Occupational Cancers

612 Pages·2014·18.696 MB·English

by  Sisko Anttila, Paolo Boffetta (eds.)

Sisko Anttila
Paolo Boff etta
Editors
Occupational Cancers
123
Occupational Cancers

Sisko Anttila (cid:129) Paolo Boffetta

Editors
Occupational Cancers
Editors
Sisko Anttila, MD, PhD Paolo Boffetta, MD, MPH
Helsinki University Central Hospital and Icahn School of Medicine at Mount Sinai
Finnish Institute of Occupational Health New York, NY
Helsinki USA
Finland
ISBN 978-1-4471-2824-3 ISBN 978-1-4471-2825-0 (eBook)
DOI 10.1007/978-1-4471-2825-0
Springer London Heidelberg New York Dordrecht
L ibrary of Congress Control Number: 2014943112
© Springer-Verlag London 2014
This work is subject to copyright. All rights are reserved by the Publisher, whether the whole or part of the material is
concerned, specifi cally the rights of translation, reprinting, reuse of illustrations, recitation, broadcasting, reproduction
on microfi lms or in any other physical way, and transmission or information storage and retrieval, electronic adaptation,
computer software, or by similar or dissimilar methodology now known or hereafter developed. Exempted from this
legal reservation are brief excerpts in connection with reviews or scholarly analysis or material supplied specifi cally
for the purpose of being entered and executed on a computer system, for exclusive use by the purchaser of the work.
Duplication of this publication or parts thereof is permitted only under the provisions of the Copyright Law of the
Publisher's location, in its current version, and permission for use must always be obtained from Springer. Permissions
for use may be obtained through RightsLink at the Copyright Clearance Center. Violations are liable to prosecution
under the respective Copyright Law.
T he use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not
imply, even in the absence of a specifi c statement, that such names are exempt from the relevant protective laws and
regulations and therefore free for general use.
While the advice and information in this book are believed to be true and accurate at the date of publication, neither
the authors nor the editors nor the publisher can accept any legal responsibility for any errors or omissions that may
be made. The publisher makes no warranty, express or implied, with respect to the material contained herein.
Printed on acid-free paper
Springer is part of Springer Science+Business Media (www.springer.com)
Foreword
Combating Cancer: Past, Present and Future
Although much of cancer is preventable, it continues to exact a huge human burden, on a global
scale. Early interventions by health authorities were hampered by inadequate knowledge, but
greater understanding of the areas requiring focus slowly grew in the late twentieth century. This
book shows the latest developments in the preventive science of occupational cancer control.
T he twentieth century saw a revolution in public health and preventive medicine, which
accelerated with scientifi c and medical advances during a time of unprecedented material
growth as the century drew to a close. Industrial carcinogens opened the era of cancer preven-
tion, and developments in the medical sciences, in toxicology in particular, have been funda-
mental to the progress in occupational cancer prevention [1]. However, it was the application
of the new fi eld of chronic disease epidemiology that fostered many of the most important
advances in understanding and tackling occupational cancers [2]. Occupational cancer rose to
prominence, as epidemiologists and toxicologists identifi ed increasing numbers of suspect
human carcinogens, and public anxiety was spurred by revelations of the toxicity of asbestos,
and by the disastrous global legacy of the asbestos industry [3, 4]. The inertia of some indus-
tries, not least of the tobacco industry, to accept the obtained scientifi c results and to adopt
costly controls to protect workers or consumers (in the case of tobacco) was not new [5]. The
uncertainties inherent in epidemiological and toxicological studies were too often cited as
justifi cation for delaying or concealing, rather than incorporating the lessons of research, as the
asbestos saga, or the global tobacco epidemic, have sadly shown.
W orldwide, there are some 100,000–140,000 asbestos-related deaths every year, and in high-
income countries, the compensation for asbestos-related diseases is likely to reach several hun-
dred billion euros over the coming years [6]. All forms of asbestos are now recognized as
carcinogenic, and to date, more than 50 countries, including all the Member States of the
European Union, have banned or restricted the use of asbestos. However, chrysotile asbestos
continues to be mined and exported to developing countries by e.g., China, Canada and Russia,
and India is the largest importer. Brazil also has mines. The World Health Organization and the
International Labour Offi ce have now both called for an international ban of use of all asbestos.
E ven though the health hazards of old scourges, such as asbestos and silica dusts, are now
well understood, they remain signifi cant causes of occupational cancer. By the 1970s, the tra-
ditional industries were already in decline in the western world, while the chemical industry
had been expanding rapidly since the Second World War. One chemical in particular, vinyl
chloride monomer (VCM), used in many countries in plastics production, was assumed to be
safe. However, evidence from laboratory animals revealed in 1973 that it could cause angiosar-
coma of the liver, a rare tumour, in humans. Soon it was revealed that VCM workers in many
countries had developed this type of tumour [7]. This then resulted in rapid actions to reduce
exposure to VCM in chemical plants.
D uring the latter part of the twentieth century, it became clear that carcinogenesis was a
multistep process. The milestones in the complexities of the neoplastic disease include
sustaining proliferative signaling, evading growth suppressors, resisting cell death, enabling
replicative immortality, including angiogenesis, and activating invasion and metastasis [8].
v
vi Foreword
Biomarkers now play a signifi cant role in the identifi cation of the key events in this process. In
recent decades, one of the most studied genes in epidemiology has been the TP53 tumour sup-
pressor gene. Its role in causing liver and skin tumours is the focus of much research activity.
Intermediate biomarkers, such as chromosomal damage and altered DNA repair, point toward
evidence of early, non-clonal and potentially non-persistent effects, which if halted or reversed
may decrease the risk of full-blown malignancy. The role of so-called ‘molecular epidemiol-
ogy’ in the study of cancer aetiology and prevention is also on the rise.
T here are currently many international initiatives addressing occupational, environmental
and consumer issues in relation to the control of toxic and potentially carcinogenic substances.
Improved control technologies and the adoption of risk assessment and risk management leg-
islation have radically altered attitudes and led to far better control of exposure to chemicals,
mixtures of chemicals, and physical agents, such as ionizing and non-ionizing radiation [9, 10].
H owever, newer concerns over cancer have arisen with the rapid introduction of technolo-
gies such as mobile phones, the use of which became widespread before studies of their poten-
tial health hazards were embarked upon [1, 11]. Today’s wide interest in developing engineered
nanomaterial-based products has also been cautioned by the previous lessons learnt from
asbestos fi bers [12, 13].
Regardless of these dangers however, the challenges facing the modern world cannot be met
without the creation of new technologies. Some of these technologies will inevitably have
adverse health consequences, a small proportion of which may be unforeseen under current
regulatory approaches, but the fact remains that many of these new technologies have the
potential to enormously improve lives.
T o conclude, despite the huge advances in cancer prevention in industrialized countries in
recent decades, specialist advice and expertise have not kept pace with the rapid changes in
either the work or general environment, nor have they kept up with consumer products [4, 14].
Unless this shortfall is adequately dealt with, cancer prevention will continue to be of high
priority in occupational health-related research, with a signifi cant focus on diminishing the
unnecessary burden of cancers worldwide.
Helsinki , F inland Harri Vainio
Finnish Institute of Occupational Health
References
1. IARC monographs on the evaluation of carcinogenic risks to humans. h ttp://monographs.iarc.fr/ENG/
Monographs/PDFs/index.php
2. Checkoway H, Pearce N, Kriebel D. Research methods in occupational epidemiology. 2nd ed. New York:
Oxford University Press; 2004.
3. Tossavainen A. Global use of asbestos and incidence of mesothelioma. Int J Occup Environ Health.
2004;10:22–5.
4. Straif K. The burden of occupational cancer. Occup Environ Med. 2008;65:787–8.
5. Peto R, Chen ZM, Boreham J. Tobacco-the growing epidemic. Nat Med. 1999;5:15–7.
6. Ramazzini C. Asbestos is still with us: repeat call for a universal ban. Eur J Oncol. 2010;15:69–75.
7. Creech JL, Johnson MN. Angiosarcoma of liver in the manufacture of polyvinyl chloride. J Occup Med.
1974;16:150–1.
8. Hanahan D, Weinberg RA. Hallmarks of cancer: the next generation. Cell. 2011;144:646–74.
9. Swerdlow AJ. Effectiveness of primary prevention of occupational exposures on cancer risk. In: Hakama
M, Beral V, Cullen JW, et al., editors. IARC scientifi c publication: evaluating effectiveness of primary
prevention of cancer. Lyon: International Agency for Research on Cancer; 1990:23–56.
10. Barnes FS, Greenebaum B. Handbook of biological effects of electromagnetic fi elds. Biological and medi-
cal aspects of electromagnetic fi elds. 3rd ed. Boca Raton: CRC Press; 2008.
11. Interphone Study Group. Brain tumour risk in relation to mobile telephone use: results of the INTERPHONE
international case-control study. Int J Epidemiol. 2010;39:675–94.
12. Kane AB, Hurt RH. Nanotoxicology: the asbestos analogy revisited. Nat Nanotechnol. 2008;3:378–9.
13. Schulte P, Geraci C, Zumwalde R, Hoover M, Castranova V, Kuempel E, Murashov V, Vainio H, Savolainen
K. Sharpening the focus on occupational safety and health in nanotechnology. Scand J Work Environ
Health. 2008;34:471–8.
14. President’s Cancer Panel. 2008–2009 annual report: reducing environmental cancer risk: what we can do
now. Washington, DC: U.S. Department of Health and Human Services; 2010.
Pref ace
Writing of the book on occupational cancer is motivated fi rst of all by the fact that a great
proportion of occupational cancers are not recognized even in post-industrial countries. In fact,
only some rare tumor types with a very strong association with certain exogenous factors, such
as pleural malignant mesothelioma with asbestos exposure, liver angiosarcoma with vinyl
chloride exposure, and intestinal type sinonasal adenocarcinoma with hardwood exposure, are
considered as occupational diseases on a regular basis. These tumors are accepted as work-
related because they rarely exist in the non-exposed, while occupational etiology of common
cancers is more diffi cult to recognize. The best example is asbestos-related lung cancer: On the
basis of epidemiology the numbers can be estimated, but much fewer cases than expected are
identifi ed and reported, although there are some differences between countries. For most com-
mon cancer types the fraction attributable to occupational factors is small and risk ratios low,
but together with life-style and genetic factors, they may signifi cantly increase an individual’s
personal cancer risk. Awareness of occupational and other risk factors offers an opportunity for
preventive actions, such as encouragement for the cessation of smoking in order to reduce lung
cancer risk and caution with hormone replacement therapy to lessen a person’s breast cancer
risk. The most important consequence of the identifi cation of occupational causes of cancer,
however, remains with the opportunity to eliminate the relevant exposures – or at least reduce
them to a level entailing no risk.
T he aim is to provide a handbook which occupational health physicians, oncologists and
other medical specialists who diagnose and treat cancer patients, and those who are involved
in the health care of individuals with cancer risk due to occupational exposures, could consult
on occupational risk factors that may be relevant for their patients. To our knowledge, this is
the fi rst present-day book where all information about occupational risk factors of cancer can
be easily found, organized by cancer sites, in order to help health professional to judge whether
the question of increased cancer risk or occupational etiology of cancer is relevant in the case
of a specifi c patient. During the years we have been involved in the research and diagnosis of
occupational cancer, we have sometimes been asked by occupational health care specialists if
we can recommend such a book. This book is intended also to people who are involved in
worker insurance, compensation, and registries of occupational diseases, as well as to graduate
and postgraduate students in occupational health and oncology.
T he main part of the book consists of organ-specifi c chapters which provide epidemiologi-
cal data on risk of the cancer in question with various occupations and with exposure to spe-
cifi c carcinogens, and touch other environmental and life-style risk factors. Exposure
assessment, clinical and pathological fi ndings, molecular mechanisms, biomarkers, and sus-
ceptibility factors are handled if relevant literature for the occupational cancer of the organ in
question is available. As regards malignant mesothelioma and lung cancer, which represent in
most populations the two most important occupation-related cancers, separate chapters are
dedicated for epidemiology, clinical fi ndings, exposure-assessment, molecular mechanisms,
molecular markers, and genetic susceptibility. A few specifi c topics, such as occupational can-
cer in the past, occupational cancer burden, prevention strategies, screening for occupational
cancer, occupationally derived cancer in children, and use of registries in cancer research, are
handled in their own chapters. We appreciate that so many researchers felt the book on
vii
viii Preface
occupational cancer so important that they were willing to dedicate their time in contributing
to it, and can say that every chapter is written by well-known scientists in the fi eld.
T here is increasing amount of scientifi c literature about molecular mechanisms and bio-
markers of cancer associated with specifi c carcinogenic agents. It is sometimes challenging to
a person whose own fi eld is other than molecular research, to become acquainted with the
newest results. Chapters 2 and 3 introduce the basic carcinogenic mechanisms and the research
on gene-environment interactions to expert and non-expert readers. Although our understand-
ing of the molecular mechanisms of occupation-related cancer is continuously increasing, it is
still premature in most instances to use this information to assess the likelihood of causation at
the level of the individual patient.
The authors of each chapter were advised to review the scientifi c literature, and not to
include jurisdiction or compensation policy, as there are remarkable differences between coun-
tries in legal systems and agreements regarding worker compensation for occupational
diseases.
It is known that the scientifi c community is divided concerning some issues where study
designs are diffi cult to set or results are discrepant, for example the carcinogenic potency of
crystalline silica and chrysotile (white) asbestos, are disputable questions. We encouraged the
authors of each chapter to present a balanced view, but did not try to infl uence their conclu-
sions. In this respect, the responsibility of the contents of individual chapters remains with
their authors. It is possible however that the authors’ personal opinion affected which literature
they cited. We tried to solve this issue by addressing some of the controversial issues in more
than one chapter; for a balanced view the readers are advised to consult other chapters on the
same carcinogen, and especially the epidemiology chapters, which list all relevant studies on
the carcinogen in question.
W e sincerely hope that this book serves well and earns its place in the hands and on the
screen of all those who diagnose and treat cancer patients, are involved in occupational health
care, or for any other reason are interested in occupational factors of cancer.
Helsinki, Finland Sisko Anttila
New York, NY, USA Paolo Boffetta
Acknowledgements
S everal people and institutions have helped us in this book project. When the fi rst outline for
the contents of the book was done, Dr. Antti Tossavainen reviewed the proposal, gave valuable
information, and suggested co-editors. Dr. Kurt Straif’s enthusiasm towards this project has
been invaluable. He worked with us during most part of the project, pointed out and invited
authors, and reviewed many of the chapters. He has remarkably infl uenced the contents of this
book. Dr. Aija Knuuttila and Dr. Agnes Kane offered their expertise in reviewing selected
chapters. We are deeply indebted to all authors for putting beside their other works and using
their time and expert knowledge in writing different chapters. We thank the Finnish Institute
for Occupational Health (FIOH) for offering a net site for the project, Mrs. Alice Lehtinen at
FIOH checked the English language for Chaps. 1 0 , 1 2 , and 1 6 , and fi nally, FIOH and Dr. Panu
Oksa provided the questionnaire for asbestos exposure assessment included in the Appendix.
Our writing and editorial work was fi nancially supported by the research funds of the Helsinki
and Uusimaa Hospital District, Helsinki, Finland (SA) and by Ichan School of Medicine at
Mount Sinai, New York, NY, USA (PB). Finally, we thank the developmental editor Joni
Fraser, who patiently and knowledgeably worked with us through the many years of this proj-
ect, and the Springer editors Manika Power, Teresa Dudley, and Joanna Bolesworth.
ix