Systematic review of occupational cancer prevention efforts

Purpose:

To compile and summarize existing evidence on the effectiveness of occupational cancer prevention efforts, including substance bans, reductions and substitutions, the use of personal protective equipment, and other exposure reduction strategies.

Background:

Reducing the risk of disease is an essential aim of occupational cancer research. Despite considerable societal efforts to eliminate or control workplace exposures of hazardous substances, the literature documenting the effectiveness of risk-reduction or prevention efforts is sparse. Reasons for this shortage may include the difficulties associated with attributing risk reduction to a particular prevention effort, challenges with quantifying the effectiveness of prevention efforts, and the absence of evaluating exposure reduction efforts once they are implemented (exposure control measures are often seen as the “final step” in the disease reduction process).

Methods:

An initial consultation with occupational cancer experts has narrowed our review to ten well-established carcinogens: arsenic, asbestos, benzene, beta-napthylamine, chromium, coal soot, nickel, radon, vinyl chloride and wood dust. These were selected because they are established human carcinogens with sizable effects and because exposure control efforts have been in place for a number of years. A literature search focused on these exposures, in addition to consultations with subject-matter experts, and a scan of articles cited by the IARC monographs will be used to identify relevant articles for this project.

Implications:

Elimination or reduction of hazardous exposures is central to ensuring a healthy workplace. Summarizing available evidence on the success of these efforts would be an important contribution to the literature. Findings may help support industry and policy decision-making, and will likely draw attention to the importance of evaluating occupational prevention efforts in the future.

Progress:

Literature collection and expert consultation have been completed for asbestos, and results will be published as they become available. Investigations for other substances are ongoing.

Investigators:

Aaron Blair (Occupational Cancer Research Centre) (PI)
Paul Demers (Occupational Cancer Research Centre and Cancer Care Ontario)
Karin Hohenadel (Public Health Ontario)

Collaborators:

Kurt Straif (International Agency for Research on Cancer)