Work and Wider Environmental Cancer Prevention: UK Perspectives

There is still considerable debate about the fractions of cancer mortality due to ‘environmental’ factors. Related morbidity tends to be ignored. Doll and Peto’s 1981 best estimate for occupational cancer deaths was 4% and for pollution and geographical factors, another 5%: a 9% total in the UK. This is a significant yet often neglected public health burden especially when each UK occupational cancer case costs an estimated £2.46 million.

The 1981 figure produces more occupational cancer deaths in Scotland each year than murders and road traffic fatalities combined¹. A 12% figure would mean more such deaths than murders, road traffic fatalities and suicides combined. Recent UK occupational cancer best estimates run at around 5% but still under-estimate the problem due to under-reporting. European Agency staff estimate 13.6% for males and 2.1% for females. Wider environmental cancer estimates are hazier except for radon-related lung cancer deaths which affect Scottish populations and some environmental asbestos-related cancer deaths but IARC estimates 7-19% of cancers worldwide are due to toxic environmental exposures^{2, 3}.

In Scotland, occupational cancer mortality disproportionately hits de-industrialised and vulnerable communities and primarily unskilled, semi-skilled and skilled workers. Towns along the Clyde have an epidemic of asbestos-related cancers. Yet estimates of those exposed to carcinogens in 2000 still ran to around a fifth of the UK workforce mainly manual workers. Double jeopardy also occurs with ‘direct’ carcinogens such as night work also increasing obesity, another cancer risk factor.

Removing carcinogens or reducing exposures is the way forward. US states have successful toxics use reduction programmes that cut carcinogen usage⁴. France has an active national occupational cancer prevention strategy but the UK lacks both. Media coverage of cancer prevention still focuses on individual lifestyles rather than life circumstance analyses that emphasise upstream approaches and includes work and wider environmental factors⁵.

1. Watterson A et al (2008) Occupational cancer prevention in Scotland: a missing public health priority. Eur J Oncol. 13(3): 161-169.
2. Global health risks: mortality and burden of disease attributable to selected major risks. Geneva: World Health Organization, 2009.
3. Straif K. The burden of occupational cancer. Occup Environ Med 2008;65:787-788
4. International Conference on Occupational and Environmental Carcinogen. Papers at http://www.nmh.stir.ac.uk/research/occupational-environmental-cancer.php
5. Parkin D et al. The Fraction of Cancer Attributable to Lifestyle and Environmental Factors in the UK in 2010British Journal of Cancer (2011) 105, Si

This article was originally published in the SCPN Newsletter Volume 3, Issue 1.
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