world cancer report - iarc
world cancer report - iarc
world cancer report - iarc
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Agent Cancer site/<strong>cancer</strong><br />
IARC Group 1<br />
Aflatoxins Liver<br />
Chronic infection with hepatitis B virus Liver<br />
Chronic infection with hepatitis C virus Liver<br />
Erionite Lung, pleura<br />
Radon and its decay products Lung<br />
Solar radiation Skin<br />
Environmental tobacco smoke Lung<br />
IARC Group 2A<br />
Diesel engine exhaust Lung, bladder<br />
Ultraviolet radiation A Skin<br />
Ultraviolet radiation B Skin<br />
Ultraviolet radiation C Skin<br />
Table 2.10 Agents and mixtures which occur mainly in the general environment but to which exposure<br />
may also occur in an occupational context.<br />
A <strong>world</strong>wide problem<br />
Evidence on occupational <strong>cancer</strong> has<br />
been obtained mainly in developed countries.<br />
To a large extent, the critical data<br />
concern the effects of high exposure levels<br />
as a consequence of industrial practice<br />
during the first half of the 20th century.<br />
Few studies have been conducted in<br />
developing countries, other than some in<br />
China. Since the period, twenty to thirty<br />
years ago, to which most studies pertain,<br />
there have been major changes in the<br />
geographical distribution of industrial<br />
production. These have involved extensive<br />
transfer of technology, sometimes<br />
obsolete, from highly-industrialized countries<br />
to developing countries in South<br />
America and in Asia. For example, the<br />
manufacture of asbestos-based products<br />
is relocating to countries such as Brazil,<br />
India, Pakistan and the Republic of Korea,<br />
where health and safety standards and<br />
requirements may not be so stringent<br />
(Reduction of occupational and environmental<br />
exposures, p135). Occupational<br />
exposures to carcinogenic environments<br />
are increasing in developing countries as<br />
a result of transfers of hazardous industries<br />
and the establishment of new local<br />
industries as part of a rapid global<br />
process of industrialization [8].<br />
A particular problem in developing countries<br />
is that much industrial activity takes<br />
place in multiple small-scale operations.<br />
These small industries are often characterized<br />
by old machinery, unsafe buildings,<br />
employees with minimal training and<br />
education and employers with limited<br />
financial resources. Protective clothing,<br />
respirators, gloves and other safety<br />
equipment are seldom available or used.<br />
The small operations tend to be geographically<br />
scattered and inaccessible to<br />
inspections by health and safety enforcement<br />
agencies. Although precise data are<br />
lacking, the greatest impact of occupational<br />
carcinogens in developing countries<br />
is likely to be in the less organized<br />
sectors of the relevant industries.<br />
Examples include the use of asbestos in<br />
building construction, exposure to crystalline<br />
silica in mining and mining construction,<br />
and the occurrence of polycyclic<br />
aromatic hydrocarbons and heavy<br />
metals in small-scale metal workshops<br />
and in mechanical repair shops.<br />
The most generally accepted estimates<br />
of the proportion of <strong>cancer</strong>s attributable<br />
Fig. 2.19 Asphalt road-workers (shown here in<br />
India) are exposed to polycyclic aromatic hydrocarbons.<br />
Fig. 2.20 In modern mines (such as those of<br />
Charbonnages de France), the prevention of occupational<br />
risk is a major concern, which is being<br />
addressed on both collective (reduction of dust,<br />
organization of transport) and individual (use of<br />
suitable protection equipment) levels.<br />
Fig. 2.21 Textile dyeing in Ahmedabad, India.<br />
Protection against occupational exposures is<br />
often suboptimal in developing countries.<br />
Occupational exposures 37