The story of asbestos disease – and the resulting litigation – is part of the larger story of “occupational cancer.” A new op-ed (free in full text) provides comments on the past and future of occupational cancer detection, investigation and prevention. It is: Rushton, Occupational cancer: key challenges and opportunities for change, Occup. Med (Lond) (2014) 64 (5): 313-316. doi: 10.1093/occmed/kqu061. The entire article is worth reading; some key quotes are below:
“In the British cancer burden study, the ranking of cancer types changes between population attributable fractions (PAF), deaths (AD) and cancer registrations [4]. The top five cancer sites for PAFs were mesothelioma (95%), sinonasal (33%), lung (14.5%), breast (4.6%) and non-melanoma skin cancer (NMSC) (4.5%). “
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“Molecular epidemiology offers the opportunity to combine the scientific disciplines of epidemiology and molecular toxicology to investigate the interactions between genetic factors and occupational factors in the causes of cancer. These techniques have so far been little used in occupational studies. Future research will need to incorporate measurement of susceptibility and adjustment for the effects of factors which might relate to both health outcome and occupational exposure to carcinogens, such as age, ethnicity, gender, socioeconomic or deprivation status, smoking and access to health care, to aid the investigation of carcinogenic pathways and to detect gene–environment interactions. This will require multidisciplinary collaborative teams involving epidemiology, toxicology and exposure assessment.
In Britain, a relatively small number (14) of carcinogenic agents and occupational circumstances have been shown to currently account for 86% of estimated occupation attributable cancer [4]. Without intervention occupational attributable cancers are forecast to remain at over 10000 annually [11]. Cancers associated with asbestos, diesel engine exhaust, polycyclic aromatic hydrocarbons, work as a painter, radon and solar radiation are forecast to continue, with construction remaining the prime industry of concern.”
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