linked to occupation is mesothelioma. It is estimated that 80-97% of mesothelioma cases or deaths in men are caused by occupational exposure to asbestos. Studies have produced substantially different estimates for the proportion of mesotheliomas in women that are attributable to occupational or spousal asbestos exposure (38%-83% of mesothelioma cases/deaths).1,2,9

It can take longer than 60 years from first asbestos exposure to development of mesothelioma. Use of asbestos was widespread in the UK until the mid-1980s, and the number of cases of mesothelioma in the UK is expected to peak sometime between 2011 and 2015. 4 Industries which used to involve high exposure to asbestos include shipbuilding and construction (Table 7.2).3 Carpenters have been shown to have a particularly high risk of mesothelioma, with a risk ratio of 50 shown in a British case-control study for men born in the 1940s working in this occupation for at least 10 years before the age of 30 .9

It is estimated that up to 46% of deaths or cases from cancer of the nasal cavity and sinuses in men are caused by occupational exposures. According to the Nordic study, the proportion of nasal cavity and sinus cancer caused by occupation in women is less than 1%. 3 However, the French and British studies estimated that at least 4% and 20%, respectively, of deaths from nasal cavity and sinus cancer in women were caused by occupational exposures. Important workplace exposures for this cancer are leather dust, wood dusts and metals.2,3

Lung cancer also has a strong occupational component, with 21% of deaths in men and 5% in women caused by workplace exposures, according to the British study.1 According to the British study, the major cause of occupation-related lung cancer is asbestos (more than 2,000 cases in 2004). Mineral oils, silica, diesel engine exhaust, dioxins, environmental tobacco smoke, metals, radon and arsenic account for a smaller number of cases (Table 7.2).1 The Nordic study made a similar estimate for the proportion of lung cancers caused by occupation in men (18%), while the French study gave a lower estimate.2,3 The proportion of lung cancer deaths/cases in women caused by occupation were estimated at lower than 1% in both the French and Nordic studies. 2,3

A  proportion of bladder and laryngeal cancer and leukaemia are also linked to occupation. In the case of bladder cancer, linked occupational exposures are PAH, paints, the rubber industry and other sources of exposure to aromatic amines.1,11 Laryngeal cancer has been linked to asbestos and strong inorganic acid mists, and leukaemia to benzene and other solvents.1-3

Other occupational exposures which are known or suspected to cause cancer include vinyl chloride, which causes liver cancer, 6 and shift work, which has been linked to breast cancer (an estimated 2,000 cases due to this cause in Britain in 2004). 8