Global Burden, Projection, and Inequalities Analysis of Cancer Attributable to Occupational Carcinogen Exposure in Individuals Aged Over 40 Years

Our plain-English summary of Global Burden, Projection, and Inequalities Analysis of Cancer Attributable to Occupational Carcinogen Exposure in Individuals Aged Over 40 Years, by N. Hu, H. Li, K. Yu, et al (Cancer Medicine, 2025).

The study

• Authors: N. Hu, H. Li, K. Yu, Y. Yu, X. Wu, X. Huang, H. Lin, S. Zou, J. Li
• Journal: Cancer Medicine
• Published: 2025;14(17):e71213
• Cited by: 3 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Background: In this study, we investigated the global burden, projection, and inequalities of cancer attributable to occupational carcinogen exposure in individuals aged over 40 years.

Methods: Using the Global Burden of Disease 2021 dataset, we examined age-standardized disability-adjusted life years (ASR-DALYs) and deaths associated with cancer attributable to occupational carcinogen exposure. Statistical analyses included: the estimated Annual Percentage Change to assess trends (1990-2021); Bayesian age-period-cohort modeling for projections to 2030 and 2050; decomposition analysis to quantify contributions of aging, population growth, and epidemiological changes; and slope and concentration indices (SII, CI) to evaluate health inequalities by sociodemographic index (SDI).

Results: In 2021, the global ASR-DALYs attributable to occupational carcinogen exposure were 239.3 per 100,000 (95% uncertainty intervals [UI]: 180.76-300.91), with significant declines found since 1990. The ASR-deaths in the same year were 11.45 per 100,000 (95% UI: 8.57-14.29). By 2050, ASR-DALYs and ASR-deaths are projected to decline to 177.24 and 8.50 per 100,000, respectively. Men exhibited higher DALYs and mortality (3.92 million DALYs, 0.18 million deaths) compared with women. From 1990 to 2021, high SDI regions exhibited the most substantial decline, whereas low-middle SDI regions experienced the highest increase. The most prominent occupational carcinogens were asbestos (ASR-DALYs: 142.36 per 100,000), silica (50.36 per 100,000), and diesel engine exhaust (20.56 per 100,000). Among the seven types of occupational cancers observe, tracheal, bronchial, and lung cancers exhibited the highest ASR-DALY and ASR-deaths. Population growth is the primary contributor to both DALYs and deaths globally, followed by epidemiological changes.

Conclusion: This study highlights the declining global burden of cancer due to occupational exposure to carcinogens; however, significant disparities persist. Addressing occupational cancer risk in low-SDI regions and under-researched populations is crucial for reducing this health burden.

© 2025 The Author(s). Cancer Medicine published by John Wiley & Sons Ltd.

In plain English

This study reanalyzed Global Burden of Disease 2021 estimates of cancer linked to workplace exposure to 13 carcinogens among people aged 40 and older in 204 countries and territories, 1990 to 2021, with projections to 2050. Burden was measured in deaths and DALYs (healthy years of life lost). In 2021 the estimates were 6,965,325.53 DALYs (95% uncertainty interval 5,270,229.28 to 8,760,723.68) and 325,614.79 deaths (244,681.75 to 406,667.12); age-standardized rates had fallen since 1990. Asbestos had the highest age-standardized DALY rate of the 13 carcinogens in this age group: 142.36 per 100,000 (103.56 to 181.48). Its rate declined, while silica and diesel engine exhaust rates rose. Age-standardized DALY rates were 207.63 per 100,000 (150.61 to 267.98) for tracheal, bronchial and lung cancer and 19.91 per 100,000 (17.73 to 21.94) for mesothelioma. Men had higher rates than women; high-SDI (more developed) regions had the highest. The authors noted that data quality varies between countries and only 13 of 47 known occupational carcinogens are included. They concluded that continued international efforts are needed on occupational health policies and data accuracy.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Secondary analysis of modeled Global Burden of Disease (GBD) 2021 estimates. It covered trends from 1990 to 2021, Bayesian projections to 2030 and 2050, decomposition analysis, and inequality analysis by sociodemographic index (SDI).
• Who was studied: People aged 40 years and older in the 204 countries and territories covered by GBD 2021, from 1990 to 2021.
• Exposure: Occupational exposure to 13 carcinogens: arsenic, asbestos, benzene, beryllium, cadmium, chromium, diesel engine exhaust, formaldehyde, nickel, polycyclic aromatic hydrocarbons, silica, sulfuric acid and trichloroethylene. Asbestos fiber types were not specified.
• Main results:
  • In 2021, global DALYs from cancer attributable to occupational carcinogens among people aged 40 and older were estimated at 6,965,325.53 (95% UI: 5,270,229.28 to 8,760,723.68).
  • The global age-standardized DALY rate in 2021 was 239.3 per 100,000 (95% UI: 180.76 to 300.91). From 1990 to 2021 it changed by an estimated annual percentage change of −1.11 (95% CI: −1.19 to −1.04).
  • In 2021 there were an estimated 325,614.79 deaths (95% UI: 244,681.75 to 406,667.12). The estimated annual percentage change in the death rate was −0.85 (95% CI: −0.94 to −0.76).
  • Among people aged 40 and older, asbestos had the highest age-standardized DALY rate of the 13 carcinogens: 142.36 per 100,000 (95% UI: 103.56 to 181.48), from 4,077,098.8 DALYs.
  • The asbestos age-standardized DALY rate declined from 1990 to 2021, with an estimated annual percentage change of −0.57 (−0.63 to −0.51).
  • Over the same period the silica and diesel engine exhaust rates rose. The estimated annual percentage change was 0.62 (0.57 to 0.67) for silica and 1.22 (1.14 to 1.30) for diesel engine exhaust.
  • By cancer type, the age-standardized DALY rate was 207.63 per 100,000 (95% UI: 150.61 to 267.98) for tracheal, bronchial and lung cancers, and 19.91 per 100,000 (95% UI: 17.73 to 21.94) for mesothelioma. These are DALY rates, not incidence or death rates.
  • In 2021 men had 3.92 million more DALYs and 0.18 million more deaths than women. Over the study period, rates in men decreased while rates in women increased slightly.
  • High-SDI regions had the highest age-standardized DALY rate in 2021: 382.08 per 100,000 (95% UI: 289.26 to 470.62). Low-SDI regions had the lowest: 54.67 per 100,000.
  • The global DALY rate was projected to be about 213.07 per 100,000 by 2030 and 177.24 per 100,000 by 2050. The uncertainty interval for 2050 was wide: 2.03 to 393.99.
  • Globally, population growth was the largest contributor to changes in DALYs and deaths, followed by epidemiological changes. Population aging had a relatively minor effect.
  • The concentration index for DALYs by SDI decreased from 0.4 in 1990 to 0.29 in 2021. The authors interpreted this as a shift towards a more equal distribution.
• The authors' conclusion: The authors concluded that the global burden declined between 1990 and 2021, which they attributed to stronger legal frameworks and surveillance. They concluded that regional, sex and age disparities persist, and that continued international efforts are essential for improving occupational health policies and data accuracy.
• Limitations the authors state:
  • GBD data quality varies across countries, which may bias estimates, particularly in low- and middle-income countries.
  • The statistical models rely on assumptions that may not reflect differences between countries.
  • Some occupational exposures, such as diesel engine exhaust, are hard to assess accurately.
  • Only 13 of the 47 agents classified by IARC in 2017 as known occupational carcinogens are included in GBD 2021.
  • The authors stated that the occupational cancer burden is heavily underestimated in developing countries.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Occupational Exposure.

Related studies

• The global burden of cancers attributable to occupational factors, 1990-2021 — B. Zou, P. Wu, et al. (2025)
• Global burden of tracheal, bronchus, and lung cancer attributable to occupational carcinogens in 204 countries and territories, from 1990 to 2019: results from the global burden of disease study 2019 — Y. Zhang, M. Mi, et al. (2023)
• Global, regional and national mortality burden of laryngeal cancer attributable to occupational exposure to sulfuric acid and asbestos: 1990-2021 and projections to 2040 — X. Gong, Y. Xu, et al. (2025)
• Global burden of mesothelioma attributable to occupational asbestos exposure in 204 countries and territories: 1990-2019 — Z. Chen, Y. Cai, et al. (2024)
• Burden of Lung Cancer Attributable to Occupational Carcinogens from 1990 to 2019 and Projections until 2044 in China — Y. Fan, Y. Jiang, et al. (2022)
• Global burden of lung cancer attributable to occupational asbestos exposure: 1990 to 2021 — Q. Huang, Y. Cheng, et al. (2025)

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