The burden of cancer at work: estimation as the first step to prevention
The burden of cancer at work: estimation as the first step to prevention
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DOI：
10.1136/oem.2007.037002
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发表时间：
2008-12-01
影响因子：
4.9
通讯作者：
Brown, T.
中科院分区：
文献类型：
--
作者：
Rushton, L.;Hutchings, S.;Brown, T.
目标：与工作有关的癌症在很大程度上是可以预防的。该项目的总体目标是估计英国目前由职业因素造成的癌症负担，并确定致癌物质、行业和职业，以进行有针对性的风险预防。估计膀胱癌、肺癌、非黑色素瘤皮肤癌和鼻窦癌的死亡率和发病率的归因分数和数量，白血病和间皮瘤的物质和职业分类为国际癌症研究机构（IARC）组1和2A致癌物与"强"或"人类特定癌症部位致癌性的连续证据。风险估计是从出版的文献和国家数据来源用于估计比例exposed.Results：在2004年，78 237名男性和71 666名女性死于癌症在英国。其中，7317例（4.9%）死亡（男性：6259例（8%）;女性：1058例（1.5%））估计可归因于评估的六种癌症的工作相关致癌物。发病率估计为13 338例（4.0%）登记（男性：11 284例（6.7%）;女性2054例（1.2%））。砷在职业性死亡中占一半以上，其次是二氧化硅、柴油发动机废气、氡、油漆工、金属工人和印刷业的矿物油、环境烟草烟雾（不吸烟者）、焊工工作和二恶英。职业暴露于太阳辐射，矿物油和煤焦油/沥青分别贡献了2557，1867和550皮肤癌登记。死亡和/或登记人数较多的行业/职业包括建筑、金属加工、个人和家庭服务、采矿（非金属）、陆运和与运输有关的服务、屋顶、道路维修/建筑、印刷、农业、武装部队、其他一些服务行业部门和运输设备制造、金属制品、机械、有色金属和金属制品，结论：估计所有，但白血病是大于目前使用的英国健康和安全战略规划和对比，从职业事故的小数字（200 - 240年）。估计数的不确定性主要来自近似数据和方法问题。总的来说，这些估计可能是对真实风险的保守估计。长潜伏期意味着过去的高风险将在不久的将来继续提供大量数据。虽然许多接触水平已经降低，但最近对其他接触水平的测量，如木尘和可吸入石英，显示仍然很高。
Objectives: Work-related cancers are largely preventable. The overall aim of this project is to estimate the current burden of cancer in Great Britain attributable to occupational factors, and identify carcinogenic agents, industries and occupations for targeting risk prevention.Methods: Attributable fractions and numbers were estimated for mortality and incidence for bladder, lung, non-melanoma skin, and sinonasal cancers, leukaemia and mesothelioma for agents and occupations classified as International Agency for Research on Cancer (IARC) Group 1 and 2A carcinogens with "strong'' or "suggestive'' evidence for carcinogenicity at the specific cancer site in humans. Risk estimates were obtained from published literature and national data sources used for estimating proportions exposed.Results: In 2004, 78 237 men and 71 666 women died from cancer in Great Britain. Of these, 7317 (4.9%) deaths (men: 6259 (8%); women: 1058 (1.5%)) were estimated to be attributable to work-related carcinogens for the six cancers assessed. Incidence estimates were 13 338 (4.0%) registrations (men: 11 284 (6.7%); women 2054 (1.2%)). Asbestos contributed over half the occupational attributable deaths, followed by silica, diesel engine exhaust, radon, work as a painter, mineral oils in metal workers and in the printing industry, environmental tobacco smoke (non-smokers), work as a welder and dioxins. Occupational exposure to solar radiation, mineral oils and coal tars/pitches contributed 2557, 1867 and 550 skin cancer registrations, respectively. Industries/occupations with large numbers of deaths and/or registrations include construction, metal working, personal and household services, mining (not metals), land transport and services allied to transport, roofing, road repair/construction, printing, farming, the Armed Forces, some other service industry sectors and manufacture of transport equipment, fabricated metal products, machinery, non-ferrous metals and metal products, and chemicals.Conclusions: Estimates for all but leukaemia are greater than those currently used in UK health and safety strategy planning and contrast with small numbers (200-240 annually) from occupational accidents. Sources of uncertainty in the estimates arise principally from approximate data and methodological issues. On balance, the estimates are likely to be a conservative estimate of the true risk. Long latency means that past high exposures will continue to give substantial numbers in the near future. Although levels of many exposures have reduced, recent measurements of others, such as wood dust and respirable quartz, show continuing high levels.