Occupational cancer. Where now and where next?

Our plain-English summary of Occupational cancer. Where now and where next?, by F.J. Roe (Scandinavian Journal of Work, Environment & Health, 1985).

The study

• Author: F.J. Roe
• Journal: Scandinavian Journal of Work, Environment & Health
• Published: 1985;11(3 Spec No):181-7
• Cited by: 4 articles, as counted by NIH iCite
• Read it: PubMed · Publisher
• In J-M's library: Johns-Manville's company medical library held a copy (J-M no. 001261).

Abstract

For each kind of occupationally associated cancer, there are three distinct stages in the development of the problem: recognition of a possible problem, confirmation, and the introduction of preventive measures. In the past, recognition of a possible problem depended heavily on chance and on the powers and observation of dedicated physicians and surgeons. Confirmation consisted of the collection of further anecdotal evidence and the conduct of case-referent (case-control) or other studies. The introduction of preventive measures often lagged woefully behind confirmation that a problem existed. Recently, the power of epidemiology as a primary investigative tool has grown to the point where unsuspected associations between occupation and cancer risk may be the first hint that a problem exists. However, it is important to recognize that investigative epidemiology is capable of constructing misleading pictures. In the future there is bound to be continuing pressure to reduce maximal permissible exposure to proven carcinogens. For chemicals for which there is no more than suspicion based on laboratory tests, one must ensure that regulatory action is based on good science, sound judgement, and common sense, rather than on the machinations of those with vested interests, of ambitious lawyers, or of the lunatic fringe. Less than 10% of all cancers are likely to be due to occupational factors. Therefore, even turning the world upside down with safety precautions against actual and suspected carcinogens would only marginally affect the present human cancer burden.

In plain English

This 1985 article was a short commentary by an independent consultant on occupational cancer. It reported no new study, and most of its figures were drawn from other published sources. Citing a survey by Doll and Peto of cancer in the United States, the author reported that about 4% of cancer deaths were attributed to occupation. Asbestos was one of the main examples. The author wrote that the extent of the cancer risk from asbestos was not appreciated until the mid-1950s. According to the author, lung cancer after asbestos exposure takes upwards of 20 years to appear, depending on the dose and smoking habits, and mesothelioma takes even longer. Health and Safety Executive figures showed that death certificates in England and Wales mentioning asbestos and/or mesothelioma rose steadily from 1968 to 1982. The author noted that asbestos gives negative results in most mutagenicity tests, and that its contribution to lung cancer is hard to estimate because of smoking. The author concluded that, since less than 10% of cancers seemed occupational, even sweeping safety precautions would only marginally affect the overall cancer burden.

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: Commentary (brief discussion of philosophical issues in occupational cancer); no original study
• Who was studied: No study population. The author discussed occupational cancer in general, citing data mainly from other sources, including United States cancer estimates and death certificates in England and Wales.
• Exposure: Occupational carcinogens in general. Asbestos was discussed as one example, along with soot, mineral oil, aromatic amines and vinyl chloride. No fiber types were specified.
• Main results:
  • Citing a survey of cancer in the United States by Doll and Peto, the author reported that occupation accounted for about 4% of cancer deaths, with a range of acceptable estimates of 2 to 8%.
  • The author wrote that, although industrial use of asbestos began about 100 years earlier, the extent of its cancer risk was not appreciated until the mid-1950s.
  • According to the author, the latency interval for lung cancer after asbestos exposure is upwards of 20 years, depending on the dose and concomitant smoking habits, and the latency interval for mesothelioma is even longer.
  • Using figures from the Health and Safety Executive, the author reported that death certificates in England and Wales mentioning asbestos and/or mesothelioma rose steadily from 1968 up to 1982, with no sign of abatement.
  • The author added that those totals did not include deaths from asbestos-associated lung cancer that were not mentioned on certificates. The author also stated that the contribution of asbestos to lung cancer is difficult to estimate because of the strong association between smoking and lung cancer.
  • The article predicted about 30 000 deaths from lung cancer from all causes, not only asbestos, in men and women in England and Wales in the year 2000. The prediction was based on present trends, and no other source was cited for it.
  • The author wrote that asbestos gives negative results in most tests for mutagenicity, and that its hazard to people is not easy to demonstrate in routine animal carcinogenicity tests.
  • The author believed that improvements in occupational hygiene over the previous 20 years or so had greatly reduced asbestos exposure and cancer risk. The author added that it could be another 10 or 20 years before a decrease in asbestos-associated lung cancer and mesothelioma deaths showed.
  • The author stated that the conditions that make case-control studies more plausible were fulfilled for the risk of mesothelioma in asbestos workers.
• The authors' conclusion: The author concluded that less than 10% of all cancers seem to be due to occupational factors. Therefore, in the author's view, even sweeping safety precautions against actual and suspected carcinogens would only marginally affect the present human cancer burden.

Topics

Medical terms in this study, explained in our Lexicon: Epidemiology.

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