Estimates of the fraction of several cancers attributable to occupational exposure to certain carcinogens in France

Anabelle GILG SOIT ILG, French Institute for Public Health Surveillance, France
HOUOT M. 1 , PILORGET C. 1,2 , IMBERNON E. 1

1 Department of Occupational Health, French Institute for Public Health Surveillance, Saint-Maurice, France
2 Epidemiological Research and Surveillance Unit in Transport, Occupation and Environment, Claude Bernard Lyon1 University, Lyon, France

Purpose:
The aim of this work is to produce the estimates of the fraction of several cancers attributable to occupational exposure to four carcinogens that are classified by the International Agency for Research on Cancer as Group 1 carcinogens: asbestos, silica, benzene, and trichlorethylene. This work also gives an estimate of the rate of recognition as occupational disease.
Methods:
The attributable fraction was calculated from the Levin’s formula, according to two scenarios. Relative risks were identified in the national and international scientific literature. The job-exposure matrices (developed through the Matgéné program) were linked to a representative sample of work histories of the French population in order to estimate the lifetime prevalence of occupational exposure to each agent. The number of cases attributable was calculated for each cancer and compared to the number of compensated of carcinogen-related occupational diseases.
Results
The results for each of the 4 carcinogens will be presented. For example, globally, the number of cases (pleural mesothelioma, lung, larynx and ovarian cancer) attributable to occupational exposure to asbestos is estimated, in 2012, between 2439 and 6184 in men and between 250 and 437 in women; based on the total number of cases for these four cancers, 7.7% to 19.4% of these cancers are attributable to occupational exposure to asbestos among men and 1.5% to 2.6% in women. Moreover, 27% to 73% of the lung cancer cases and 24.5% to 44% of the mesothelioma cases from the French general employees social insurance fund are not compensated as an occupational disease.
Conclusion
Notwithstanding the methodological limitations inherent to this exercise, these estimates are important to improve occupational health and public health knowledge. They confirm the substantial burden of occupational exposures in the occurrence of several cancers in the French population and hence the importance of under-recognition of the attributable cancers.