A union thinktank has welcomed a call for more research and action on the prevention of work-related breast cancer, and has criticised a study that suggested bad luck was the major factor in cancer causation.

The European trade union research institute (ETUI), which has its own health and safety unit, was commenting after the publication of two contrasting reports. One, a resolution from the American Public Health Association (APHA), called for more research and action to address the occupational causes of breast cancer. The other, in the journal Science, suggested most cancers were the result of ‘bad luck’, and largely dismissed the occupational, environmental, socioeconomic and other causes.

According to ETUI: “The organisations struggling to support workers who have fallen victim to cancer as a result of their jobs” will have welcomed the APHA appeal, in contrast to the message of the Science paper. ETUI was critical of the Science paper, which had already been denounced by the International Agency for Research on Cancer (IARC) and others.

Laurent Vogel, a researcher in the ETUI’s health, safety and working conditions unit, said the paper ignores breast and prostate cancers and “confuses causality with a merely statistical relationship. It bypasses an essential feature that certainly cannot be attributed to individual luck, for it is possible to come up with a social mapping of each form of cancer and to show important links between working conditions and the different locations of cancer in the human body.”

Jim Brophy, whose research for Stirling University prompted the APHA resolution, said: “Breast cancer is the most prevalent cancer in women across the globe but the majority of women do not have the known or suspected risk factors, therefore more attention to the exposures and hazards faced by women at work is required.”

ETUI news report. Stirling University news release. Risks 687.

Unite members who think they’ve been exposed to asbestos are being urged to join the union’s asbestos register. The call forms a part of the union’s new campaign to raise awareness about “the silent killer”. The register already contains the details of over 11,000 Unite members and has been developed to identify members who were employed by the same company, or on the same site, to support personal injury claims by those developing asbestos related diseases. As part of the campaign the union is issuing new guidance to safety reps on dealing with asbestos at work.

Unite news release and online campaign pack on asbestos for Unite members. Risks 687

A study of refinery workers has found exposure to crude oil may lead to a marked increase in kidney cancer risk. Researchers, whose findings were published in the Journal of Occupational and Environmental Medicine, looked at cancer patterns in 9,454 workers employed in the oil refinery industry in Finland in the period 1967 to 1982 and found there was a threefold increase in the kidney cancer risk for exposure to hydrocarbons in crude oil.

Ahti Anttila and others. Kidney cancer risk in oil refining in Finland: a nested case-referent study, Journal of Occupational and Environmental Medicine, volume 57, issue 1, pages 68–72, January 2015. Risks 686.

People with substantial exposure to wood dust at work have a greatly increased risk of lung cancer, a study has found. The paper published in January 2015 in the journal Environmental Health concludes there was “evidence of increased risk of lung cancer among workers with substantial cumulative exposure to wood dust.”

Eric Vallières, Javier Pintos, Marie-Elise Parent and Jack Siemiatycki. Occupational exposure to wood dust and risk of lung cancer in two population-based case-control studies in Montreal, Canada,  Environmental Health, volume 14, number 1, 7 January 2015. doi:10.1186/1476-069X-14-1. Risks 686.

The International Agency for Research on Cancer (IARC) has said it “strongly disagrees” with the conclusion of a scientific report on the causes of human cancer published in the journal Science on 2 January 2015.

The World Health Organisation’s specialised cancer agency said the study, which has received widespread media coverage, compares the number of lifetime stem cell divisions across a wide range of tissues with lifetime cancer risk and suggests that random mutations (or “bad luck”) are “the major contributors to cancer overall, often more important than either hereditary or external environmental factors.”

IARC says there are “limitations and biases in the analysis” and a “serious contradiction” between the paper’s conclusion and the extensive body of scientific evidence on the issue. “We already knew that for an individual to develop a certain cancer there is an element of chance, yet this has little to say about the level of cancer risk in a population,” explains IARC director Dr Christopher Wild.

“Concluding that ‘bad luck’ is the major cause of cancer would be misleading and may detract from efforts to identify the causes of the disease and effectively prevent it.” Noting that preventive efforts and not luck had led to substantial reductions in some cancers, the IARC director concludes: “The remaining knowledge gaps on cancer aetiology should not be simply ascribed to ‘bad luck’. The search for causes must continue while also investing in prevention measures for those cancers where risk factors are known.”

IARC statement, 15 January 2015. Risks 686

An American Public Health Association (APHA) policy statement on ‘Breast Cancer and Occupation: The Need for Action’ is thought to be the first such call by a major public health body on breast cancer and the risks faced by women due to the hazards in the work environment.

The policy statement says “gender and social class bias” could explain the lack of research and preventive efforts on occupational breast cancer. It concludes: “Action required starts with making a national priority of promoting and supporting research on occupational and other environmental causes of breast cancer. Other public health actions include hazard surveillance and primary prevention activities such as reductions in the use of toxic materials, informed substitution, and green chemistry efforts.”

The related webpage includes detailed information on the research establishing a clear occupational breast cancer risk. The impetus for the resolution came from a groundbreaking study by Stirling University’s Jim Brophy, Margaret Keith, Andy Watterson and others, who in a 2012 paper revealed that working in a “toxic soup” of chemicals can double a woman’s risk of developing breast cancer (Risks 583).

High risk jobs included those in agriculture, plastics, food packaging, metal manufacture and the bar and gambling industry, according the study. The research led to prevention initiatives and calls worldwide, including a campaign by the North American steelworkers’ union USW (Risks 594). APHA is the largest and oldest public health organisation in the world.

Breast Cancer and Occupation: The Need for Action, APHA, agreed November 2014, posted online January 2015. Risks 686, 17 January 2015. Stirling University news release.

One of the final acts of the Italian presidency of the European Union, which ended on 31 December 2014, was to host a conference on future health and safety at work policy.

The event, on 4-5 December 2014 heard Laurent Vogel, a researcher with the European trade union research organisation ETUI, call for the Europe-wide directive on carcinogens and mutagens in the workplace to be overhauled.  He told the event: “100,000 people die each year in the European Union from a failure to prevent work-related cancers,” adding: “The review process was started ten years ago; it is high time something was actually done at last to cut down workers’ exposure to countless carcinogens, mutagens and reprotoxins.”

The Italian Labour Ministry’s director general for occupational health policies, Paolo Onelli, said that Italy would join with Germany, Austria, Belgium and the Netherlands to fashion a common legislative framework for more effective preventive action on occupational cancers.

The issue of occupational health will return to the EU agenda in March 2015 at the EU Council of Ministers meeting. There are fears the EU will embark on a new deregulatory drive halting any progress on health and safety initiatives after the 18 December 2014 appoint of German right-wing politician Edmund Stoiber as the European Commission’s special adviser on ‘better regulation.’

Commenting on the move, Veronica Nilsson, confederal secretary of the European Trade Union Confederation, said: “I fear Mr Stoiber will not help with better regulation, but lobby on behalf of business for less regulation. That risks being at the expense of workers, consumers and the environment. It could mean further delays in much needed health and safety regulations such as on exposure at work to cancer-causing chemicals.”

ETUI news report, 16 December 2014, and Laurent Vogel’s presentation: The point of view of the European trade unions: It is urgent to revitalise the EU occupational health and safety policy. ETUC news release, 18 December 2014 and better regulation webpages. Risks 685.

Bad genes, bad luck and bad habits are frequently blamed for cancers, but stronger evidence of the occupational and environmental origins of our cancers is much more likely to be disputed or dismissed.

A December 2014 paper in journal Science, concluded two-thirds of the cancer types analysed were caused just by chance mutations. It noted: “These results suggest that only a third of the variation in cancer risk among tissues is attributable to environmental factors or inherited predispositions. The majority is due to ‘bad luck,’ that is, random mutations arising during DNA replication in normal, noncancerous stem cells. This is important not only for understanding the disease but also for designing strategies to limit the mortality it causes.”

The mention of ‘bad luck’ being the root cause of most cancers attracted blanket coverage in the popular press. In December 2014, Cancer Research UK (CRUK) said more than four in 10 cancers could be prevented by changes to lifestyle. According to CRUK, nearly 600,000 cancer cases in the UK could have been avoided in the last five years if people had healthier lifestyles.

However the tendency to blame genes, personal habits or just plain bad luck, steers the blame from many of the major environmental and occupational factors where regulatory and other interventions could eliminate the risk. ‘Chance mutations’ are frequently the product of exposure to carcinogens, with benzene exposure a particularly well documented example.

Ted Schettler, science director of the Collaborative on Health and the Environment (CHE), criticising the “bad luck” paper, noted: “By drawing conclusions that go beyond their data, the authors may deflect attention from the critical need to expand public health cancer prevention programs in our homes, communities, and workplaces. That would truly be an unfortunate outcome.”

Hazards magazine points to the 100 per cent mortality from bladder cancer in workers exposed to beta-naphthylamine in one US plant (Hazards, 2008). Or the conservative 2009 study that concluded one in 10 UK carpenters born in the 1940s would die of asbestos-related lung cancer or mesothelioma (Peto, 2009).

Other examples like nasal cancer in leather workers or mesothelioma hotspots in areas with high concentrations of dockwork or chemical production show that the working and living environment is frequently the difference between being at risk and being killed. Almost all causes of lung cancer, the biggest cancer killer, were identified in workplace studies (Infante, 1975).

Cristian Tomasetti and Bert Vogelstein. Variation in cancer risk among tissues can be explained by the number of stem cell divisions, Science, volume 347, number 6217, pages 78-81, 2 January 2015.
Lifestyle behind more than half a million cancers in five years, CRUK news release, 26 December 2014.
Ted Schettler. Cancer, stem cells and bad luck, critical online commentary from the Collaborative on Health and the Environment, 6 January 2015.
Silent Spring commentary. BBC News Online on the ‘bad luck’ and ‘lifestyle’ cancer stories. Risks 685.

An analysis of data from the world’s largest and longest-running study of women’s health found that rotating night shift work is associated with higher death rates.

The international team of researchers investigated possible links between rotating night shift work and all-cause, cardiovascular disease, and cancer mortality in a study of almost 75,000 registered US nurses. Using data from the Nurses’ Health Study (NHS), the authors analysed 22 years of follow-up.  Reporting in the American Journal of Preventive Medicine, they conclude that all-cause and cardiovascular disease-related mortality were significantly increased among women who worked more than five years of rotating night shifts when compared to those who never worked the night shift.

In addition, the study found that working 15 or more years of rotating night shifts was associated with a modest increase in lung cancer mortality.

Fangyi Gu, Jiali Han, Francine Laden and others. Total and Cause-Specific Mortality of US Nurses Working Rotating Night Shifts, American Journal of Preventive Medicine, published online ahead of print, 5 January 2015. DOI: http://dx.doi.org/10.1016/j.amepre.2014.10.018. Risks 685.

The Industrial Injuries Advisory Council (IIAC) has decided there is not a case for recommend recognising dioxin related lung cancers as a prescribed industrial disease. An IIAC information note concludes: “After reviewing the limited evidence available on this subject, the Industrial Injuries Advisory Council (IIAC) decided not to make any recommendations for changes to the list of prescribed diseases for which people can claim Industrial Injuries Disablement Benefit (IIDB).”

Lung cancer and dioxins, IIAC information note.