Category: cancer

Cancer fears in Tasmanian school

Over recent years Australia has had its share of cancer cluster fears, most of which have not had a cause identified.  Cancer clusters are one of the most difficult workplace hazards to manage for several reasons:

  • Worker’s fear for their health;
  • Management fears for its staff;
  • Some management worry about the related business costs;
  • Clusters can generate considerable media coverage; and
  • Noone knows what’s really going on.

An August 2008 case appeared in Tasmania and, therefore, got almost no coverage in other States, even though it occurred in a media-friendly venue, a school.  The experts say that the incident is not technically a “cancer cluster” however semantics is the least of the worries for the participants and, in terms of safety management (and the management of any “outrage”), the differentiation is irrelevant.

In early March 2009, the investigation was completed and, sadly, no cause was identified.  In 3 March, the Director of Public Health,  Dr Roscoe Taylor, issued a media statement.

The investigation concerned the potential risks from electro-magnetic radiation from nearby power lines.

Dr Taylor found there was no statistical significance in the cancer rates of employees who had worked at the school

“Taking into account the lack of identifiable hazards, as well as the very small population we are dealing with, the most probable explanation for the numbers of cancers appears to be chance variation,” said Dr Taylor. 

“This was a rigorous and thorough investigation and while we probably can’t provide staff with the absolute assurances and certainty they would have been looking for, I think the results of the analysis mean we can be fairly confident that there has been no serious threat to public or occupational health at the school.

More details and Frequently Asked Questions are available.  A particularly useful factsheet on clusters is available HERE.

The Australian Broadcasting Corporation’s Health Report has an excellent podcast available in which cancer clusters in workplaces are discussed.

Kevin Jones

Eliminate the hazards

The first control measure on the “hierarchy of controls” is to eliminate the hazard.  OHS consultants and professionals should always consider ways to achieve this.  It may prove to be impractical, or politically unpopular, but it should always be discussed or recommended.  Reports and submissions that do not consider this control measure can be considered invalid.

In late-January 2009, the organic farmers in Australia reminded the media that its farming members are developing a safer industry for the customer and the producer.  This industry has boomed in Australia since the 1970’s in as a result of a desire and commitment to “eliminate the hazard”.

Interviews conducted by Biological Farmers of Australia (BFA) to help  discover why producers ‘go organic’ reveal a high number of farmers consider the switch for the health of themselves and their families.

Rob Bauer (Bauers Organic Farm, Qld), one of Australia’s largest organic horticultural growers, says he turned to organic farming 27 ago after farmers in his area became ill with cancer.

He says he wanted to decrease health risks associated with synthetic farm chemicals.

“I started thinking about farming differently after growing up in the Lockyer Valley (Qld) where friends and family passed away in their fifties after years of intensive agrichemical production.”

He says neurological problems, tumours, and cancer were among the chronic diseases he watched take their toll on his local farming community.

“I wasn’t comfortable with producing food using harsh farm chemicals for consumers,” he says.

Steve Skopilianos, commercial lettuce producer from Ladybird Organics in Keilor (Vic) looked into organics when he started a family.

“We had been applying pesticide blends with no understanding of their effect on people and employees.  There were times prior to organic conversion where I would not take my own produce home for my family to eat.”

Biodynamic producers of macadamias are happy to avoid high levels of agrichemicals typically used on the nuts.

“Working without a high exposure to synthetic chemical farm products is a weight off your mind,” says Marco Bobbert, from Wodonga Park Fruit and Nuts macadamia plantation (Qld), certified biodynamic since 1987.

He says direct chemical exposure could easily occur on conventional farms from accidents in production. “All it takes is a broken spray pipe.”

He says it is not just organic farmers who are concerned – “All farmers try to minimise their contact with chemicals on-farm. But organic production actively works toward negating that risk”.

Research has shown there is good reason for producers’ concern – a high exposure to some farm chemicals can lead to major health problems.

Particularly problematic substances include organophosphate insecticides and pesticides, which have been connected to several types of cancer, sterility and cognitive deficits (1).

The agrichemical endosulfan is one example of a highly toxic  organochlorine cyclodiene) insecticide still in use in Australia.

1. (1) Ciesielski, S, Loomis, D, Rupp Mims, S, Auer, A, Pesticide Exposures, Cholinesterase Depression, and Symptoms among North Carolina Migrant Farmworkers; American Journal of Public Health, 1994.

Possible cancer cluster at fish hatchery

For several weeks News Limited papers have reporting weird goings on around a fish hatchery in Queensland.  In a small area of Cooloothin Creek people living on properties neighbouring the Sunland Fish Hatchery have been noticing an increase in cancers.  The latest victim is a hatchery foreman who has been diagnosed with bowel cancer.

The issue has been bubbling along since a two-headed fish larva was discovered around 11 January 2009.  On 26 January 2009, the foreman has formally requested an investigation into a cancer cluster.  The 26 January quotes cancer expert, Bruce Armstrong.

Professor Armstrong said the fact there was more than one type of cancer would normally militate against a cluster. But the deaths and health problems among chickens, horses and dogs — as well as the fish — were extremely worrisome. “Clearly, there does seem to be an ecological issue here,” he said.

He suggested an investigation could help determine if the agrichemicals posed a threat to humans.

Local residents produced a video about the issue of crop spraying which is available on YouTube.

This current case will increase the pressure on government’s for increased regulation of farm chemicals and delivery systems.

UPDATE – 28 January 2009

Queensland’s Primary Industries and Fisheries Minister Tim Mulherin has established a taskforce to investigate the Noosa fish abnormalities.  It’s first meeting will be on 28 January 2009.

It includes private aquaculture veterinarian Dr Matt Landos, who says the available  evidence points to farm chemicals.

According to a ministerial media release Dr Landos said

“I am extremely pleased that the minister is keen to progress this issue and welcome the opportunity to work with the minister and the State Government. We need to consider interim alternative chemicals and farming practices in co-operation with macadamia farmers, to provide improved safety for aquatic animals and sustainable macadamia production.”

The ministerial release also said  that

“claims of a cancer cluster in the area are a matter for Queensland Health to consider.

Queensland Health has said the need for an investigation into an alleged cancer cluster will be determined once specific information is received from the community about their health concerns.”

SafetyAtWorkBlog will be following the taskforce’s progress.

New potential carcinogen and occupational asthma

There are two reports of concern in the next edition of the journal of Occupational and Environmental Medicine.  One (Cancer risks in chemical production workers exposed to 2-mercaptobenzothiazole – Online First Occup Environ Med 2009; 10.1136/oem.2008.041400) raises the increasing likelihood that 2-mercaptobenzothiazole, or MBT, could be carcinogenic.

The article reports on a study of workers in a rubber chemicals plant in North Wales.   It found that 

“Based on national statistics for expected death rates, workers exposed to MBT were twice as likely to die of gut (large intestine) and bladder cancers.

Based on national statistics for expected new cases of cancer, they were also twice as likely to be diagnosed with bladder cancer, and four times as likely to be diagnosed with multiple myeloma (bone marrow cancer).”

The other article (Occupational exposures to asthma among nursing professionals Online First Occup Environ Med 2009; 10.1136/oem.2008.042382) is similarly worrying.  Moreso because the chemical products mentioned in the report are well-known substances, such as latex gloves and gluteraldehyde, and control measures are very well established.

“…those who regularly cleaned instruments were 67% more likely to report a diagnosis of asthma since starting their job.

And nurses who were regularly exposed to general cleaning products and disinfectants were 72% more likely to say they had been newly diagnosed with asthma, and 57% more likely to report symptoms similar to asthma.

Those nurses working with solvents and glues used in patient care were also 51% more likely to say they had symptoms similar to asthma.”

In both these circumstances occupational health and safety has established control measures that can reduce the harm from these products.  What they illustrate is that OHS professionals may apply a consistent standard of expectations that often strengthen as clients remain in one specific industrial demographic but workplaces, decades after hazards are known, have a highly variable level of safety and compliance.  This sounds obvious but specialisation can lead to complacency in advisers as much as customers.

It is also useful to note that the carcinogen research was in North Wales and the asthma study in Texas.  Both these countries have strong OHS legislation and a good amount of OHS resources but still unacceptable levels of occupational illness.  It is this level of resource and attention that has provided the chance for these studies to be undertaken.  

“The more we look, the more we find”

Kevin Jones

Absence management survey results

On January 8 2009, the Mercer’s 2008 Pan-European Health & Benefit Report was released.  It had some useful information about the causes of workplace absenteeism in Europe.  The information was compiled in 2008 so is as current as can be but also occurred in a  period of severe economic unrest.

As with all studies, the applicability to other nations and regions is up for debate but the data is a great starting point for discussion on managing these issues in workplaces.

According to the available report information

“Musculoskeletal conditions were identified by 78 percent of respondents as the cause of most long-term absences.  Thirty-one percent specifically referenced lower back pain and 47 percent other musculoskeletal conditions.  Stress and mental health issues (52 percent) and cancer conditions (20 percent) were also featured amongst the highest disability causes.”

By looking at policies and practices in the multi-jurisdictional structure of Europe, the demographic variations and management initiatives may be applicable elsewhere.

As Steve Clements of Mercer says

“Absence management remains haphazard at best.  Targeted absence management policies and procedures are by no means universally applied, and even the ability to quickly and accurately measure absence remains fairly poor.  Many employers offer a broad range of health-related benefits, but their presence is driven by recruitment and retention, and it appears there is only sporadic evidence of integration of these benefits within a broader employee health and wellness or absence management agenda.  At a time when cost is under the microscope, employee absence remains under-managed and presents a great opportunity for savings and improved productivity.”

Kevin Jones

New UV Safety Guidance Note

As the Australian Safety & Compensation Council winds down before its transformation into Safe Work Australia, it is leaving with a flurry of activity.  The legacy that had most immediate appeal was the revised Guidance Note for the Protection of Workers from the Ultraviolet Radiation in Sunlight.  This is the most relevant and contemporary approach to UV as a workplace issue for many years and deserves to be carefully considered.uvguidancenote-cover

The need is great.  The report includes these justifications

  • Australia and New Zealand have the highest incidence of skin cancer in the world (Ferlay J, Bray F, Pisani P, Parkin D. GLOBOCAN 2002. Cancer incidence, mortality and prevalence worldwide. IARC CancerBase No. 5, version 2.0. Lyon: IARCPress, 2004)
  • At least 2 in 3 Australians will be diagnosed with skin cancer before the age of 70 (Staples M, Elwood M, Burton R, Williams J, Marks R, Giles G. Non-melanoma skin cancer in Australia: the 2002 national survey and trends since 1985. Medical Journal of Australia 2006; 184: 6-10); and
  • Skin cancer costs the Australian health system around $300 million annually, which is the highest cost of all cancers (Australian Institute of Health and Welfare. Health system expenditures on cancer and other neoplasms in Australia, 2000 – 01. Canberra: AIHW2005).

The report lists the following skin cancer contributory factors

  • exposure received during childhood
  • participation in outdoor work and leisure activities resulting in increased exposure to solar UV radiation
  • because of higher solar UV exposures, the closer people live to the equator, the more likely they are to develop skin cancer. Queensland has a higher rate of diagnosed skin cancers than Tasmania
  • solar UV radiation intensity increases with height above sea level 
  • solar UV radiation is at its greatest intensity between the hours of 10.00 am and 2.00pm, although dangerous levels of UV radiation can still be experienced outside those hours. (Note: These times should be adjusted to 11.00 am and 3.00 pm when there is daylight saving.)
  • the risk of skin cancer is greatest in people with a fair complexion, blue eyes and freckles, who tan poorly and burn easily, but others, for example, individuals who have Dysplastic Naevi Syndrome, are also at risk, and
  • there is an increased risk in people who have already had a skin cancer or Keratoses diagnosed.

These are the bases for a good, contemporary and useful workplace policy on UV protection.

Inquiry into health impacts of maintaining jet-fighter fuel tanks

Earlier this century the Australian Defence Force established the F-111 Deseal-Reseal Health Care Scheme to compensate workers who may have been affected through exposure to chemicals while cleaning F111 fighter aircraft between 1977 and the late 1990s.

A parliamentary inquiry has been established to further investigate the issue of compensation. In the 29 July 2008 edition of The Australian newspaper details of the work exposures have been restated.

“More than 800 RAAF personnel were forced to do the work on the fuel tanks, removing old sealant using chemicals.

The work was done because of a basic flaw in the design of the aircraft — their fuel tanks did not include a bladder, and the sealant used on rivets to stop leaking had to be replaced at regular intervals.”

Details of the impact of this work on workers and their families have also been restated. Ian Fraser, Queensland president of the F-111 Deseal-Reseal support group has said that

“former workers now suffer temper swings, drug abuse and broken marriages — and some had committed suicide.

A significant number have died from cancer, which Mr Fraser’s organisation says is directly attributable to them being made to work with the chemicals — particularly one known as SR51.”

Those OHS professionals who have read Professor Andrew Hopkins’ book “Safety, Risk and Culture” should be familiar with the case as Hopkins investigated the issue and devoted a chapter to his book on the F111 Deseal/Reseal process.  A review of the Hopkins book is available online as is a useful article by Hopkins on safety culture.

It is worth remembering that exposure to chemicals and inadequate protection is not something from the developing nations or from Western industrial history.  These workers faced unacceptable risks within the last twenty years.

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