Mixed exposures to lung carcinogens at work heightens risks

Greater than expected increases in lung cancer rates have been found when workers faced exposures to more than one potential workplace cause, a study has found.

The findings have implications for those working in construction, foundries and welding where multiple exposures to some or all of these carcinogens may be routine.

Scientists from the UN’s International Agency for Research on Cancer (IARC) and partner institutions have found that whereas occupational co-exposure to some known lung carcinogens increased workers’ risk of developing lung cancer in a way that is generally in line with the combined increased risk of the individual agents, some co-exposures created a synergistic effect that increased the risk by more than this combination.

The results were published online on 18 January 2024 in the journal Environmental Health Perspectives.

The project partners analysed data from 16,900 lung cancer cases and 20,900 control subjects, collected over 15 years by scientists at IARC, in Canada, and in 13 countries in Europe.

The researchers estimated the effect that exposure to two carcinogens would have on lung cancer risk. They did this for each possible pairing from a group of five major occupational lung carcinogens: asbestos, respirable crystalline silica, nickel, chromium(VI), and polycyclic aromatic hydrocarbons (PAHs), while also taking cigarette smoking into account.

A stronger effect than the sum of the individual risks was observed for lung adenocarcinoma for chromium(VI)–silica exposure among men, and for small cell lung cancer for silica and joint exposures with asbestos, PAHs, or chromium(VI) among women.

Some jobs, for example in construction or foundries, can involve routine exposures to all these occupational carcinogens.

“We show that most co-exposure to the selected lung carcinogens result in higher risk compared to individual exposures that underline the importance to eliminate or reduce and control exposures to carcinogens in workplaces and the general environment,” the authors conclude.

They say these results underline the importance of eliminating or reducing exposures to carcinogens in workplaces and in the general environment.

Studies included in the research included data from Canada, Czech Republic, France, Germany, Hungary, Italy, the Netherlands, Poland, Romania, Russia, Slovakia, Spain, Sweden, and the United Kingdom.

Hundreds of chemicals linked to breast cancer

More than 900 chemicals, many of which are present in common consumer products, have the potential to increase breast cancer risks, a new study has concluded.

Researchers at the Silent Spring Institute examined chemicals listed in major reference databases, including those from the International Agency for Research on Cancer and the US Environmental Protection Agency. They then classified chemicals based on their toxicity and ability to interfere with key human hormones associated with breast cancer.

Based on that analysis, the researchers identified 921 chemicals that can promote breast cancer, including pesticides and those used in food, drinks and medications. Chemicals on the list include permethrin, which is used to control mosquitoes; profenofos, which is used to kill bugs on cotton crops; and trifluralin, which is used to control weeds.

About a third of the chemicals on the list have been linked to mammary tumours in rodents, according to the study, which was published on 10 January 2024 in Environmental Health Perspectives.

Chemicals associated with mammary tumours included 30 pesticides and herbicides approved by the US Environmental Protection Agency, such as malathion. Public Health Watch reports that in August 2023, the EPA limited application of malathion — used as an insecticide in both food agriculture and residential gardening — to protect birds, fish and other wildlife from harm.

[This entry is based on a news update from The Watch, published by the US non-profit Public Health Watch].


Top work cancer risks in Europe identified

A major survey of work-related cancer risk factors has identified the top cancer causing chemical exposures at work.

Initial results of the European Agency for Safety and Health at Work’s (EU OSHA) workers’ exposure survey on cancer risk factors (WES) found 20 per cent of EU workers are exposed to diesel engine exhaust emissions, 13 per cent to benzene, 8.4 per cent to respirable crystalline silica (RCS) and 6.4 per cent to formaldehyde.

EU OSHA said results from WES are expected to affect future amendment proposals to the carcinogens, mutagens and reprotoxic substances directive (CMRD), which might include new or stricter occupational exposure limits for substances that pose a high risk to workers.

The agency is releasing the survey results in phases, with a final assessment of exposure to 24 cancer risk factors due in 2024.

EU OSHA says solar UV radiation just tops the list of occupational cancer risks at work, with 20.8 per cent of workers affected.


Organic solvents are a breast cancer risk

Exposure to organic solvents could be a significant cause of breast cancer in women, with over 50 per cent higher rates in workers exposed to chlorinated alkanes, chlorinated alkenes, and MAHs (mononuclear aromatic hydrocarbons – for example, aromatic solvents with one benzene ring – benzene, toluene, xylene).  

The study examined whether past occupational exposures to selected organic solvents were associated with the incidence of invasive breast cancer in postmenopausal women in Montréal, Canada.

“Our findings suggest occupational exposure to certain organic solvents may increase the risk of incident postmenopausal breast cancer,” the authors said.

Westra, S, Goldberg, MS, Labrèche, F, Baumgartner, J, Ho, V. The association between the incidence of postmenopausal breast cancer and occupational exposure to selected organic solvents, Montreal, Canada, 2008-2011. American Journal of Industrial Medicine, volume 66, pages 911-927, 2023.


Australian regulator’s silica plan will save lives – unions

Australia’s top union body ACTU has welcomed a report by the country’s national safety regulator recommending a complete prohibition on the use of engineered stone.

The use of the product has been linked to especially damaging exposures to respirable crystalline silica, which can cause the lung scarring and progressive disease silicosis, lung cancer and autoimmune and other diseases.

The Safe Work Australia report followed broad consultation with business groups, engineered stone manufacturers and fabricators, unions and health experts. It also included detailed economic evaluation and an analysis of evidence from the best available science when developing its recommendation.

Safe Work Australia endorsed the medical and scientific evidence that lung diseases caused by engineered stone dust take less time to develop, are more severe and become worse quickly.

There were three options considered by Safe Work Australia:

  • Option 1  Prohibition on the use of all engineered stone
  • Option 2  Prohibition on the use of engineered stone containing 40% or more crystalline silica
  • Option 3  As for option 2, with an accompanying licensing scheme for PCBUs working with engineered stone containing less than 40% crystalline silica.

Given that scientific evidence found that even engineered stone with lower silica content posed unmanageable risks to the health and safety of workers, Safe Work Australia recommended a blanket ban of the product.

The report noted that engineered stone dust is very fine – nano scale – meaning it penetrates deep into the lungs of workers, with the dust containing resins, metals, pigments, and other forms of silica dust. Thus, even when workers cut and fabricate low-silica stone products, the very fine dust particles of silica that enter the lungs of workers cause diseases including silicosis.

Current laws have not protected workers, ACTU says – 1 in 4 engineered stone workers have contracted silicosis under the current framework. The report made clear that the costs to the community from the continued use of engineered stone far outweighed any benefits, and that the only way to protect future workers was to prohibit the use of engineered stone entirely.

The ACTU Executive this week joined the construction and mining union CFMEU in outlining the union movement’s intention to ban this deadly product, commonly used for kitchen and bathroom benchtops, if state governments had not acted by July next year.

“This recommendation by Safe Work Australia will save lives. We urge all governments to introduce it at the earliest opportunity. ” commented ACTU assistant secretary Liam O’Brien.

“Silicosis and silica-related diseases pose an unacceptable health risk to workers. This report shows that there is no type of engineered stone that is safe for workers.

“No worker in Australia should have to plan their funeral and farewell their loved ones, all because of a lung disease they got from working with this deadly stone.

“The report made clear that there is no other option than an outright ban on engineered stone. Keeping this deadly product legal means more workers getting health problems and more workers dying.

“We welcome the decision earlier this year of WHS Ministers to introduce stronger silica rules covering all work. However, this report makes clear that to truly protect the health and wellbeing of workers, we must ban this deadly fashion product once and for all. ”

A joint statement supporting the action was signed by organisations including: Australian Institute of Health & Safety; Australian Institute of Occupational Hygienist; Cancer Council; Lung Foundation; Public Health Association of Australia; The Australian and New Zealand Society of Occupational Medicine Inc; and the Australian Council of Trade Unions.

Australia is also planning to lower its current workplace exposure limit for respirable crystalline silica from 0.05mg/m³. The current limit is half the 0.1mg/m³ level in the UK.

Great Britain’s safety regulator, the Health and Safety Executive (HSE), has refused to improve the limit, despite both the US, Australia and other jurisdictions making evidence-based decisions to move to a standard at least twice as protective.

HSE has admitted six times more workers will develop silicosis at the less protective standard. Overall, several thousand additional deaths per year could result from the weaker standard.

IAFF calls for broad strategy to end fire fighter cancer

The union representing US firefighters is calling on the fire service, government, industry, and scientific community to unite in support of a broad strategy to combat fire fighter occupational cancer.

“All of us have lost friends to cancer – too many of them. Too many of our brothers and sisters gone far too soon. We need to do whatever it takes to end the scourge of cancer in the fire service,” International Association of Fire Fighters (IAFF) General President Edward Kelly said at the 2023 US Fire Administrator’s Summit on Fire Prevention and Control.

Urging that time is of the essence, Kelly said a comprehensive fire fighter cancer prevention strategy is needed, one that invests in critical research programs, prioritizing the most dangerous cancer risks for fire fighters. Fighting occupational cancer must include cancer screenings for fire fighters, education, and training to help better understand increased risk, he said.

Kelly said national cancer presumption coverage should be available for all fire fighters diagnosed with cancer. Currently, U.S. states and Canadian provinces have different forms of presumption coverage. for the IAFF also supports the expansion of the Public Safety Officer Benefit (PSOB) Program to cover line-of-duty deaths and permanent disabilities due to occupational cancer.

“As fire fighters, we take risks; we knew that when we came on the job. We accept that we may die trying to save the lives of others. All we ask for in return is that you help us minimize the risk of dying needlessly and help us do our job as safely as possible,” Kelly said.

Hundreds of members of the fire service joined appointed and elected officials and academics for the daylong USFA Summit, held at the National Emergency Training Summit in Emmitsburg, Maryland.

President Joe Biden addressed attendees through a live feed. He praised fire fighters as “the heart of the community” and noted that too often “people don’t appreciate you until they need you.”

Biden said the Administration is doing everything possible to fund the fire service and make sure fire fighters have what they need to stay safe on the job. The President cited numerous ways his administration has supported the fire service, including:

  • $350 billion included in the American Rescue Plan for first responders.
  • 2023 budget request for $320 million in federal grants for new hires and equipment.
  • Support for presumptive cancer legislation and legislation to address toxic chemicals, including PFAS.
  • Support for the Federal Firefighters Fairness Act, helping federal fire fighters access workers’ compensation; the Protecting America’s First Responders Act, which extends PSOB benefits; and the Infrastructure Investment and Jobs Act, which supports wildland firefighting.

While noting progress is being made, Department of Homeland Security Secretary Alejandro Mayorkas said more resources are needed to address the emerging challenges fire fighters confront, including more destructive wildfires, risks from lithium battery fires, mental health issues, and the urgent need to recruit and retain fire fighters.

“The emergencies to which a fire fighter responds are as varied as life itself. The character of the fire fighter who responds, however, is constant: courageous, devoted to duty, committed to community, willing to sacrifice,” said Mayorkas.

While the IAFF continues to fight for federal resources to combat occupational cancer, IAFF Chief of Field Services Patrick Morrison urged fire service leaders to do more. Saying, “We must advocate for ourselves,” Morrison noted that early cancer screenings can dramatically increase survival rates. He also urged all in attendance to encourage fire fighters to enroll in the National Firefighter Registry for Cancer, which will help improve the science behind fire fighter occupational cancer over time.

October 13, 2023
IAFF news release.



Work cancers in women go unstudied and unaddressed


Cancer studies have neglected the workplace risks faced by women. Hazards editor Rory O’Neill looks at new evidence of the damaging consequences for prevention, compensation and women’s health.

A rare study of occupational hazards and ovarian cancer has found new evidence that many common jobs undertaken by women are associated with an elevated risk.

After accounting for other risk factors, calculations using the Canadian job-exposure matrix (CANJEM) confirmed that working for 10 or more years as a hairdresser, barber, beautician and in related roles was associated with a three-fold higher risk, while employment for 10 or more years in accountancy was associated with a doubling in risk, and working in construction with a near tripling in risk.

Similarly, long term work in the clothing industry, including embroidery, was associated with an 85 per cent heightened risk of developing the disease while working in sales or retail was associated with heightened risks of 45 per cent and 59 per cent respectively.

Heightened risks of more than 40 per cent were observed for high cumulative exposure (8 or more years) – compared with none – to 18 different agents.

These included talcum powder; ammonia; hydrogen peroxide; hair dust; synthetic fibres; polyester fibres; organic dyes and pigments; cellulose; formaldehyde; propellant gases; naturally occurring chemicals in petrol and bleaches.

The authors of the study conclude their results “suggest that employment in certain occupations and specific occupational exposures may be associated with increased risks of ovarian cancer.”

Drs Melissa Friesen and Laura Beane Freeman of the US National Cancer Institute, in a linked commentary in the journal, note there are wider lessons from the study.

“The limited representation of women in occupational cancer research studies has been recognised for decades,” they write.

“Unfortunately, this remains true today for many cancer sites and workplace exposures despite the fact that in 2021 women made up 40 per cent of the global workforce, with percentages in some countries much higher.”

The commentary on the ovarian cancer study notes it “reminds us that while the lack of representation of women in occupational cancer studies – and indeed, even potential strategies to address this issue – have been long recognised, there is still a need for improvement in studying women’s occupational risks.

“By excluding women, we miss the opportunity to identify risk factors for female specific cancers, to evaluate whether sex-specific differences in risk occur, and to study exposures occurring in occupations held primarily by women.”

There is a price to pay. Occupational cancer compensation schemes rarely compensate women. For others, it is a deadly oversight.

Low level radiation risk ‘under-estimated’

The cancer risk resulting from ‘low level’ radiation exposures at work has been under-estimated, the UN’s top cancer agency has said.

Researchers from the International Agency for Research on Cancer (IARC), working with institutions in France, Spain, the UK, and the USA, report that workers in nuclear facilities who are persistently exposed to low doses of ionizing radiation experience an increase in deaths due to cancer.

The study published in the BMJ has implications for all workers potentially exposed to ionising radiation, including those in the nuclear, military, weapons, offshore, health and engineering sectors.

“This major update of cancer risk in a large cohort of nuclear workers who were exposed to ionizing radiation provides additional evidence to strengthen radiation protection measures for workers and the general public,” said IARC’s Dr Mary Schubauer-Berigan.

“Protection against harmful effects of exposure to ionizing radiation is of primary interest as its use becomes more widespread in contemporary medical and occupational settings.”

Co-author, Dr David Richardson, a professor of environmental and occupational health at the University of California, Irvine, added: “We wanted to strengthen the scientific basis for radiation protection by directly studying workers in settings where low-dose and low-dose-rate radiation exposures occur.”

The International Nuclear Workers Study (INWORKS) study followed up 309,932 workers in the nuclear industry.

This latest analysis estimated the cancer risk increased by 52 per cent for every unit of radiation (Gray; Gy) workers had absorbed.

But when the analysis was restricted to workers who had been exposed to the lowest cumulative doses of radiation (0-100 mGy), this approximately doubled the risk of death from solid cancers per unit Gy absorbed.

Richardson DB and others. Cancer mortality after low dose exposure to ionising radiation in workers in France, the United Kingdom, and the United States (INWORKS): cohort study, BMJ, volume 382 :e074520, 2023. www.bmj.com

IARC website.

DISCOUNTING WOMEN | Work cancers go unstudied and unaddressed

Cancer studies have neglected the workplace risks faced by women. Hazards editor Rory O’Neill looks at new evidence of the damaging consequences for prevention, compensation and women’s health.

A rare study of occupational hazards and ovarian cancer has found new evidence that many common jobs undertaken by women are associated with an elevated risk.

The authors of the University of Montreal study, published in the journal Occupational and Environmental Medicine in July 2023, note relatively few studies have evaluated the occupational hazards faced by women.

And those that have, have often failed to account for potentially influential factors, previous employment history, or have included relatively few participants, so limiting the findings, they say.

The UN’s top health and cancer agencies were accused in August 2023 of ‘institutional failure’ and of perpetuating the under-count of occupational cancers in women through “the publication of inaccurate statements about the adverse health effects of exposure to asbestos among females.”

Read the whole story here:


WHO accused of ‘failure’ on women’s work cancer

The UN’s top health and cancer agencies were accused in August 2023 of ‘institutional failure’ and of perpetuating the under-count of occupational cancers in women through “the publication of inaccurate statements about the adverse health effects of exposure to asbestos among females.”

A commentary in the Journal of Scientific Practice and Integrity by authors from universities in Italy, Germany, USA and Canada, notes that the most recent editions of the Classification of Tumours published by the World Health Organisation’s International Agency for Research on Cancer (IARC) state that asbestos is rarely the cause of malignant mesothelioma (MM) – an aggressive and usually deadly cancer linked primarily to asbestos exposure – in females, “when, in fact, the epidemiologic literature shows that the risk of MM in females exposed to asbestos approaches that in males.

“While it is correct that the overall incidence of MM in females is lower than in males, the view that MM in females is not caused by asbestos is unsupported.

“This view results from an inadequate occupational history, the failure to recognise the importance of environmental exposures, and the misrepresentation of published literature by the selection of limited literature and biased bibliographies, often by authors with financial conflicting interests.”

They say despite “several fruitless attempts to correct the record” WHO has refused to amend the classification. They conclude the classification is “inconsistent with the published scientific literature, suggesting deliberate misrepresentation and raising the question of undisclosed COI [conflicts of interest] as a factor. The consequences in this case are dire for the females at risk, for their families, and for the public at large.”

A continually-updated, annotated bibliography of occupational cancer research produced by Hazards magazine, the Alliance for Cancer Prevention and the International Trade Union Confederation (ITUC).