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The European Agency for Safety and Health at Work (EU-OSHA)
reported on an overview of assessment tools for measuring exposure to carcinogens in the workplace, identified major knowledge gaps, and made recommendations for filling in those gaps.
“Although cancer research has progressed significantly in the recent past, awareness of occupational cancer risks is still low,” EU-OSHA Director Christa Sedlatschek said in a press release. The agency also called for the knowledge gained from research to be translated into prevention measures and regulations.
Much More Needs to Be Known
While chemical substances and radiation are well-known causes of occupational cancer, only a relatively small number of cancer-causing chemicals have been investigated thoroughly, and much research remains to be done concerning other risks, according to the report.
EU-OSHA listed physical, pharmaceutical and biological factors that need to be investigated, including night shift work that involves circadian disruption, sedentary work, nonionizing radiation, work-related stress and exposure to nanomaterials. “Occupational exposure is rarely about a single factor; rather, it involves a combination of factors … this needs greater attention,” the agency said. It also stressed the need to consider subcontracting and temporary work, workers with multiple jobs, female employment in exposed occupations, atypical working times and multiple exposures.
Current information on occupational exposure to carcinogens in Europe is “outdated and incomplete,” according to EU-OSHA. “Scientists agree that the current understanding of the relationship between occupational exposures and cancer is far from complete. Only a limited number of individual factors are established occupational carcinogens. For many more, no definitive evidence is available based on exposed workers. However, in many cases, there is considerable evidence of increased risks associated with particular industries.”
Improved data are necessary because “occupational exposure data are the basis for assessing risks, the burdens of diseases and other consequences of exposure, identifying high-risk worker groups, and setting prevention priorities.”
Current Sources of Data
There are three types of data sources that currently provide information about occupational exposure to carcinogens in the European Union (EU): national registers, exposure measurement databases and exposure information systems.
Some countries have established national registers on exposures to selected carcinogens, such as the Finnish ASA Register, the Italian SIREP and the German ODIN Register.
Sources from other countries, such as Poland, Slovakia and the Czech Republic, are difficult to access for professionals from other countries because of language issues, according to the report. These systems usually provide information on a pre-set selection of suspected or proven carcinogens, about which a certain amount of information already exists.
National registers “do not cover even nearly all relevant carcinogens and underreporting is very likely,” the EU-OSHA report said. On the plus side, these registers identify workplaces where certain carcinogens are being used, may encourage preventive measures to be taken, and may also help safety regulators to focus their activities.
Exposure measurement databases also exist in many countries, such as the MEGA database in Germany, and the international ExpoSYN database, which covers five respiratory carcinogens and data from 19 countries.
Data in these databases are potentially useful for prevention, but access to data is restricted for confidentiality reasons and data are available only in the national language, according to the report.
Finally, international and national exposure information systems about carcinogens are not based on notifications of exposed workers or workplaces or on workplace measurements, but instead rely on estimations of the numbers of exposed workers and their level of exposure to selected carcinogens. These numbers can be used for hazard surveillance and risk/burden assessment, according to the report.
The International Information System on Occupational Exposure to Carcinogens (CAREX) was set up in the mid-1990s and includes estimates of exposure prevalence and numbers of exposed workers in 55 industries for 15 member states of the European Union between 1990 and 1993. According to the CAREX data, exposure to carcinogens at work is common, with the number of workers estimated as being exposed in the early 1990s exceeding 30 million, or over 20 percent of the entire workforce.
EU-OSHA recommends updating the CAREX database and including data on the levels of exposure in different occupations, jobs and tasks. “Information systems such as CAREX would be more useful as systems for hazard surveillance, quantitative risk and burden assessment, and setting of priorities for prevention if they incorporated estimates of levels of exposure among the individuals exposed,” the agency said.
Other useful improvements to CAREX might be including important noncarcinogens, incorporating a time dimension, better use of exposure measurement data in estimations, including all member states of the EU, and including gender-specific and occupation-specific estimates.
“The most highly developed model at the moment is probably CAREX Canada, which has incorporated most of these features, and in addition disseminates information on exposures and risks through an informative, easy-to-use and free-of-charge web application,” the report said.
Broader employer knowledge about occupational cancer also is necessary, according to the report, which called on agencies to use awareness-raising campaigns, provide detailed guidance on reducing exposures to certain risks and increase inspections.
EU-OSHA stressed that the most important priority is the avoidance of exposure to carcinogens. This principle should be strengthened by enforcing the hierarchy of control measures and putting more efforts into providing tailored guidance to employers.
Roy Maurer is an online editor/manager for SHRM.
Follow him @SHRMRoy
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