Cancer data needs to start a discussion on effective controls

Cover of Cancer Occupational reportThe Cancer Council of Western Australia has released a report (not yet available online)that states:

“The number of occupationally caused cancers compensated each year equates to less than eight per cent of the expected number.” (Executive Summary)

This is an extraordinary statistic but consistent with the history of occupational health and safety (OHS) statistics where the core data originates from compensation figures rather than incident figures.  Cancer has always been a challenge in this area as it can manifest years after exposure or not at all. But this report also provides important data, and a challenge, for OHS professionals and business owners as

“Occupational exposures to carcinogens are estimated to cause over 5,000 new cases of cancer in Australia each year.” (Executive Summary)

The report has an excellent discussion on why such statistics are estimates and the unreliability of previous data in Australia and overseas but there is only a short, but important, discussion about risk and hazard controls – the principle focus for OHS professionals.

“An additional consideration is that neither study investigated the presence or adequacy of workplace controls which may be in place that would reduce or eliminate the potential risk of exposure to workplace carcinogens. This was beyond the scope of the studies, and is also a difficult (and costly) task to undertake, as it would need to consider assessments of individual workplaces. This further highlights the employer’s duty to ensure that their safety management system is both identifying and reducing the risk posed by each hazard so far as is reasonably practicable.

Regardless of these uncertainties, it is clear from these estimates that the burden of occupational cancer is higher than the early estimates of Doll and Peto (1981), or any earlier Australian research that adopted their methodology.” (page 11, link added)

It is unlikely that the data situation will change as many workplaces, particularly in relation to risks from ultraviolet radiation (UVR), have already instigated controls based on risk estimates.  Construction sites provide shaded work areas and frequent hydration breaks in hot weather. Gardeners and landscapers have increased the use of wide-brimmed hats, long-sleeved shirts and other PPE, as well as rescheduling working hours to avoid the worst UVR risks.  Largely, these controls have been introduced because they are a good idea and in anticipation of prosecution and law suits, rather than on hard data, but the precautionary principle works in OHS.

It is reasonable to ask why the level of controls, the context of the working environment, was “beyond the scope of the studies” when analysing the level of control is the most effective mechanism for reducing the risk of cancer and the cost and social burden of occupational cancers?

This report, like many similar ones, provides the data and a call for action but fails to provide a strategy for this action or even clues and suggestions for action. This is not surprising as this is probably “beyond the scope” of these studies.  The report concludes with

“Known carcinogens should as much as possible be removed from the workplace. Where this is impossible all reasonable steps would be taken to minimise the exposure and the associated cancer risk. In circumstances where that exposure has occurred and a resultant cancer diagnosis occurs,  compensation should be made available.” (page 18)

For some years not OHS has not been about taking “all reasonable steps” for minimising exposure.  There is only the obligation to do what is “reasonably practicable” of which one element is the state of knowledge but in the are of occupational cancers, the state of knowledge is vague and, in the past, unreliable.  The status of this data, and the concept of reasonably practicable” allows OHS and risk managers to delay action until better information is available, which provides little comfort to the ill and dying workers.

It would have been good if the Cancer Council had conducted a symposium with OHS regulators and specialists to discuss the data in this report and to formulate a way forward. Although the Council missed the opportunity, the OHS and regulators should not. To truly combat the risks of occupational cancers, from UVR and hazardous substances, this report should start the discussion on controls.  These controls are likely to lead to changing the way work is done outdoors and provide a renewed discussion on the use of hazardous substances at work (a topic that seems to has lost impetus over the last decade). These changes could, and in some cases should, be significant and should not be focussed on additional regulation, if it can be avoided.

The Cancer Council of Western Australia report has only just been released and the Australian media has begun reporting on it (mostly in terms of compensation, understandably). The OHS profession, regulators, safety advocates and business leaders now need to build on this momentum to develop effective control strategies.

Kevin Jones

 

5 thoughts on “Cancer data needs to start a discussion on effective controls”

  1. People are exposed to asbestos mainly by inhaling fibers in the air they breathe. This may occur during mining and processing asbestos, making asbestos-containing products, or installing asbestos insulation. It may also occur when older buildings are demolished or renovated, or when older asbestos-containing materials begin to break down. In any of these situations, asbestos fibers tend to create a dust composed of tiny particles that can float in the air.

  2. Stephen, in response to your question “where would industry be?” I would ask where would workers be if we don’t start looking at the bigger picture? Any change to chemical exposure would be a massive task but the discussion needs to start, particularly if the social cost of occupational cancers continues to increase.

    It also needs to start outside of the “traditional” context of public health and workers compensation, or to build on that context.

  3. The biggest at risk workers for cancer exposure are probably fire fighters, not only because of poor resources (especially rural areas), but poor training and risk management. The number of exposures to toxic fumes is becoming a huge impost on the government agencies as these start to manifest as terminal diseases. UV exposure will increase owing to the increasing number of workers in the solar PV industry being exposed to direct and reflected UV radiation.
    There is little recognition of the studies undertaken at Fiskville and the incidence of cancers during the training exercises whilst burning toxic chemicals. Even now the incidence of asbestos exposure is too high for fire fighters, with all the known dangers of exposures there are too few SCBA sets in outer rural areas.

  4. Cancer Causing carcinogens – clearly no suggestions in the big picture as it might mean having to eliminate things like unleaded petrol with its diverse group of known additives that are already identified as cancer causing carcinogens – and then where would industry be? With unreliability of data I do have a problem with some of the estimates that are put out there and which gain credence sometimes as fact – bit like ATO estimates of the percentage of taxpayers not doing the right thing. However I do agree that we need, as safety professionals, to be more alert in identifying possible risk and ensuring solid evidence based risk assessments are conducted to identify and then mitigate the risks

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