10 facts you should know about occupational carcinogens · occupational carcinogens . ... became...

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Carcinogens are the “time bombs” of hazardous substances in the workplace. But many substances do not develop their deadly effect until years after expo-sure. It’s a risk for the worker that is often underestimated – and represents an enormous challenge for industrial hygienists. The good news is that occup-ational cancer can be prevented through monitoring and protective measures.

10 facts you should know about

occupational carcinogens


10 FACTS ABOUT OCCUPATIONAL CARCINOGENS

Cancer is a major health hazard in the workplace.Cancer in the workplace is twice as common as occupational accidents.

Every year, 660,000 deaths occur worldwide due to work-related cancer.1

1.

2. Plastic is a deadly threat.For many years, vinyl chloride was considered to be safe. This com-pound of carbon, hydrogen and chlorine is a raw material used in the production of PVC. In 1974, seven cases of severe (and very rare) liver cancer were found in individuals who worked at a PVC plant in Louisville, Kentucky. Five of the afflicted workers, all of whom had worked with vinyl chloride for 20 years, had already died.2

It is only because of the efforts of the National Institute for Occup-ational Safety and Health (NIOSH) and the energetic probing of a few scientists that the connection between cancer and vinyl chloride became known. The authorities reacted quickly: In 1974 OSHA es-tablished a threshold limit for vinyl chloride that was 500 times more rigorous that before. As a result, liver tumors in workers as a result of vinyl chloride exposure have not occurred since.

Carcinogens are toxic to cells.Carcinogenic substances are a subgroup of toxic agents, which have the potential to cause cancer in living tissues. Carcinogen exposure can occur from the inhalation, ingestion, or absorption of many dif-ferent types of substances in our bodies.Carcinogens may increase the risk of cancer by altering cellular metabolism or damaging substances such as proteins, ribonucleic acids, and especially DNA directly in cells – which interferes with biological processes. This causes genetic abnormalities to develop in the normal cell. With cancer, cells go out of control, multiply wit-hout order, and invade and destroy the surrounding tissue.The changes in a cell’s DNA are called genetic “blueprint”. Some of these changes may be inherited from our parents and grandparents. If, and to what degree, a carcinogen actually causes cancer is highly dependent on each individual organism.

3.



Approximately 3 to 6% of all cancer cases are

due to substances in the workplace 4,5

Europe: More than 100,000 deaths every

year are due to job-rela-ted cancer 6

Carcinogens pose a lifelong risk.Carcinogens do not cause cancer in every case. Substances labeled as carcinogens may have different levels of cancer-causing potential. It is true that a large amount of a cancer-causing substance leads to cancer much more frequently. But even very small doses can develop a harmful effect – although the probability is clearly lower. The risk of developing cancer due to contact with a carcinogen remains throughout one‘s lifetime, since in many cases cell damage does not develop until years after contact with the substance. And for any particular person, the risk of developing cancer depends on many factors – including how they are exposed to a carcinogen, the length and intensity of the exposure, and the person´s genetic makeup.

Substances are acutely toxic at first, then carcinogenic.Exposure time is a critical factor for carcinogenic substances in the workplace. Most carcinogens do not develop their carcinogenic effect in a brief exposure. However, they can cause toxic effects in other ways. For instance, acute inhalation of chromium IV com-pounds starts by causing nausea, but can lead to caustic effects on the skin and mucous membranes.

For the threat of cancer to exist, long-term exposure to a carcinogen is often necessary. For example, many workers who were exposed to asbestos for a prolonged period developed a particular form of lung cancer called mesothelioma. It takes at least 20 years – and in many cases 40 years – before the cancer appears. Since asbestos is no longer used in the construction industry, no new cases of oc-cupational mesothelioma are expected to occur in the United States after 2042.3

A mouse is not a human, and vice versa.Detecting the cancer-generating property of a chemical agent is often very difficult. It is not ethical to test a substance by exposing people to it and seeing if they get cancer. That’s why scientists must use other types of tests – which may not always give clear answers. For example, it is not easy to deduce whether or not a substance is carcinogenic from animal testing. Rodents and humans often react to chemical substances in entirely different ways. 19 out of 20 test substances that are considered safe for humans cause cancer in rodents.8 However, of 19 sub-

Occupational cancer is more common than previously thought.

stances known to cause cancer in humans, only seven prove to be carcinogenic in rodents.9 Here’s another example: The artificial sweetener saccharine gives rise to bladder cancer in male rats, but not in female rats – or humans.10

This is why multiple sources should be used and combined, such as:– Lab studies in animals and examinations– Tests and lab studies of human cell cultures– Human case and epidemiologic studies and observations from

practice

6.

USA: Each year, there are as many as 90,000 new cases of cancer

and 30,000 work-related deaths globally 7

5.

7.

4.



The chemical industry is subject to a particularly high risk.From benzene to formaldehyde and acid aerosols: Carcinogenic substances are found in many areas of the chemical industry. The protection of employees from carcinogens is therefore one of the central challenges for occupational health and safety.

WHEN IS A SUBSTANCE LABELEDAS CARCINOGENIC?

When the evidence is conclusive, the substance is labeled as a carcinogen. When the available evidence is compelling but not felt to be conclusive, the subs-tance may be considered to be a probable carcino-gen. But in some cases, there simply isn‘t enough information to be certain one way or the other.

Lung

Asbestos, crystalline silica,diesel engine exhaust,arsenic, chromium, nickel

8.

Graphic modified according to Siemiatycki, J, et al. Listing occupational carcinogens. Environmental Health Perspectives, Vol. 112, no. 15 (2004). p. 1447-1459

Liver and biliary tract

Trichloroethylene, vinyl chloride

Bladder

Aromatic amines

Skin

mineral oils, polycyclicaromatic hydrocarbons

Nasopharynx

Formaldehyde

Larynx

Acid mists, asbestos

Mesothelioma

Asbestos

Ovary

Asbestos

Leukemia

Benzene, formaldehyde

Non-hodgkin lymphoma

trichloroethylene



Binding occupational exposure limits brings greater safety. Most people know that asbestos is a potential cancer threat in the workplace. But what about trichloroethylene, benzene, or the various chromium compounds? The European Trade Institute has listed 71 cancer-causing substances that constitute 80% of the carcinogens to which people may be exposed in the workplace.11 Binding occupational exposure limits are being mandated for at least 50 substances that cause work-related cancer.11 Various organizations test chemicals for their cancer-causing potential. Chemicals, mixtures, substance groups, and other carcinogens are divided into different groups, as follows:

More knowledge leads to more safety.All types of occupational cancer are preventable. To minimize the risk of cancer caused by on-the-job exposure, substances consi-dered to be carcinogenic should not be used at all. But that is not always possible. However, taking appropriate measures can si-gnificantly reduce the health danger to workers. Strong regulatory control – including occupational exposure limits, worker education, and constant attention to safe practices – are needed to minimize workplace exposure to carcinogens.

Binding occupational exposure limits are only one aspect of better health and safety at work - hazardous substances can still pose a health hazard. In addition to the minimization of exposure, appro-priate protective and safety equipment is therefore important. In addition, all employees dealing with carcinogenic substances should be trained and treated with medical care.

Danger BenzeneEC no: 200-753-7

Occupational cancer has been known since 1755

1755: Recognition of testicular

cancer in chimney sweeps as an occupational cancer

1895: Identification of 2-naphthylamine

as cause of bladder cancer in dye plant workers

1974: Recognition of vinyl chloride as the cause of liver tumors in the

plastics industry

2011: Classification of formal-dehyde as carcinogenic

IARC*

Group 1: Carcinogenic to humans

Group 2A: Probably carcinogenic to humans

Group 2B: Possibly carcinogenic to humans

Group 3: Not classifiable with regard to carcinogenicity to humans

Group 4: Probably not carcinogenic to humans

IARC*

Group 1: Carcinogenic to humans

Group 2A: Probably carcinogenic to humans

Group 2B: Possibly carcinogenic to humans

Group 3: Not classifiable with regard to carcinogenicity to humans

Group 4: Probably not carcinogenic to humans.

* International Agency for Research on Cancer (IARC)/Division of the World Health Organization (WHO)

10.9.



1 Nenonen N., Hämäläinen P., Takala J., et al. (2014) Global estimates of occupational accidents and fatal work-related diseases in 2014, Singapore, Workplace Safety & Health Institute. http://goo.gl/UlZorD

2. Mundt, KA, Dell, LD, Austin, RP et al. Historical cohort study of 10,109 men in the North American vinyl chloride industry, 1942–72: update of cancer mortality to 31 December 1995. Occup Environ Med. 2000; 57: 774–781

3. Price B, Ware A. Time trend of mesothelioma incidence in the United States and projection of future cases: an update based on SEER data for 1973 through 2005. Crit Rev Toxicol. 2009;39(7):576-88

4. Straif K. The burden of occupational cancer. Occupational and Environmental Medicine. 2008;65(12):787-788

5. Driscoll T, Takala J, Steenland K, et al. 2005. Review of estimates of the global burden of injury and illness due to occu-pational exposures. Am J Ind Med 48:491-502

6. Figures of the European Trade Institute (ETUI) at https://www.etui.org/Topics/Health-Safety/Occupational-cancers (Accessed: October 31, 2016)

7. Centers for Disease Control and Prevention. U.S. Cancer Incidence Statistics: an Interactive Atlas. https://nccd.cdc.gov/DCPC_INCA/. (Accessed October 29, 2016)

8. Ennever FK, Noonan TJ, Rosenkranz HS. The predictivity of animal bioassays and short-term genotoxicity tests for carcinogenicity and non-carcinogenicity to humans. Mutagenesis. 1987 Mar;2(2):73-78

9. Salsburg, D. The Lifetime Feeding Study in Mice and Rats - An Examination of Its Validity as a Bioassay for Human Carcinogens. Fundamental & Applied Toxicology 1983;3:63-67

10. National Cancer Institute: What have studies shown about a possible association between specific artificial sweete-ners and cancer? At https://www.cancer.gov/about-cancer/causes-prevention/risk/diet/artificial-sweeteners-fact-sheet#q2 (Accessed: October 31, 2016)

11. Wriedt H. Carcinogens that should be subject to binding limits on workers’ exposure. 2016. At http://www.etui.org/Publications2/Reports/Carcinogens-that-should-be-subject-to-binding-limits-on-workers-exposure (Accessed: October 31, 2016)

For an extensive list of potentially carcinogenic substances that includes IARC, ACGIH and OSHA classifications, go to: https://www.ehs.uci.edu/programs/sop_library/CARCIN.pdf

SOURCES:

IMPRINT/CONTACTCORPORATE HEADQUARTERSDräger Safety AG & Co. KGaARevalstraße 123560 Lübeck

www.draeger.com

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