Don’t miss our upcoming webinars: Subscribe today! In this webinar, Dr. Paul Demers, Director of the Occupational Cancer Research Centre and Professor with the University of Toronto, talked about the impact of the most common workplace carcinogens in Canada and how exposure can be prevented. The webinar was followed by a question & answer session. View the video: https://youtu.be/3xVYsrHjE_U To learn more about CCSN, visit us at survivornet.ca Follow CCSN on social media: Twitter - https://twitter.com/survivornetca Facebook - https://www.facebook.com/CanadianSurv... Instagram: https://www.instagram.com/survivornet... Pinterest - https://www.pinterest.com/survivornet...

1. Understanding the Major Workplace
Causes of Cancer in Canada
Paul A. Demers, Ph.D.
Director, Occupational Cancer Research Centre
Professor, University of Toronto

2. Scrotal Cancer among Chimney Sweeps
• Percival Pott (1775) linked
scrotal cancer in chimney
sweeps to the nature of
their work and their
exposure to cancer causing
agents in soot
• He was the first to identify
an occupational carcinogen
• Finally in 1840’s laws were
passed prohibiting young
boys from performing the
work

5. International Agency for Research on Cancer
Centre Internationale de Recerche sur le Cancer
• IARC/CIRC: a specialized
agency of the United
Nations created in 1965
• In 1970 program
conceived to provide
advice on environmental
carcinogens
• First monograph on
carcinogenic risks in 1972

6. International Agency for Research on Cancer
IARC evaluate the carcinogenicity of:
– Chemicals, metals, dust
– Radiation
– Biological agents
– Pharmaceuticals
– Personal habits
– “exposure circumstances”

7. IARC Evaluation of Carcinogens
• Group 1: Carcinogenic in humans (120 agents)
– 57% can be found in workplaces
• Group 2A: Probably carcinogenic in humans (82 agents)
– 65% can be found in workplaces
• Group 2B: Possibly carcinogenic in humans (311 agents)
– 62% can be found in workplaces
• Group 3: Not classifiable (502 agents)
– 65% can be found in workplaces

8. Why are IARC Classifications
Important?
IARC’s classifications contribute to prevention by:
 Stimulating regulations, guidelines, and policies
(Occupational Exposure Limits (OELs), Rotterdam
Convention, pesticide registration (by PMRA),
labeling/WHMIS, toxic use reduction…)
 Stimulating voluntary actions by employers and/or
workers
 Raising awareness

9. This report is available online at
http://www.occupationalcancer.ca/2017/news
-occupational-burden-ontario-report

10. The Burden of Occupational
Cancer Project
• A national team project funded by the Canadian
Cancer Society
• The objective was to identify how many cancers
are caused by workplace exposures
• The report also includes?
– The number of people are currently exposed in
Canada (from www.CAREXCanada.ca)
– How can these cancers be prevented

11. Hierarchy of hazard controls (U.S. National
Institute of Occupational Safety & Health)

12. The Impact of Asbestos in Canada
• Mesothelioma: over 500 new cases
each year (the numbers are still rising)
• Lung cancer: estimates of approximately
1,900 new cases each year
– Economic costs of mesothelioma and lung
cancer alone: $2.35 billion annually
• Other cancers: smaller numbers of larynx, ovary,
stomach and colorectal
• Asbestosis: 80 deaths per year, but likely 1000’s with
some level of lung scarring

13. Number of mesothelioma cases by year of diagnosis
and province (3-year rolling average)
0
50
100
150
200
250 1992
1993
1994
1995
1996
1997
1998
1999
2000
2001
2002
2003
2004
2005
2006
2007
2008
2009
2010
2011
2012
2013
2014
2015
Numberofmesotheliomacases
Year of diagnosis
Atlantic Provinces Quebec Ontario Manitoba
Saskatchewan Alberta British Columbia

14. Asbestos Prevention
• Approximately 150,000 Canadians are still regularly exposed
– Majority are in construction and related occupations
– Many more irregularly exposed
• Canada banned asbestos January 1st this year, but much more is
needed:
– Removal of asbestos containing material from buildings
– Create a public registry of all public buildings & workplaces
that contain asbestos
– Establish an inter-ministerial working group to address
exposure & issues such as safe disposal, building
renovation/abatement, public health…

15. Solar Ultraviolet (UV) Radiation
• 4,600 non-melanoma skin
cancers annually
• 1,500,000 workers exposed
• Greatest burden in construction &
agricultural. Other groups, such as
outdoor parks & recreation
workers, gardeners…

16. Solar Ultraviolet (UV) Prevention
Some prevention options:
• Provide shade (either natural or shade structures)
• Avoid outdoor sun exposure
mid-day, 11:00-3:00
• Require all workplaces with workers that work outdoors for
part or all of the day to develop a comprehensive, multi-
component sun safety program (Sun Safety at Work Canada
provides examples)

17. Diesel Engine Exhaust
• 900,000 workers exposed
• 560 lung and possibly, 200 bladder
cancers annually
• Greatest burden in transportation,
construction & mining
• Some prevention options:
– Upgrade or replace old on-road and off-road trucks and
diesel engines
– Alternative fuels
– No idling technology and rules
– Exhaust treatment systems
– Adopt occupational exposure limits

18. Crystalline Silica
• 140,000 workers exposed
• 570 lung cancers annually
• Greatest burden in construction, mining,
and mineral products processing
• Some prevention options:
– Replace silica with other substances
– Ventilation and filtration systems
– Use wet or vacuum methods for drilling, cutting, grinding and
clean-up
– Follow best practices for Occupational Exposure Limits

19. Shift Work at Night
• Up to 1200 breast cancer
suspected annually
• 1.9 million working Canadians,
depending on definition
– Healthcare, hospitality
industry, manufacturing,
public safety
Prevention is challenging
• Optimizing work schedules to
minimize circadian disruption

20. Welding Fumes
• IARC upgraded all welding fumes from
group 2B to Group 1, published in 2012
• Over 500,000 workers exposed ?
• 310 lung cancers annually, in addition to
eye cancer
• Greatest burden in manufacturing &
construction
• Some prevention options:
– Local exhaust ventilation
– Appropriate Occupational Exposure Limits are needed

21. Environmental Tobacco
Smoke at Work
• Significant progress has been made
over the past decades to reduce ETS
in workplaces through legislation,
supported by increased awareness
• 130 lung, 35 pharynx, 20 larynx annually among never
smokers
• Some prevention options:
– Build on successes by strengthening enforcement of
smoke-free workplace legislation
• According to the Canadian Tobacco Use Monitoring
Survey many workers still report exposure to ETS at
work and a lack of smoke-free policies

22. Radon
• Approximately 190,000 workers
exposed in underground work
or poorly ventilated workplaces
in high background regions
• Approximately 190 lung cancers
annually
• Some prevention options:
– Monitor for exposure! (radon is colourless & odourless)
• Much is known about how to reduce exposure
– Develop explicit and specific regulation of radon in indoor
air (such as NORM (Naturally Occuring Radioactive
Materials) Guidelines

23. Major Occupational Carcinogens in Canada
Carcinogen Annual Cancers Current Exposure*
Solar UV at Work 4600 non-melanoma skin 1.5 million
Asbestos 1900 lung, 430 mesothelioma, 45
larynx, 15 ovarian, (? digestive)
152,000
Diesel Exhaust 560 lung, (200 bladder) 897,000
Crystalline Silica 570 lung 382,000
Welding Fumes 310 lung ?
Nickel 170 lung 117,000
Chromium VI 50 lung 104,000
ETS at work 130 lung, 35 pharynx, 15 larynx** 125,000
Radon 190 lung 188,000
PAH’s (130 lung, 50 skin, 80 bladder) 350,000
Shiftwork (470-1200 breast) 1.9 million
* People exposed, CAREX Canada ** Among never smokers (probable associations)

24. Recent IARC Pesticide Evaluations
Glyphosate – Classified as Group 2A (NHL)
Malathion – Upgraded to Group 2A (NHL,
prostate)
Diazinon – Upgraded to Group 2A (NHL,
leukemia, lung)
Lindane – Upgraded to Group 1 (NHL)
DDT – Upgraded Group 2A (NHL testicular, liver)
Pentachlorophenol – Upgraded Group 1 (NHL)
Dieldrin & Aldrin – Upgraded to 2A (breast)

25. Conclusions
• Occupational cancer is more common in Canada than
most people think
– There are many well-established causes of cancer in
the workplace and many more that are suspected
– There are thousands of cancers diagnosed every year
that were caused by workplace exposures
– Millions of Canadians, in a wide range of jobs, are
exposed to carcinogens at work
• These cancers can be prevented through actions taken at
workplaces and government policies and regulations

26. Towards a cancer free workplace
https://occupationalcancer.ca
https://www.carexcanada.ca

27. Canadian Cancer Survivor Network
Contact Info
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