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Are workplace exposures still causing cancers?
The Cancer Council has reported that crystalline silica (CS) dust causes more than 230 cases of lung cancer in Australia each year but it can be prevented easily through dust controls & respirators. According to Cancer Council Australia, about 600,000 Australian workers like miners, construction workers, demolition workers, engineers, stone masons & farmers are exposed to CS dust from stones, bricks, tiles, concrete, some plastics & other materials annually. When worked on or cut, these materials release silica as a very fine dust that can lead to lung cancer if inhaled, it says.
Of around 11,000 new cases of lung cancer diagnosed each year in Australia, over 8000 (73%) are due to smoking, 230 (2%) due to CS dust & 130 (1%) due to diesel exhaust. The Cancer Council suggests these cancers are preventable, & given the poor survival rate for lung cancer it is vital we do all we can to prevent them. Generally, the SC cases could all have easily been prevented through dust prevention or control, adequate ventilation or personal respiratory protection but proper protection involves a lot more than just wearing a mask. Previously a BMJ reports on the re-emergence of lung disease silicosis in Australia found that 3 of 7 studied victims had worn disposable masks while working with artificial stone, which has a very high silica content
In August, a NSW parliamentary inquiry into the Dust Diseases Scheme called for the urgent formation of a taskforce to review safety standards in the manufactured stone industry, after hearing that silicosis is becoming a "huge problem" in the sector because dust suppression is either "non-existent or inadequate”. This is predominantly associated with an artificial stone, which became commercially available overseas in 1986, & was first used in Australia, mainly in the fabrication of bathroom & kitchen benchtops, in the early 2000s. It is formed by moulding a mix of finely crushed rock & polymeric resin into slabs, & its silicosis-causing silica content is about 90%, which is far higher than the average content of marble (3%) & granite (30%). The researchers found that artificial stone-associated silicosis is characterised by shorter latency periods & more rapid loss of lung function than chronic silicosis in other industries.
Researchers however suggest that there are probably many unidentified cases of silicosis, & Israel, which started using artificial stone 15 years earlier than Australia, has experienced a rapidly increasing burden of associated silicosis. Some 193 cases of artificial stone-associated silicosis were reported in Israel between 2009 & 2014, & the disease accounted for 4% of that country's lung transplants in the 15 years to 2012, they say. There is no proven treatment for silicosis other than lung transplantation. Thus, prevention of this disease through control of respirable silica dust exposure is vital. The researchers examined the 7 cases of artificial stone-associated silicosis identified by respiratory physicians in NSW, Victoria & Queensland between 2011 & 2016
Preventing workplace exposure to CS dust is an employer responsibility to meet their legal HS obligations but also for workers to ensure to protect their future health. It requires on-site ventilation, using specialised tools with appropriate blades & dust suppression features & a range of other important safeguards. Those involved in regular demolishing of materials, sandcasting, sandblasting, bricklaying or cutting stone, tiles or bricks are at risk, so these workers & home renovators need to be informed you need to get informed today.
Canadian research has also identified the high toll each year from work-related cancers (WRC) in a study, ‘Burden of Occupational Cancer in Ontario’, which concluded there are many opportunities to reduce the number of WRC. This was produced jointly by the Occupational Cancer Research Centre (OCRC) & Cancer Care Ontario’s Population Health & Prevention team. It found solar radiation, asbestos, diesel engine exhaust & crystalline silica had the largest estimated impact on cancer burden & also the highest number of exposed workers in Ontario, Canada’s most populous province. Approximately 450,000 Ontario workers are exposed, causing an estimated 1,400 non-melanoma skin cancer cases/ year, according to the study. Fewer than 55,000 workers are exposed to asbestos, but the potent carcinogen is estimated to cause 630 lung cancers, 140 mesotheliomas, 15 laryngeal cancers & fewer than five ovarian cancers annually. About 301,000 workers are exposed to diesel exhaust fumes every year, the study found, causing 170 lung & 45 bladder cancer cases. An estimated 142,000 Ontario workers are exposed to CS, which annually causes almost 200 lung cancer cases. The paper adds that shiftwork may be responsible for 180 to 460 new cases of breast cancer in the province a year. The researchers also suggest that just raising awareness does not always lead to effective prevention actions. Do you know what carcinogens are used in your workplace & are you simply relaying on respiratory masks for protection or have you followed a complete program involving isolation & other engineering controls, as well as training, air & health monitoring supervision & PPE.
Hoy, R et al; Artificial stone-associated silicosis: a rapidly emerging occupational lung disease., Occ Env Med, online first 2017, Doi: 10.1136/oemed-2017-104428; Burden of occupational cancer in Ontario: Major workplace carcinogens & prevention of exposure
This article was written by Julie Armour and was first published in the October 2017 newsletter, Working Armour.