The great debate on occupational cancer

  Trumpet| News | 08 May 2018

ICOH debate on occupational cancer

Work-related cancers are all avoidable – so how do we stop people dying from them?

One of the most critical workplace health and safety issues of our time was the focus of a central debate at the world’s largest gathering of occupational health experts last week.

The ILO (International Labor Organization), WHO (World Health Organization), ISSA (International Social Security Association), EU-OSHA, cancer classification agency IARC , ICOH (International Commission on Occupational Health) and we, IOSH, were among organisations taking part in a global policy forum at Convention Centre Dublin, as part of ICOH 2018, the triennial congress.

There is not enough space here to cover the entirety of the 90-minute session, but here are six talking points from the forum.

1. Consensus on the urgency to act now – “It’s high time for us all to act together to bring a difference,” said Dr Shengli Niu, of the ILO. People were being denied the basic human right to safe and healthy work, said Ivan Ivanov, of WHO. The fact that we do not live in an asbestos-free world is “embarrassing”, said Hans-Horst Konkolewsky, Secretary General of ISSA. For the European Commission, tackling workplace carcinogens was “a priority”, said EU-OSHA director Dr Christa Sedlatschek.

Widespread agreement, then, on the need to tackle occupational cancer. Less clear from the forum was how these organisations would come together as one to act.

2. Occupational carcinogen exposure registers tops list of discussion topics – ICOH 2018 delegates were asked for their top six priorities for discussion in the policy forum. They were, in order:

  • Occupational carcinogen exposure registers
  • Implementation of policy on prevention of occupational cancer
  • Programme on the elimination of occupational cancer
  • Use media to increase visibility and awareness
  • IOSH No Time to Lose campaign of prevention
  • Global estimates on the burden of occupational cancer

This survey gave a clue to the importance now being placed on the introduction of occupational carcinogen exposure registers.

3. Knowledge gaps exist with occupational cancers – According to Dr Kurt Straif, of IARC, “there are still major knowledge gaps in terms of workplace exposure and cancer risks”. A shift in funding priorities has seen most of today’s research funding dedicated to genetic and personalised medicine, and basic and clinical medicine.

Dr Straif was not alone in highlighting the lack of research into one of the deadliest risks facing workers today.

4. Challenges in the prevention and control of occupational cancers – ILO gave its take on the challenges to tackle work cancers. They included:

  • Most cancers are multi-factorial in etiology, that is the cause of the disease
  • It is extremely difficult to link a specific cancer case with a specific exposure
  • Most cancers have a long latency period after the initial exposure
  • The prevention of occupational cancer has a much lower profile in the workplace than preventing workplace accidents.

Following on from 3, the lack of information and clarity around work-related cancers is hampering efforts to act.

5. There is much countries can do to prevent exposure to workplace carcinogens – Ivan Ivanov outlined WHO’s advice for countries and their cancer control national programmes. From core measures, including:

  • Develop regulatory standards and enforce control of the use of known carcinogens in the workplace
  • Avoid introducing known carcinogens in the workplace
  • Include occupational cancer in the national list of occupational diseases
  • Identify workers, workplaces and worksites with exposure to carcinogens “desirable” measures, such as

  • Develop programmes for cancer prevention and control in the workplace
  • Organise registries of occupational exposures to carcinogens and exposed workers
  • Estimate the national occupational burden of disease from carcinogens.

A lack of global consensus on policy and implementation is leaving wide discrepancies in the protections afforded working people in different parts of the world.

6. Lessons learned from the leading occupational cancer campaign - IOSH’s No Time to Lose campaign was highlighted during the forum as an “excellent example” of an initiative to prevent work cancers with practical solutions. “The campaign cements specific actions which are critical to tackling occupational cancer,” said Hans-Horst Konkolewsky, of ISSA.

Awareness of occupational cancers is being raised through IOSH's No Time to Lose campaign

IOSH Chair Bill Gunnyeon (pictured), however, said lessons had been learned from the campaign, including:

  • Measurement of impact on behaviours is difficult
  • Alignment with other global initiatives is critical
  • Engagement with policy-makers is challenging
  • Long latency means delays in establishing efficacy of measures.

As No Time to Lose enters into a new phase, IOSH will aim to gather more evidence of the campaign’s impact on workplace behaviours, and to collaborate further with other organisations to coordinate efforts in tackling work cancers.

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