Article by: Shraddha Lanjewar. MPH. Physiotherapy
According to WHO occupational health is a multi disciplinary activity aimed at the protection and promotion of health of workers by preventing and controlling occupational diseases and accidents and by eliminating occupational factors and conditions hazardous to health and safety at work. A variety of occupational risks are known to cause cancer. Worldwide occupational cancer accounts for about 4 to 20% of the total cancer cases and about 10% cases are cancers of lung, trachea and bronchus.
It is estimated that 2.3 million deaths occur globally every year, majority (2.0 million) being occupational deaths. Cancer forms the leading causes (32%) followed by workrelated circulatory diseases (23%), communicable diseases (17%) and occupational accidents (18%). International Labour Organisation publication states that over 666,000 fatal cancers are occupation related. There is an increase in the total economic costs to society due to new cases of work-related cancers in Britain (2010)
The lung cancer incidence rates in asphalt workers in Nordic countries like Denmark, Norway, Finland, Sweden have shown an increasing trend since 2004 with standardized incidence ratio (SIR) of 1.21 (95% CI 1.07-1.36). In addition, a suggestive evidence of an excess risk of bladder cancer among asphalt workers with relative risk of 1.85 (95% CI 0.90-3.78) was also observed.
Incidence of cancer mortality among European asphalt workers in 2003 also showed higher standardized mortality ratios (SMR) for lung cancer (1.17 95% CI 1.04-1.30) with a relative risk of 1.09 (95% CI 0.89-1.34). Risk factors like asphalt and tar exposure are associated with a statistically significant excess risk of lung cancer. Data on African Americans and Latino Americans of the San Francisco Bay area is found to be consistent with the literature suggesting that exposure to asphalt and tar may increase risk of lung cancer. Cancer risks from 3 both dermal and inhalation exposure is also increased among roofing workers applying built-up roofing asphalt (BURA) in USA.
A retrospective cohort study in a Dutch cohort of asphalt workers concluded that the excess lifetime risk for lung cancer was above standard risks as applied by the Dutch Health Council and suggested further exposure control to reduce the risk. Similarly exposures to polycyclic aromatic hydrocarbons (PAHs) present in hot asphalt fumes are associated with increased risk of DNA damage among roofers(3). Exposure to airborne respirable particles (PM10) and polycyclic aromatic hydrocarbons (PAHs) of asphalt manufacturing and road paving workers in the Campania region (Italy) in 2007 showed constant health hazards.Exposure to bitumen fumes can also cause genotoxic effects.
A recent case control study for lymphocyte DNA damage in asphalt workers in Turkey detected by comet assay showed higher DNA damage in those exposed to asphalt fumes. But other studies have shown conflicting results and hence exposure to bitumen could not be ruled out as being responsible for the increased incidence of lung cancer. A higher prevalence of alcohol and tobacco consumption has also showed increase in cancer risks.
A recent case control study of lung cancer in asphalt workers in Europe showed no evidence of an association between the exposure to bitumen and lung cancer. Some results did not conclude a causal link between asphalt exposure and bladder cancer. A systematic review and meta analysis of cohort studies in 2016 identified 41 studies and showed no significant excess risk of any lymphatic and hematopoietic neoplasms among workers employed in jobs or industries entailing high PAH exposure.
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