Priorities for Occupational Cancer Research and Prevention in Canada Paul A. Demers, PhD

Transcription

1 Priorities for Occupational Cancer Research and Prevention in Canada Paul A. Demers, PhD OCRC Research Day 2011 March 23 rd, 2011

2 Research Program Priority Areas from the OCRC Strategic Plan Surveillance of occupational cancers & workplace exposures Identification of causes of cancer in the workplace Intervention research to develop and evaluate prevention and exposure reduction strategies

3 What substances and circumstances should be priorities? ~ 60 definite or probable workplace carcinogens Over 100 additional workplace exposures are possible carcinogens Many other workplace exposures with a suspicion of human carcinogenicity Even greater number of workplace substances with little formal evaluation

4 Recent Reports Relevant to Setting Priorities Report of the Advisory Group to Recommend Priorities for IARC Monographs during IARC, Internal Report 08/001. Lyon, France, 2008 Ward EM, Schulte PA, Straif K, et al. Research Recommendations for Selected IARC Classified Agents. Environmental Health Perspectives 2010:119(10): Presidents Cancer Panel. Reducing environmental cancer risks. U.S. National Cancer Institute, April Demers PA, Peters CE, Nicol AM. Priority Occupational Carcinogens for Surveillance in Canada: Preliminary Priority List. CAREX Canada, Hohenadel K, Marrett L, Pichora E, Brown J, Harris S, Blair A. Occupational Cancer Research Centre Stakeholder Consultation Report. OCRC, November All reports are available at: resources/reports/

5 IARC Evaluation Priorities High Priorities (occupational) Medium priorities (occupational) Asphalt & bitumen* Carbon based nanoparticles Crystalline fibres other than asbestos Ultrafine particles Motor vehicle exhaust emissions Perfluorinated compounds (e.g. PFOA) Radiofrequency electromagnetic fields* Sedentary work Stress Iron & iron oxides Welding Atrazine Metalworking fluids & lubricants N Nitrosamines* Polybrominated biphenyls (PBB) Polybrominated diphenyl ethers (PBDE) Polychlorinated biphenyls (PCB) DEHP and other phthalates* Styrene Trichloroethylene & other chlorinated solvents * IARC review already scheduled

6 NIOSH/IARC Top 20 Research Priorities Ultrafine particles Titanium dioxide Carbon black Diesel Engine Exhaust Welding fumes Metals Lead & lead compounds Indium phosphide Metallic cobalt Pesticides Atrazine Shiftwork Chlorinated solvents Trichloroethylene Perchloroethylene Methylene chloride Chloroform Other Chemicals Formaldehyde Styrene & Styrene 7,8 Oxide Acetaldehyde Propylene Oxide Polychlorinated Biphenyls (PCBs) Di (2 ethylhexyl) phthalate (DEHP)

7 Priorities for Etiologic Research versus Prevention? Both the IARC Monograph Program and the NIOSH priorities focus on contributing to the classification of new carcinogens Research on established carcinogens? Some are defined only by job or industry (e.g. painting & welding) and targets for prevention are needed Some are poorly defined (e.g. wood dust) Dose response often poorly understood

8 OCRC Stakeholder Needs Assessment Survey Most frequently identified exposures Exposure category Examples of commonly listed exposures Frequency Chemicals Formaldehyde, amines, PCB, sulphuric acid mists 30 Dusts and fibres Asbestos, fibreglass, silica, wood dust, carbon black 27 Radiation Electromagnetic fields, nuclear, cell phone, solar, 24 ionizing radiation, radiofrequency radiation, WIFI Lifestyle factors Smoking, physical activity, stress, diet, alcohol 18 Shiftwork 16 Pesticides 15 Nanomaterials 14 Exhaust Diesel, gasoline 14 Metals Uranium, chromium, cobalt, gold, nickel, smelter 13 fumes, tungsten, welding fumes, lead Work environment Indoor air, environmental tobacco smoke, mould 12 Solvents Solvents (general), benzene, trichloroethylene 9 Fossil fuels & oils Metal working fluid, oil mists, coal tar, fuel, asphalt 7 Pharmaceuticals Antineoplastic drugs, cytotoxic drugs 4

9 CAREX Canada Estimated Exposure in Ontario Over 250,000 exposed: Shift work at night, diesel exhaust, solar radiation ,000: Other PAHs, crystalline silica, benzene ,000 exposed: Lead, wood dust, asbestos, artificial UV 25 50,000 exposed: Chromium, chlorophenoxy herbicides 10 25,000 exposed: Nickel, cobalt, styrene, ionizing radiation, formaldehyde, cadmium, toluene diisocyanate 5 10,000 exposed: Tetrachloroethylene, trichloroethylene, methylene chloride, antineoplastic drugs, arsenic 1 5,000 : PCBs, refractory ceramic fibres, antimony trioxide, acrylonitrile, acrylamide, napthalene, vanadium pentoxide, pentachlorophenol

10 OCRC Cancer Research Priorities: General Principles Focus on suspected carcinogens to contribute to the classification of carcinogens Studies of new and emerging issues (e.g. shiftwork) and under studied populations (e.g. women) Cancer surveillance to identify new groups at increased risk and identify new potential carcinogens Focus on established carcinogens for exposure surveillance and preventions related research Consider past, current, and future exposure in Ontario

11 Towards a cancer free workplace