Strengthening occupational carcinogen surveillance in Latin America and the Caribbean

Status: in progress

Purpose:

This project aims to enhance estimates of exposure to occupational carcinogens in Latin America and the Caribbean. It is also intended to promote widespread awareness about workplace exposures as an important cause of cancer in the region and to encourage the use of exposure estimates for informing cancer prevention strategies.

This project was initiated at the request of the Pan American Health Organization/Americas Regional Office of the World Health Organization, the National Cancer Institute of Colombia, and the Universidad El Bosque in Colombia. The OCRC, in collaboration with these organizations and with CAREX Canada, secured the funding and designed the training.

Background:

Cancer is a leading cause of death and major disease burden in Canada and Latin America and the Caribbean. According to the World Health Organization’s estimates in 2005, approximately 8% of lung cancer cases in Latin America and the Caribbean are attributed to workplace exposures such as asbestos, silica, and diesel exhaust. Although data on exposure to occupational carcinogens is limited in this region, levels of exposure and rates of work-related cancer are suspected to be high since many workplaces do not meet required health and safety standards to prevent exposure and enforcement is lacking. Additionally, informal work is pervasive in key industries like agriculture, mining, manufacturing, and construction where workers are often exposed to excess levels of carcinogens. Detailed and reliable estimates of occupational carcinogen exposure are needed to raise the profile of occupational cancer and develop preventative strategies.

Methods:

To achieve project goals, participating countries in Latin America and the Caribbean will develop or improve the surveillance of occupational carcinogen exposures by using the CAREX (CARcinogen EXposure) method. Pioneered in the European Union in the 1990s, CAREX is an approach that generates estimates of the number of workers exposed to cancer-causing agents in the workplace. To enhance CAREX in Latin America and the Caribbean, a knowledge exchange and capacity-building workshop will be held with researchers and stakeholders from over a dozen countries in the region. This collaborative approach will involve representatives from government, informal worker groups, and the private sector who will share input on priority occupational carcinogens and discuss ways to translate knowledge. Following the workshop, CAREX Canada will provide ongoing technical assistance for CAREX research, development, and application. This includes creating a practical guide that outlines how to develop a CAREX project so that other countries can apply and adapt the methods for their national circumstances.

The secondary objective of this project is to raise the profile of occupational cancer in Latin America and the Caribbean. As CAREX exposure estimates are produced, project partners will encourage their use in occupational cancer prevention strategies by communicating with ministers of health and labour, informal worker groups, and large employers. This intensive approach of integrating stakeholders from the beginning is hoped to increase the uptake and application of research findings.

Implications:

This project will generate high-quality estimates of the numbers of people exposed to occupational carcinogens in Latin America and the Caribbean by country, state/province, industry, occupation, informal/formal work, and sex. CAREX projects can be used to build awareness, identify and monitor current and historic exposure, support toxic use reduction and cancer prevention policies, and provide exposure information to improve estimates of the global burden of disease.

Progress:

A two-day, in-person workshop with researchers and policy, labour, and employer stakeholders from 13 countries spanning Canada, the Caribbean, and Central and South America took place on May 6th and 7th, 2014 at the Universidad El Bosque in Bogota, Colombia. Resources that were produced in preparation for the workshop can be found below. Proceedings from the workshop are in preparation.

Resources:

Funding:

This project is primarily funded by the Canadian Partnerships Program within the International Development Research Centre based in Ottawa, Canada. Additional support is provided by the National Cancer Institute of Colombia and the Pan American Health Organization/Americas Regional Office of the World Health Organization.

Investigators:

Alexandra Yepes Boada (Universidad El Bosque)
Hugh Davies (CAREX Canada)
Paul Demers (Occupational Cancer Research Centre)
Calvin Ge (CAREX Canada)
Julietta Rodriguez Guzman (Pan American Health Organization/Americas Regional Office of the World Health Organization)
Anne-Marie Nicol (CAREX Canada)
Manisha Pahwa (Occupational Cancer Research Centre)
Cheryl E Peters (CAREX Canada)
Maria Teresa Espinosa Restrepo (Universidad El Bosque)