Occupational Cancer

What is a carcinogen?

• context A carcinogen is a substance, mixture or agent that can cause cancer or increase the risk of developing cancer. Known carcinogens include viruses (e.g., Hepatitis B, Kaposi sarcoma-associated herpes virus, etc.), hormones (e.g., estrogens), chemicals (e.g., benzene, diesel exhaust, alcohol), naturally occurring minerals (e.g., asbestos), bacteria (e.g., Helicobacter pylori), ionizing radiation (e.g., X-rays) and solar radiation (e.g., ultraviolet radiation). Carcinogens may also include work organization factors, such as shift and night work.

What is occupational cancer?

• context Occupational cancer is the term given to cancers that are caused wholly or partly by exposure to a carcinogen or situation at work. Generally speaking, this exposure would occur over a long period of time (e.g., more than 10 years).

How common is occupational cancer?

• context Research shows that the amount of cancer related to occupational exposure varies with the type of cancer. Common types of occupational cancer are lung cancer, bladder cancer, and mesothelioma. The Occupational Cancer Research Centre produces reports on the burden of occupational cancers.

How do we know if an agent or situation may cause cancer?

Scientists identify cancer-causing agents using information from: Scientists generally use information or evidence from all of these sources when determining if an agent can cause cancer.

• context studies that look at the relationship between an exposure and the risk of developing cancer in human populations,
• context experiments that examine the relationship between exposure and the risk of developing cancer in laboratory animals,
• context tests that examine the ability of an agent to cause mutations (genetic changes) in cells, and
• context knowledge of chemical structures and the way in which chemicals interact with the body.

Do all exposures to a carcinogen result in occupational cancer?

No. Whether or not exposure to a carcinogen will result in cancer depends on many factors, including: The number of weeks or years on the job may provide an estimate of the degree of exposure. In general, the higher the exposure (duration or amount), the higher the risk of developing a health effect, including cancer. For more information, please see the following OSH Answers documents:

• context Route of exposure
• context Concentration of the carcinogen
• context Dose (toxicity) of the carcinogen
• context Frequency (how often the worker was exposed)
• context Duration (how long the worker was exposed)
• context Exposure to other agents at the same time (including smoking, medical treatments, etc.)
• context Individual characteristics (e.g., age, genetic ancestry, etc.)
• context How Workplace Chemicals Enter the Body
• context What Makes Chemicals Poisonous
• context What is an LD50 and LC50?
• context Occupational Hygiene - Occupational Disease

International Agency for Research on Cancer (IARC)

IARC classifies each agent or exposure into one of five groups according to the strength of scientific evidence for carcinogenicity, as follows: A list is available at the IARC Monographs website.

• context Group 1 - Carcinogenic to humans
• context Group 2A - Probably carcinogenic to humans
• context Group 2B - Possibly carcinogenic to humans
• context Group 3 - Not classifiable as to its carcinogenicity to humans
• context Group 4 - Probably not carcinogenic to humans

American Conference of Governmental Industrial Hygienists (ACGIH)

ACGIH assigns chemicals or agents to one of the following 5 categories: Carcinogens identified by ACGIH are listed in ACGIH's TLVs® and BEIs® booklet, which is published annually. See the ACGIH website for more information.

• context A1 - Confirmed human carcinogen
• context A2 - Suspected human carcinogen
• context A3 - Confirmed animal carcinogen with unknown relevance to humans
• context A4 - Not classifiable as a human carcinogen
• context A5 - Not suspected as a human carcinogen

US National Toxicology Program (NTP)

NTP publishes a list of agents that they have evaluated and assigned to one of two categories: Their most recent Report on Carcinogens is available online.

• context Known to be Human Carcinogens
• context Reasonably Anticipated to be Human Carcinogens

What are examples of occupational exposures that have been associated with cancer?

• context Examples of occupations and occupational groups that have been associated with occupational cancer are listed in the following table Occupations or Occupational Groups Associated with Carcinogen Exposure.

Is exposure to a specific carcinogen associated with a certain type of cancer?

• context In many cases, certain types of cancer are associated with specific carcinogens. Our OSH Answers document Cancer Sites Associated with Occupational Exposures has a list of examples.

Are workplace exposures to carcinogenic agents regulated?

• context Canadian jurisdictions regulate workplace exposures to carcinogens. The specific substances regulated and regulatory requirements vary by jurisdiction. Regulations typically specify maximum occupational exposure limits. In some cases, the regulations may require routine monitoring of the workplace, medical surveillance of workers, specific record keeping, etc.
• context Check with your local department or ministry responsible for occupational health and safety for more information.

How does WHMIS apply to carcinogens?

In Canada, the Workplace Hazardous Materials Information System (WHMIS) is a nationwide system that ensures people have the information they need to work safely with hazardous products (including carcinogens) in the workplace. See the OSH Answers document on WHMIS – General for general information. WHMIS requirements are defined in the Hazardous Products Act and regulations. The carcinogenicity hazard class has two categories - Category 1 and Category 2. Category 1 has two subcategories - Category 1A and Category 1B. “Substances” or “mixtures of substances” are determined to be carcinogenic hazardous products when the available scientific data shows the substance or mixture meets the criteria for Category 1, 1A,1B or Category 2. If there is sufficient scientific data to differentiate between Subcategory 1A or 1B, then these subcategories are assigned instead of Category 1. Note: Consult the Hazardous Products Act and regulations for additional information. When a hazardous product is classified as a carcinogen, the following label elements apply: *State route of exposure if it is conclusively proven that no other routes of exposure cause cancer. Note: The supplier may adapt the precautionary statements as allowed by the Hazardous Products Regulations.

• context Pictogram
• context Signal Word | Danger | Warning
• context Hazard Statement | May cause cancer* | Suspected of causing cancer*
• context Precautionary Statements | Obtain special instructions before use. Do not handle until all safety precautions have been read and understood. Wear protective gloves/protective clothing/eye protection/face protection. If exposed or concerned: Get medical advice/attention. Store locked up. Dispose of contents/container to ...

Is it possible to work safely with a carcinogen?

Yes. There are many ways to control the hazards and risks of working with a possible carcinogen. A hazard control program consists of all steps necessary to protect workers from exposure, and the procedures required to monitor worker exposure and their health. Knowing which control method is best can be a challenging process. It often involves doing a risk assessment to evaluate and prioritize the hazards and risks. For more information, please see the following documents in OSH Answers: The following general advice can help workplaces work safely with a carcinogen: If personal protective clothing is used, it should be used as part of a personal protective equipment program that outlines responsibilities, selection, use, maintenance, limitations, etc...

• context Hazard and Risk - Risk Assessment
• context Hazard and Risk - Hazard Control
• context Hazard and Risk - Hierarchy of Controls
• context Eliminate exposures to and the use of carcinogens from the workplace, where possible.
• context Eliminate unnecessary tasks involving exposure to a carcinogen.
• context Substitute a carcinogen with a less hazardous product when possible.
• context Make sure engineering controls (e.g., ventilation) are operating properly. Closed handling systems may be necessary to prevent the release of the product (dust, mist, vapour, gas) into the workplace.
• context Enclose the process to reduce exposure.
• context Use alternative methods that reduce exposure where possible, such as using the product in a solid form (versus a liquid, which evaporates faster).
• context Limit time exposed to carcinogens by using job rotation, allowing only limited access to the area, or reducing the number of workers.
• context Develop and implement safe work instructions. Consult the Safety Data Sheet (SDS) or technical literature for information about the hazards and necessary precautions for the specific carcinogenic product being used.
• context Determine the amount of airborne exposure and compare it to the occupational exposure limit.
• context Make sure containers are closed and clearly labelled.
• context Understand all of the hazards associated with the product, including additional health concerns (e.g., serious short-term health effects or irritation), reactivity and flammability.
• context Understand and practice emergency procedures so that you know what to do in case of a spill or other emergency.
• context Provide education and training programs.
• context Know how to use the product safely to protect yourself and co-workers.
• context Use the smallest quantity possible.
• context Follow safe work practices specified by your employer.
• context Follow good personal hygiene practices when recommended, such as washing skin regularly, storing work clothing separately from personal items, washing work clothing, and washing hands before eating, drinking or smoking.
• context Report ventilation failures, leaks, or spills to your supervisor immediately.
• context Report health concerns to your supervisor, health and safety committee or representative, or employer.
• context Wear the appropriate personal protective equipment specified for the job. This equipment may include respiratory protection and chemical protective clothing, such as goggles, glasses, face shields, aprons and gloves, made from materials that protect against the chemicals being handled. Not all materials will protect from all chemicals.