John W Cherry

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Occupational Medicine 2009;59:96–100
doi:10.1093/occmed/kqn172

IN-DEPTH REVIEW

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Reducing occupational exposure to chemical
carcinogens
John W. Cherrie
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Abstract

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Key words

Cancer; chemicals; workplace.

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Introduction
Occupational cancer deaths in Great Britain are still at an
unacceptable level. Rushton et al. [1] estimate that there
are .7000 deaths attributable to work-related carcinogens
for the six cancers that they assessed, 4.9% of the total
cancer deaths. In comparison, there are just .3000 people
who lose their lives in road traffic accidents in Britain and 240 died as a consequence of accidents at work.
There are .170 chemicals or exposure circumstances
that have been classified by the International Agency for
Research on Cancer (IARC) as known or probable human carcinogens (Groups 1 and 2a, respectively). In addition, there are 250 substances or circumstances that
are classified as possibly carcinogenic in humans (Group
2b). Details are available on the IARC website (http://
monographs.iarc.fr/ENG/Classification/index.php). A
large proportion of these substances may be found in
workplaces, either because they are used in processes
or because they are emitted during the operation of
processes. They range from asbestos, which has been
a confirmed human carcinogen for many decades, to
Zidovudine (AZT), a drug used in HIV treatment that
was classified as an IARC Group 2b substance in 2000.
The basic approach to protect workers from occupational carcinogens is either to eliminate the use of the material, as has been done in a small number of instances, or Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK.

Correspondence to: John W. Cherrie, Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK. Tel: 11 (0)870 850 5131; fax: 11 (0)870 850 5132; e-mail: john.cherrie@iomhq.org.uk

to control exposure to a level where the risk is acceptably
small, where the maximum exposure level that is considered acceptable is usually defined by an Occupational Exposure Limit (OEL). This paper discusses the strategies that are open to reduce exposure to occupational chemical carcinogens and attempts to identify which substances require priority action and what barriers need to be overcome to ensure exposure is controlled.

Strategies for reducing exposure to
chemicals
The European Union Carcinogens Directive (2004/37/
EC) provides minimum standards for the protection of
workers from risks related to exposure to carcinogens
and mutagens at work. The Directive is implemented
in each European Union (EU) country under national
legislation; for example, in Great Britain, it is brought into force through the Control of Substances Hazardous to
Health (COSHH) Regulations. Article 5 of the Carcinogens Directive sets out the strategy for controlling exposure and risks; first, that the carcinogen be eliminated and if this is not technically possible, it should be handled in an enclosed system. Where this is not possible, the employer shall apply the control measures seen in Table 1. In all cases, the OEL, if specified, should not be

exceeded and exposure should be reduced as far as is
technically feasible....
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