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Prev Med. 2019 May;122:128-139. doi: 10.1016/j.ypmed.2019.03.016.

The current burden of cancer attributable to occupational exposures in Canada.

Author information

1
Institut de recherche Robert-Sauvé en santé et en sécurité du travail, Montréal, Québec, Canada; School of Public Health, Université de Montréal, Montréal, Québec, Canada.
2
Occupational Cancer Research Centre (OCRC), Cancer Care Ontario, Toronto, Ontario, Canada; Department of Epidemiology, Biostatistics and Occupational Health, McGill University, Montréal, Quebec, Canada.
3
Occupational Cancer Research Centre (OCRC), Cancer Care Ontario, Toronto, Ontario, Canada.
4
CAREX Canada, Simon Fraser University, Burnaby, British Columbia, Canada; Institute for Risk Assessment Sciences, Universiteit Utrecht, Utrecht, the Netherlands.
5
Occupational Cancer Research Centre (OCRC), Cancer Care Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
6
School of Population and Public Health, University of British Columbia, Vancouver, Canada; Institute for Work & Health, Toronto, Ontario, Canada.
7
CAREX Canada, Simon Fraser University, Burnaby, British Columbia, Canada; Department of Cancer Epidemiology and Prevention Research, Alberta Health Services, Calgary, Alberta, Canada; Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Alberta, Canada.
8
School of Public Health, Université de Montréal, Montréal, Québec, Canada; Centre de recherche du Centre hospitalier de l'Université de Montréal, Montréal, Québec, Canada.
9
CAREX Canada, Simon Fraser University, Burnaby, British Columbia, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada.
10
CAREX Canada, Simon Fraser University, Burnaby, British Columbia, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, British Columbia, Canada.
11
Occupational Cancer Research Centre (OCRC), Cancer Care Ontario, Toronto, Ontario, Canada; Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada; School of Population and Public Health, University of British Columbia, Vancouver, Canada. Electronic address: Paul.Demers@cancercare.on.ca.

Abstract

Exposure to occupational carcinogens is often overlooked as a contributor to the burden of cancer. To estimate the proportion of cancer cases attributable to occupational exposure in Canada in 2011, exposure prevalence and levels of 44 carcinogens were informed by data from the Canadian carcinogen exposure surveillance project (CAREX Canada). These were used with Canadian Census (between 1961 and 2011) and Labour Force Survey (annual surveys between 1976 and 2013) data to estimate the number of workers ever exposed to occupational carcinogens. Risk estimates of the association between each carcinogen and cancer site were selected mainly from published literature reviews. Population attributable risks were estimated using Levin's equation and applied to the 2011 cancer statistics from the Canadian Cancer Registry. It is estimated that 15.5 million Canadians alive in 2011 were exposed, during at least one year between 1961 and 2001, to at least one carcinogen in the workplace. Overall, we estimated that in 2011, between 3.9% (95% CI: 3.1%-8.1%) and 4.2% (95% CI: 3.3%-8.7%) of all incident cases of cancer were due to occupational exposure, corresponding to lower and upper numbers of 7700-21,800 cases. Five of the cancer sites - mesothelioma, non-melanoma skin cancer, lung, female breast, and urinary bladder - account for a total of 7600 to 21,200 cancers attributable to occupational exposures such as solar radiation, asbestos, diesel engine exhaust, crystalline silica, and night shift work. Our study highlights cancer sites and occupational exposures that need recognition and efforts by all stakeholders to avoid preventable cancers in the future.

KEYWORDS:

Asbestos; Breast cancer; Burden of disease; Lung cancer; Mesothelioma; Non-melanoma skin cancer; Occupational cancer; Population attributable risk; Solar exposure

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