European Code against Cancer 4th Edition: Environment, occupation and cancer

Abstract

People are exposed throughout life to a wide range of environmental and occupational pollutants from different sources at home, in the workplace or in the general environment - exposures that normally cannot be directly controlled by the individual. Several chemicals, metals, dusts, fibres, and occupations have been established to be causally associated with an increased risk of specific cancers, such as cancers of the lung, skin and urinary bladder, and mesothelioma. Significant amounts of air pollutants - mainly from road transport and industry - continue to be emitted in the European Union (EU); an increased occurrence of lung cancer has been attributed to air pollution even in areas below the EU limits for daily air pollution. Additionally, a wide range of pesticides as well as industrial and household chemicals may lead to widespread human exposure, mainly through food and water. For most environmental pollutants, the most effective measures are regulations and community actions aimed at reducing and eliminating the exposures. Thus, it is imperative to raise awareness about environmental and occupational carcinogens in order to motivate individuals to be proactive in advocating protection and supporting initiatives aimed at reducing pollution. Regulations are not homogeneous across EU countries, and protective measures in the workplace are not used consistently by all workers all the time; compliance with regulations needs to be continuously monitored and enforced. Therefore, the recommendation on Environment and Occupation of the 4th edition of the European Code against Cancer, focusing on what individuals can do to reduce their cancer risk, reads: "In the workplace, protect yourself against cancer-causing substances by following health and safety instructions."

The European Status Quo in legal recognition and patient‐care services of occupational skin cancer

“…Although there is sound evidence that workers at various workplaces across Europe, being exposed to intense levels of UVR, develop a much higher incidence of non‐melanoma skin cancer, this evidence has yet not been translated into a common approach towards a common European, governmentally regulated standard for UVR prevention on work sites, management protocols for work‐related skin cancer or a common European agreement regarding financial compensation for patients with a work‐related skin cancer history …”

“…3,4 Although there is sound evidence that workers at various workplaces across Europe, being exposed to intense levels of UVR, develop a much higher incidence of non-melanoma skin cancer, 5 this evidence has yet not been translated into a common approach towards a common European, governmentally regulated standard for UVR prevention on work sites, management protocols for work-related skin cancer or a common European agreement regarding financial compensation for patients with a work-related skin cancer history. 6 Historically, occupational skin cancer was the first 'occupational' disease of all. In 1775, the English surgeon Sir Percival Pott was the first to describe an association between exposure to soot and related high incidence of scrotal squamous cell carcinoma in adolescent patients working as chimney sweeps since childhood.…”

Primary prevention: a need for concerted action

“…Notably, with for instance stopping smoking, maintaining a healthy body weight, being physically active, having a healthy diet and reducing alcohol intake, the individual has means to significantly reduce their cancer risk; nonetheless, all those actions should be encompassed in regulatory actions on for instance taxation and price policies on tobacco, alcohol or unhealthy foodstuffs, or urban policies to facilitate physical activity or ensuring sufficient shady places for solar radiation protection, for example in kindergartens or schools. Other smaller contributors to the cancer burden, but nevertheless established modifiable risk factors, are exposure to environmental pollutants or carcinogens in the work place, where action at a population level is required, such as for air pollution, safe work places or protection guidelines to eliminate or reduce exposures against harmful chemicals (Espina et al ., ). Espina et al .…”

Moteurs et freins à la reconnaissance en maladie professionnelle des patients atteints de cancers bronchiques : une étude psychosociale

“…En France, on estime que 10 à 20 % des cancers bronchopulmonaires (CBP) seraient liés au travail [1][2][3]. Bien que le tabagisme soit le premier facteur de risque des CBP, de nombreuses substances cancérogènes présentes dans l'environnement professionnel ont été reconnues comme cancérogène avéré chez l'Homme pour les CBP [4]. Si le nombre d'indemnisations des cancers d'origine professionnelle a progressé ces dernières années, 60 % des CBP ne seraient ni repérés ni indemnisés [5].…”