Occupational Cancer –

Transcription

13th EWHN Conference
Fighting for safe and healthy work
and a safe and healthy world
Bologna, 4 – 6 October 2013
Occupational Cancer –
Well-known problems and new challenges
(in memory of Simon Pickvance 1949 – 2012)
Wolfgang Hien
Forschungsbüro für Arbeit,
Gesundheit und Biographie
Bremen, Germany
kontakt@wolfgang-hien.de
Henning Wriedt
Beratungs- und Informationsstelle
Arbeit & Gesundheit
Hamburg, Germany
wriedt@arbeitundgesundheit.de
Overview
Outline of the workshop
Part A
Overview of relevant carcinogens at the workplace
Basic information on cancer and how it is studied
Part B
Differences between scientific knowledge and
legislation
Legal framework conditions in Europe, main
regulatory obligations, and workplace realities
Approaches and (regulatory) concepts at national
level
Part C
Solutions and models of good practice in different
industries
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
2
Part I:
Introduction of participants –
your interests, questions, and expectations
Outline of the workshop: focus and omissions
Focus on chemicals and particulates
Basic information on cancer
Part II:
Differences between scientific knowledge and legislation
Legal framework conditions in Europe, regulatory obligations,
and workplace realities
Approaches and (regulatory) concepts at national level
Part III:
Solutions and models of good practice in different industries
Differences in cultural traditions in different countries /
potential for mutual support
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
3
Your questions and expectations
see flipchart
Omitted issues
approaches for identifying as yet unknown carcinogens or
activities
Focus on chemicals and particulates
omission of other carcinogens and activities relevant at the
workplace, such as
radioactive material, ionizing and non-ionizing radiation
radon emissions from the ground
tobacco smoke (passive smoking)
shift work
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
4
International context & additional material
Occupational Cancer/Zero Cancer is a global union
campaign to prevent occupational cancer.
More information, campaign material, and resources at:
www.imfmetal.org/cancer
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
5
Overview of relevant
carcinogens at the workplace
The burden of work-related cancers in
european countries and new challenges –
the example breast cancer
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
6
The most important carcinogenic substances
in the present world of work
Asbestos
Polycyclic aromatic hydrocarbons (PAHs)
for example: mineral oils
for example: diesel engine exhaust
for example: passive smoking
Silica dust, crystalline
Chromium (VI) and nickel compounds,
particularly in welding fumes
October 2013
© Dr. Wolfgang Hien
Forschungsbüro für Arbeit, Gesundheit und Biographie
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Classification of Diesel engine emissions (DEE), 2012:
NOx
Damage to the alveolae
PAH, BaP
partial migration to the
blood circulatory system
nitro-aromatics
aldehydes etc.
Pollutants are adsorbed to soot particles (and soot particles themselves contain polycyclic
aromatic hydrocarbons)
The smaller a particle, the greater its specific surface area and, at the same time, the
deeper its penetration into the lungs
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The most important occupational activities with
carcinogenic potential
Occupational exposures as a painter (IARC: 1)
Occupational exposures during iron and steel
founding (IARC: 1)
Occupational exposures in the rubber
manufacturing industry (IARC: 1)
Occupational exposures to oxidized bitumen
and its emissions during roofing (IARC: 2A)
Night shift work (females) (IARC: 2A)
Occupational exposures as a hairdresser (?)
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pigments
binders, resins
solvents
additives
biocides
nanoparticles
(…)
et al.
2012
October 2013
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SiO2
CH2O
R(NCO)2
PAK
Cd, Pb, Co, Ni et al.
2012
October 2013
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Three remarks:
The number of workplaces with carcinogenic
substances is systematically underestimated
(Rushton takes only IARC group 1 carcinogens into
consideration).
Exposure to carcinogens at the workplace appears
mostly as normal dust, normal contamination and
normal dirt.
Very bad workplaces can be found mainly in small
and medium companies, in subcontractors of large
companies, and in the construction industry.
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Additional remark:
We use the terms „work-related cancer“ and
„occupational cancer“ synonymously. They are
not identical with the much smaller fraction of
recognized occupational cancers (in German:
„Berufskrankheit“).
work-related cancer (occ. cancer)
recognized occ. cancer
The work-attributable part of all cancers
The burden of work-related cancers in
European countries – a new approach
by Lesley Rushton et al. (2012)* attributable fractions:
all cancer sites
lung cancer (male)
5,7 %
21,1 %
lung (female)
5,3 %
bladder (male)
7,1 %
breast (female)
4,6 %
* BJC (2012), 107, S3-S7
October 2013
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Cancer incidence in Europe – some examples
Germany
all sites
work-related
470,000
26,800
lung (male)
work-related
34,000
7,140
breast (female)
work-related
74,000
3,400
October 2013
(per year)
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United Kingdom*
all sites
work-related
343,000
18,000
lung (male)
work-related
22,400
4,600
breast (female)
work-related
46,500
2,000
(per year)
* Rushton et al. 2012
October 2013
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Italy*
all sites
work-related
340,000
18,000
lung (male)
work-related
19,000
4,000
breast (female)
work-related
47,000
2,000
(per year)
* GLOBOCAN 2008 (www-dep.iarc.fr)
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An startling new discussion:
work-related breast cancer
Ethylene oxide (1)
Formaldehyde (1)
Cyclophosphamide (1)
nurses in hospitals
X-Ray (1)
Night work (1)
Epichlorohydrine (2A)
female workers in plastics
Bisphenol A (2A)
processing, e.g. in the
Acrylonitrile (2B)
automotive industry
Di(2-ethylhexyl)phtalate (2B)
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October 2013
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Some results of the Canadian breast cancer study
(Brophy et al. 2012)
Occupational activity
Relative Risk
Plastics processing in the
automotive industry
- all females
- premenopausal
2.68
4.76
Food canning
- all females
- premenopausal
2.35
5.70
statistically
significant
Working in bars, gambling
- all females
- premenopausal
October 2013
2.28
not sign.
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Further open questions:
Combined effects of several carcinogens simultaneously?
Chemical interactions of several agents outside human body?
Chemical interactions of agents in the human organism?
Combined effects of several carcinogens in the course of a life?
Additional or potentiating effects (tumour promotion)?
Tumour promoting effects of chronic stress at the workplace?
October 2013
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Basic information on cancer
What is cancer, how is it studied and who
decides (here: IARC) that a substance or
an other factor is carcinogenic?
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
25
What is cancer and how is it studied?
Cancer is a consequence of a multi-stage process in our
organism
The initial stage is a
mutation in the genetic
material of our cells
The main mutation
factor is a
chemical attack
Other factors include
viruses and radiation
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Source: Kamp 2008
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Computer modelled image of
benzo[a]pyrene-adduct with two DNAbases
Many substances can build DNAadducts (natural and synthetic)
Many substances can stimulate
(promote) mutated cells
Source: Weston/Harris 2000
(http://www.ncbi.nlm.nih.gov/books/NB
K20839)
October 2013
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The multi-stage model of cancer development
initiation
promotion
mutation
reparase
in oncoinhibition
gens or
by
protonickel,
oncogens cadmium,
by
cobalt,
chemicals or other
or
agents
radiation
October 2013
epigenetics:
induction
of growth
of mutated
cells by
hormones
or
endocrine
disruptors
progression
proliferation
of cancer cells
caused by
damage
to the
immune system
by dioxins
or other
agents
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Majority of cancer causing agents have no threshold
level below which there is no biological effect
For majority of cancer causing agents there is a doseeffect-relation starting from the point of origin
effect (=risk)
dose (=exposure)
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Some substances, e.g. dioxins, polychlorinated
biphenyls, and endocrine disruptors (xenoestrogens)
act as tumour promoters.
They selectively amplify cells with a mutation in the
genetic material, and they strengthen the carcinogenic
effect of genotoxic agents.
effect with
promotor
effect without
promotor
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Estrogens, xenoestrogens
and other endocrine
disruptors stimulate cancer
cell growth in female tissue,
especially in breast tissue.
One example is Bisphenol A,
a component of epoxy
resins, polyester resins, and
many other plastics.
Source: http://www.unc.edu/courses/2005spring/envr/132/001/Carcinogenesis.pdf
October 2013
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Aetiology of cancer: a multifactorial causation
genetic factors
social environment
chemical
and physical
environment
stress and strain
socioeconomic
status
human
being
nutrition / tobacco
and alcohol
housing
working conditions
At least 5 % of all cancers are occupational cancers
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Epidemiology
= the study of the patterns, causes and effects of diseases in
defined populations with a result as relative risk (RR)
study population
incidence or deaths?
Observed
= RR
reference population
incidence or deaths ?
Expected
example:
RR = 2 = the disease occurs in the study group
twice as often as in the reference group
note:
RR = 2 => every second case in the special
group is preventable; the attributable fraction (AF)
in this group is 50 %
RR = 3 => 2 of 3 cases preventable; AF = 66 %
October 2013
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• Epidemiology is not a wholly exact science – epidemiology is
embedded in a social environment of living
• Epidemiology is, like every science, influenced by
different economic and political interests
• Epidemiology is based on many estimations and
approaches, for example that of exposition at the workplace
• Epidemiological results are probability statements, which are
statistical statements about a particular population
• Epidemiological data can be transformed into estimations on
attributable fractions of occupational cancer in the whole
population
October 2013
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The debate on occupational
cancer has a long history.
Samuel S. Epstein, M.D. and
professor emeritus of Environmental and Occupational
Medicine at the University of
Illinois School of Public
Health, and Chairman of the
Cancer Prevention Coalition,
in 1978 published his book
“The Politics of Cancer”, in
which he accused the
chemical industry of avoiding
and suppressing relevant
scientific findings on
occupational cancer.
October 2013
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Who decides that a substance or a
particular exposure is carcinogenic?
IARC = International Agency of Research on Cancer in
Lyon (an institute of the Word Health Organisation)
EU = special committees or groups (Joint Research
Centre) of the European Commission in Brussels
National Governments = for example, in Germany:
classified by the „Ausschuss für Gefahrstoffe“
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Since 1971, IARC working groups (scientific experts, from many
different countries, who specialize in this particular area) have
evaluated empirical data from all over the world on more than 900
physical, chemical and biological agents. More than 400 substances or
factors have been classified as certain, probable or possible
carcinogens in humans.
October 2013
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Categories of IARC evaluation
Carcinogenicity in humans: criteria are, amongst others, validity of
the study, temporal sequence, dose-effect-relationship
Carcinogenicity in experimental animals: criteria are, amongst
others, two or more different species, two or more research labs
Sufficient evidence of carcinogenicity: … a causal relationship
has been established between exposure to the agent and cancer …
Limited evidence of carcinogenicity: … a positive association has
been observed between exposure to the agent and cancer, but …
Inadequate evidence of carcinogenicity: … studies are of
insufficient quality … or no data (on carcinogenicity) are available …
Evidence suggesting lack of carcinogenicity: … not showing a
positive association between exposure to the agent and any studied
cancer
October
2013 …
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IARC classifications
Group 1: The agent is carcinogenic to humans.
This category is used when there is sufficient evidence of
carcinogenicity in humans. Exceptionally, an agent may be placed in
this category when evidence of carcinogenicity in humans is less
than sufficient but there is sufficient evidence of carcinogenicity in
experimental animals and strong evidence in exposed humans that
the agent acts through a relevant mechanism of carcinogenicity. (…)
Group 2A: The agent is probably carcinogenic to humans.
This category is used when there is limited evidence of
carcinogenicity in humans and sufficient evidence of carcinogenicity
in experimental animals. In some cases, an agent may be classified
in this category when there is inadequate evidence of carcinogenicity
in humans and sufficient evidence of carcinogenicity in experimental
animals and strong evidence that the carcinogenesis is mediated by
a mechanism
that
also
operates
October
2013
© Dr.
Wolfgang
Hien in humans. (…)
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Group 2B: The agent is possibly carcinogenic to humans.
This category is used for agents for which there is limited evidence of
carcinogenicity in humans and less than sufficient evidence of
carcinogenicity in experimental animals. … (or) inadequate evidence
of carcinogenicity in humans but sufficient evidence of carcinogenicity in experimental animals. (…)
Group 3: The agent is not classifiable as to its carcinogenicity to
humans.
This category is used most commonly for agents for which the
evidence of carcinogenicity is inadequate in humans and inadequate
or limited in experimental animals. (…)
Group 4: The agent is probably not carcinogenic to humans.
This category is used for agents for which there is evidence
suggesting lack of carcinogenicity in humans and in experimental
(…) © Dr. Wolfgang Hien
Octoberanimals.
2013
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Synopsis of the different classifications of IARC, UN, EU,
Germany (MAK, AGS), and Austria (A)
IARC
UN/GHS*
(EU new)
EU
(old)
MAK
AGS
A
1
1A
K1
1
K1
A1, C
2A
1B
K2
2
K2
A2
2B
2
K3
3B
K3
B
3
3A, 4, 5
4
* Globally Harmonised System of Classification and Labelling of Chemicals
October 2013
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Overview
Basic information on cancer and how it is studied
Part B
Differences between scientific knowledge and
legislation
Legal framework conditions in Europe, main
regulatory obligations, and workplace realities
Approaches and (regulatory) concepts at
national level
Part C
Solutions and models of good practice in
different industries
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
43
Differences between scientific
knowledge and legislation
Scientific knowledge vs. different regulatory treatment
under different jurisdictions – three striking examples
(1) Diesel engine emissions (DEE)
scientific knowledge:
IARC: carcinogenic to humans (group 1)
German MAK Commission: carcinogenic to animals,
to be considered as carcinogenic to humans (group 2)
regulatory situation:
EU (classification of substances): not classified – not on the
market, only process-generated
EU (OSH legislation): not yet included in Annex I of
Carcinogens and Mutagens Directive (CMD), but inclusion
suggested
Germany (OSH legislation): carcinogenic to animals (group 1B),
identical obligations as for other carcinogens of groups 1A/1B
What is the regulatory situation on DEE in your country?
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
44
Scientific knowledge vs. different regulatory treatment under
different jurisdictions – three striking examples
(2) Crystalline silica dust (quartz dust)
German MAK Commission: carcinogenic to humans (group 1)
EU (OSH legislation): not yet included in Annex I of
Carcinogens and Mutagens Directive (CMD); inclusion suggested
by trade unions, opposed by industry
Germany (OSH legislation): carcinogenic to humans (group 1A),
What is the regulatory situation on crystalline silica in
your country?
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
45
different jurisdictions – three striking examples
(3) Hardwood dust (beech, oak)
German MAK Commission: carcinogenic to humans (group 1)
EU (OSH legislation): included in Annex I of Carcinogens and
Mutagens Directive (CMD) –
therefore obligatory for all EU Member States to impose
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
46
different jurisdictions – legal background
Legal definition of a “carcinogen” at EU level
for substances which are marketed via CLP-Regulation –
relevant for all fields of law
for process-generated substances via Carcinogens and
Mutagens Directive (CMD) –
relevant for OSH regulation only
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
47
Legal definition of a “carcinogen” in the CLP-Regulation:
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
48
Legal definition of a “carcinogen” in the CMD:
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
49
… and what is the content of Annex I ?
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
50
Legal framework conditions in Europe,
main regulatory obligations,
Legal situation
Carcinogens and Mutagens Directive
(CMD: Dir. 2004/37/EC) defines minimum standards which are
obligatory for all EU Member States
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
51
Regulatory obligations
Risk assessment
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
52
Replacement (substitution) of a carcinogen is preferable
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
53
Use of closed system:
where the replacement of a carcinogen is not technically
possible, it should be manufactured and used in a closed
system, in so far as is technically possible
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
54
Minimization of exposure:
where neither the replacement of a carcinogen nor its
manufacture and use in a closed system is technically possible,
the employer shall ensure that the level of exposure is reduced
to as low a level as is technically possible
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
55
Minimization of exposure – control measures (1):
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
56
Minimization of exposure – control measures (2):
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
57
Minimization of exposure – access restrictions:
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
58
Information and training of workers
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
59
Information and training of workers has to be renewed and
repeated
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
60
Information for workers
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
61
Record-keeping of exposure data
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
62
… and limit values?
Since 1990, limit values have been derived at EU level for
only three substances:
benzene, hardwood dust, vinyl chloride monomer
Even after 20+ years of the CMD, limit values are a virtually
non-existent tool at EU level
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
63
Workplace realities
The obligations set out in the CMD (which are minimum
requirements) were transposed into national legislation by
all EU Member States two decades ago.
So what is the situation really like today in many
workplaces all across Europe?
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
64
Workplace realities
Compare the following obligations with your own experience:
risk assessment, including determination of exposure
substitution
closed system
extraction at source
exposure minimization
restriction of access to exposed work areas
documentation of exposed workers
record-keeping for at least 40 years
Can you identify any deficits?
What are the obstacles to remedying them?
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
65
Approaches and (regulatory)
concepts at national level
After more than 20 years of the CMD, progress seems to be limited
In some EU Member States new approaches to add
momentum to the CMD requirements
Spain:
Zero Cancer at Work Campaign
initiated by Spanish trade unions (CCOO)
in autumn 2011
Website:
http://www.cancerceroeneltrabajo.ccoo.es
more information in English
can be found at:
https://osha.europa.eu/en/seminars/worksho
p-on-carcinogens-and-work-relatedcancer/speech-venues/session-1c-cancerprevention-action-plans-and-campaigns-toprevent-work-related-cancer/the-spanish-ccoocampaign-2018zero-cancer201d/presentationc.-narocki
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
66
Some details of the Zero Cancer at Work Campaign:
Goals
•
•
•
identify workplace carcinogens
eliminate or reduce the use of carcinogens at workplaces
create social awareness, giving visibility to occupational
exposures & cancer cases
Actions at workplaces – goals:
•
•
•
•
•
eliminate or substitute carcinogens
better control measures
adequate training
adequate heath surveillance
social security recognition and reporting
Policy
forwarding demands to central, regional,
and local administrations:
• enforcement
• plans for occupational cancer prevention
• tightening up existing legislation
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
67
Obligations of the EU Carcinogens Directive
Substitution
(art. 4 (1))
Closed system
(art. 5 (2))
Exposure minimization
(art. 5 (3))
Substitution is the preferred approach but …
… it has to be complemented by a
strategy on exposure minimization
for tasks with, and uses of, carcinogens during the period in
which substitution is not yet feasible.
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
68
New approaches in some EU Member States
… on promotion of exposure reduction when substitution
or closed system are not feasible
The Netherlands:
Since the mid-1990s introduction of risk-based exposure
levels
•
•
upper risk level (4 : 1,000): maximum allowed exposure level –
starting point for (further) exposure reduction
lower risk level (4 : 100,000): target level for exposure reduction
Germany:
Since 2007 introduction of risk-based exposure levels plus
substance-independent tiered control scheme
(a number of elements “borrowed” from the Dutch approach)
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
69
Rationale behind risk-based concepts
Shortcomings of previous concepts
• minimization of exposure under the former concept based on
technical-based exposure levels (TRK – “as low as technically
possible”) did not work in practice:
overall cap – yes
further reduction below the TRK value – no
• minimization progress at workplaces difficult to verify
• technical-based exposure levels do not reflect differences in technical
possibilities between different tasks or processes for the same
carcinogen
• minimization “to zero” impossible in reality
Objectives of risk-based concepts
• verifiable implementation of minimization requirement
• assistance in carrying out minimization
• priority for minimization of high risks
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
70
We need to remember:
For the majority of cancer causing agents there is a
dose-effect-relationship starting from the point of origin
Conclusion: The higher the exposure to a carcinogen
at the workplace, the higher the resulting cancer risk
effect (=risk)
dose (=exposure)
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
71
The German risk-based approach for
avoiding work-related cancers
Exposure minimization is orientated to the health risk
risk
strength of the
measures
general
ventilation
Wolfgang Hien
Henning Wriedt
local exhaust
ventilation
Bologna, 4. – 6. Oct. 2013
containment
systems
72
The risk-based approach in a nutshell
three bands (risks / control measures) – schematic view
risk of contracting cancer
high risk:
most stringent measures
upper risk limit
medium risk:
less stringent measures
lower risk limit
low risk:
least stringent measures
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
73
Intention behind the introduction of three bands
(risk bands / bands of control measures)
• Grading of control measures should help to make the
minimization obligation dynamic:
the higher the risk, the more urgent further exposure
reduction
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
74
Consequences (1)
Written documentation of risk assessment has to be
complemented by an action plan
(modelled after Dutch example)
mandatory for high and medium risks
description of planned concrete measures for further
exposure reduction:
when, how, amount of expected reduction
Action plan will create transparency both externally
(enforcement agencies) and internally (works councils) –
efficacy of this instrument will critically depend on the way it
is actively used for monitoring the actual implementation of
the measures described therein.
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
75
Consequences (2)
higher level of protection for selected carcinogens:
carcinogen
acrylonitrile
benzene
benzo(a)pyrene
1,3-butadiene
refractory ceramic fibres
hydrazine
naphthalene
N-nitrosamines
trichloroethylene
vinyl-2-pyrrolidone
former TRK [µg/m³]
tolerable concentration
[µg/m³]
7,000
2,600
3,200 (1 ppm)
1,900 (0.6 ppm)
2/5
0.7
11,000 / 34,000
5,000
250,000 f/m³
100,000 f/m³
130
22
10 ppm
0.1 ppm (AGW)
1 / 2.5
0.7
50 ppm
11 ppm
500
50 (AGW)
AGW: health-based OEL
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
76
Consequences (3)
minimization of metals particularly challenging:
carcinogen
former TRK [µg/m³]
tolerable concentration
[µg/m³]
100
8
cadmium
15 / 30
1.6 (respirable fraction)
chromium VI
50 / 100
1 (?)
cobalt
100 / 500
5
500
< 5 (?) (respirable fraction)
arsenic
nickel compounds
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
77
The Risk-based approach:
Consequences and outlook
Advantages of the approach
limitation of individual cancer risk
thresholds for other detrimental health
upper risk level
effects are also covered
focus on minimization of high risks:
the higher the risk, the more urgent
further exposure reduction
identification of uses with particularly
high risks
lower risk level
guidance on selection and application of
control measures provided, in particular
on the use of respiratory protective
equipment
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
78
Solutions and models of good
practice in different industries
What can be done to reduce the cancer risk
at the workplace? What‘s the difference
between good models and real practice?
Wolfgang Hien
Henning Wriedt
Bologna, 4. – 6. Oct. 2013
79
Exposure-Risk-Relationships for some cancer causing
agents
Agent
tolerance
4 x 10-3
acceptance*
4 x 10-4
4 x 10-5
Asbestos and
Alu silicate fibers
100,000 F/m3
10,000 F/m3
1,000 F/m3
BaP
700 ng/m3
70 ng/m3
7 ng/m3
Benzene
0.6 ppm
60 ppb
6 ppb
Chromate (as Cr-VI)**
1 µg/m3
100 ng/m3
10 ng/m3
NiO**
2 µg/m3
800 ng/m3
80 ng/m3
Trichloroethylene
11 ppm
6 ppm
0.6 ppm
* The stricter value is intended from 2018 at the latest for more than 30 substances
** Values in discussion
October 2013
Folie 80
Example: chromium-nickel welding (stainless steel
welding)
Cr (VI) in respirable particles
“no go area”
2 µg/m3
0.2 µg/m3
0.02 µg/m3
improved exhaust
ventilation
October 2013
welding helmets with
purified air supply
Folie 81
Welding helmet with powered air purifying
October 2013
Folie 82
Welding helmet with fresh-air connection
October 2013
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Example, diesel engine exhaust: Several ways
and technical measures to reduce exposure
Particle filters
(permanently
installed)
pluggable
filters
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Funnel and
tubes for
local exhaust
ventilation
Further measures:
Reduce engine idling time. Start engines only when necessary, and turn them
off whenever it’s practical. Exhaust is still being emitted whenever engines
are idling. Reduce idling time!
October 2013
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October 2013
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October 2013
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October 2013
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October 2013
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October 2013
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October 2013
Folie 91
Example iron and steel founding – an exposure reduction
programme in USA (Source: OSHA 2008)
Problem:
The forward leaning of
the worker’s upper body
caused the air to "roll" in
front of the worker and
confine some of the
dust generated by the
process into the vicinity
of the breathing zone.
Makeup air was pushed
unrestricted into the
plenum over the
worker’s head.
October 2013
Folie 92
Solution:
October 2013
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Some Conclusions:
Work-related cancers are preventable
But prevention is a matter of political will
We need education of the workers
We need employers with insight or remorse
We need experts in our trade unions
We need a broad discussion about
tolerable and acceptable cancer risks
October 2013
Folie 94

Occupational Cancer –

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