The proportion of cancer attributable to occupational exposures

Abstract

Purpose To review the literature on the estimation of the population attributable fraction (PAF) of cancer due to occupational exposures and to describe challenges in the estimation of this metric. To help illustrate the inherent challenges, we also estimate PAFs for selected cancers diagnosed in the United States in 2010 attributable to work as a painter (causally associated with bladder and lung cancer) and shiftwork (possibly associated with breast cancer). Methods We reviewed and summarized previous reports providing quantitative estimates of PAF for total cancer due to occupational exposures. We calculated PAF estimates for painters and shiftwork using methodology from a detailed investigation of the occupational cancer burden in Great Britain, with adaptations made for the U.S. population. Results The estimated occupation-attributable fraction for total cancer generally ranged between 2% and 8% (men, 3-14%; women, 1-2%) based on previous reports. We calculated that employment as a painter accounted for a very small proportion of cancers of the bladder and lung diagnosed in the United States in 2010, with PAFs of 0.5% for each site. In contrast, our calculations suggest that the potential impact of shiftwork on breast cancer (if causal) could be substantial, with a PAF of 5.7%, translating to 11,777 attributable breast cancers. Conclusions Continued efforts to estimate the occupational cancer burden will be important as scientific evidence and economic trends evolve. Such projects should consider the challenges involved in PAF estimation, which we summarize in this report.

Bladder Cancer Incidence and Mortality: A Global Overview and Recent Trends

“…In a recent review, 7.1% of all bladder cancers in men (1.9% in women) in the UK were attributed to occupational exposure to carcinogens [48]. However, the global impact of occupational exposures on bladder cancer incidence remains difficult to assess and is likely to be relatively limited [49].…”

Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being

“…However, a number of studies have found no association between cancer and shift work [64,65,66,67]. The variability in these findings may be related to other contributing factors, such as individual differences in susceptibility to carcinogenesis, occupational exposure to carcinogenic agents, and lifestyle [68,69]. Taken together, the literature suggests that further studies are needed to quantify and understand the relationship between shift work and risk of cancer.…”

Occupational and work‐related disease underestimated and linked to temporary disability through Primary Health Care Services

“…Of these occupational cancers reported, men were the most affected, as they were in our results, too. Although the consequences of this group of pathologies are very serious, research into occupational cancer is still rare (Gonzalez Sanchez, ; Purdue, Hutchings, Rushton, & Silverman, ) despite the data provided by the International Agency for Research on Cancer (IARC), which recognizes that there are around 150 physical or chemical agents which could possibly be carcinogenic present in workplaces (Lißner, Kuhl, Kauppinen, & Uuksulainen, ; Mattei et al, ). In our study, the prevalence rate of neoplasms was the lowest among all the illnesses studied, and these may not even be related to work.…”