Occupational Cancer And The Research Program Of The OCRC .
Occupational Cancer and theResearch Program of the OCRC andCAREX CanadaPaul A. Demers, PhDCHSI Research Exchange SeriesOctober 18th, 2011
Outline An Overview of the Major OccupationalCarcinogens The Occupational Cancer Research Centreand its Research Program CAREX Canada
Scrotal Cancer among Chimney Sweeps Percival Pott (1775) linkedscrotal cancer in chimneysweeps to the nature oftheir work and theirexposure to cancer causingagents in soot He was the first to identifyan occupational carcinogen Finally in 1840’s laws werepassed prohibiting youngboys from performing thework
IARC Monograph Evaluations
IARC Classification of CarcinogensGroupClassificationAgents1Carcinogenic to Humans2AProbably Carcinogenic592BPossibly Carcinogenic2673Unclassifiable5084Probably Not Carcinogenic1071
What do we Know aboutOccupational Carcinogens? 60 definite or probable workplacecarcinogens (IARC 1 and 2A) Over 100 additional workplace exposures arepossible carcinogens (IARC 2B) Many other workplace exposures with asuspicion of human carcinogenicity Even greater number of workplace substanceswith little formal evaluation
CAREX Canada Priority OccupationalCarcinogens (IARC Classification, cancers)Industrial ChemicalsAromatic amines (1, bladder)1,3-Butadiene (1, lymphohemaetopoietic)TCDD (dioxins) (1, all cancers)Benzene (1, leukemia, multiple myeloma?non-Hodgkin’s lymphoma?)Formaldehyde (1, nasopharynx, leukemia,sinonasal?)Vinyl chloride monomer (1, liver)Ethylene oxide (1, lymphoid?, breast?)Polychlorinated Biphenyls (PCBs)(1/2A, ?)Acrylamide (2A), Epichlorohydrin (2A), many7
CAREX Canada Priority OccupationalCarcinogens (IARC Classification, Cancers)MetalsArsenic & compounds (1, lung, bladder,kidney?, liver?, prostate?)Beryllium and compounds (1, lung)Cadmium & compounds (1, lung,prostate?, kidney?)Chromium, hexavalent (1, lung,sinonasal?)Nickel & compounds (1, lung, sinonasal)Lead & compounds (2A/2B), Antimonytrioxide (2B), Cobalt (2A/2B)8
CAREX Canada Priority OccupationalCarcinogens (IARC Classification, Cancers)Dust and FibresAsbestos (1, lung, mesothelioma, larynx,ovary, pharynx?, colorectal?, stomach?)Erionite (1, mesothelioma)Silica (1, lung)Wood Dust (1, sinonasal, nasopharynx)Leather Dust (1, sinonasal)9
CAREX Canada Priority OccupationalCarcinogens (IARC Classification, cancers)RadiationX-radiation, gamma-radiation (1, lung,breast, leukemia, many others)Radon decay products (1, lung)Plutonium (1, lung liver, bone)Solar radiation (1, skin)UV Tanning Devices (1, skin &eye melanoma)Magnetic fields (ELF)(2B)10
CAREX Canada Priority OccupationalCarcinogens (IARC Classification, cancers)Combustion Products and OthersPolycyclic aromatic hydrocarbonrelated exposures (mix of 1/2A/2B,lung, skin, bladder)Mineral oils (1, skin)Diesel Exhaust (2A, lung?)Environmental Tobacco Smoke (1,lung)Antineoplastic Agents (1/2A, leukemia,bladder)Shiftwork at Night (2A, breast?)11
CAREX Canada Priority OccupationalCarcinogens (IARC Classification)Chlorinated SolventsTetrachloroethylene (2A)Trichloroethylene (2A)1,2 – Dichloroethane (2B)Dichloromethane (2B)Chloroform (2B)12
CAREX Canada Priority OccupationalCarcinogens (IARC Classification)PesticidesChlorophenoxy Herbicides(2,4-D, MCPA, MCPP)(2B)Chlorothalonil (2B)Dichlorvos (2B)Lindane (2B)Pentachlorophenol (2B)Atrazine (3)13
600500400300Accepted Claims for WorkplaceFatalities: 96 1997 1998 1999 2000 2001 2002 2003 2004 2005Centre for the Study of Living Standards. Five Deaths a day: Workplacefatalities in Canada 1993-2005. CSLS Paper 2006-04 Ottawa, 2006.
300250200Accepted Claims for WorkplaceFatalities: 001996 1997 1998 1999 2000 2001 2002 2003 2004 2005Centre for the Study of Living Standards. Five Deaths a day: Workplacefatalities in Canada 1993-2005. CSLS Paper 2006-04 Ottawa, 2006.
Estimated Burden of Occupational Cancerfrom Various StudiesAttributable Fraction (%) By Cancer Site and �2Author and LocationNurminen et al(2001)FinlandSteenland et al(2003)United StatesRushton et al(2010)United KingdomAlberta HealthServices, AHS(2010), Alberta
Funding for Cancer Research in Canada:2005‐2007* Funding from 37 federal, provincial, and voluntaryprograms (does not include WCB’s) for cancer research– Funding for all cancer research:– Risk and prevention research:– Occupational cancer 1,143 million 122.3 million (10.7%) 1.3 million (0.11%) 2008: CAREX Canada funded by CPAC: 4.2 million 2009: Occupational Cancer Research Centrefunded by WSIB, Canadian Cancer Society,Cancer Care Ontario: 4.6 million* Investment in Cancer Risk and Prevention Research, 2005‐2007.Canadian Cancer Research Alliance. May, 2010
Occupational Cancer Research CentreA partnership for the prevention of occupational cancerFunded in 2009 to:1. Build an occupational cancer research program2. Build research capacity in Ontario3. Deliver and exchange knowledge4. Build a sustainable centre
OCRC Vision, Mandate & ScopeVISIONMANDATESCOPEThe prevention of occupational cancer through theidentification and elimination of exposures tocarcinogens in the workplace Conduct research on occupational cancer andcarcinogens Bridge occupational, environmental, and public health Build research capacity Ontario‐wide focusNationally/internationally networkedMulti‐disciplinary approachApplied research
Occupational Cancer Research Centre Based at Cancer Care Ontario Current staff:– Director– Associate Director– 5 other affiliated scientists (working on one ormore OCRC projects)– 5 research associates (2 additional being recruited)– Administrative Assistant (being recruited) Current trainees:– 5 student research assistants– 1 post‐doctoral fellow
The OCRC’s Research ProgramThree focus areas:1. Identification of causes of cancer in theworkplace2. Surveillance of occupational cancers &workplace exposures3. Intervention research to develop &evaluate prevention & exposure reductionstrategies
OCRC Stakeholder Needs Assessment SurveyMost frequently identified exposuresExposure categoryExamples of commonly listed exposuresChemicalsFormaldehyde, amines, PCB, sulphuric acid mists 30Dusts and fibresAsbestos, fibreglass, silica, wood dust, carbon black27Radiation24181615141413Work environmentElectromagnetic fields, nuclear, cell phone, solar,ionizing radiation, radiofrequency radiation, WIFI Smoking, physical activity, stress, diet, alcohol‐‐‐‐‐‐Diesel, gasolineUranium, chromium, cobalt, gold, nickel, smelterfumes, tungsten, welding fumes, leadIndoor air, environmental tobacco smoke, mouldSolventsFossil fuels & oilsPharmaceuticalsSolvents (general), benzene, trichloroethylene Metal working fluid, oil mists, coal tar, fuel, asphaltAntineoplastic drugs, cytotoxic drugs974Lifestyle lsHohenadel et al. Priority issues in occupational cancer research: Ontariostakeholder perspectives. Chron Dis Can 2011;31(4):147-51.Frequency12
ACS/NIOSH/IARC Top 20 PrioritiesUltrafine particlesChlorinated solventsTitanium dioxideTrichloroethyleneCarbon blackPerchloroethyleneDiesel Engine ExhaustMethylene chlorideWelding fumesChloroformMetalsOther ChemicalsLead & lead compoundsFormaldehydeIndium phosphideStyrene & Styrene‐7,8‐OxideMetallic cobaltAcetaldehydePesticidesAtrazinePropylene OxidePolychlorinated Biphenyls (PCBs)Di (2‐ethylhexyl) phthalate (DEHP)ShiftworkWard EM, Schulte PA, Straif K, et al. Research Recommendations for Selected IARCClassified Agents. Environmental Health Perspectives 2010:119(10):1355-1362.
IARC Evaluation Priorities 2010‐2014High Priorities(occupational)Asphalt & bitumenCarbon‐based nanoparticlesCrystalline fibres other than asbestosUltrafine particlesMotor vehicle exhaust emissionsPerfluorinated compounds (e.g. PFOA)Radiofrequency electromagnetic fieldsSedentary workStressIron & iron oxidesWeldingMedium priorities (occupational)AtrazineMetalworking fluids & lubricantsN‐NitrosaminesPolybrominated biphenyls (PBB)Polybrominated diphenyl ethers (PBDE)Polychlorinated biphenyls (PCB)DEHP and other phthalatesStyreneTrichloroethylene & other chlorinatedsolventsReport of the Advisory Group to Recommend Priorities for IARC Monographsduring 2010–2014. IARC, Internal Report 08/001. Lyon, France, 2008
Epidemiologic Studies the Causes of Cancer‐ Cross‐Canada study of pesticides‐ Analyses of the risk of Non‐Hodgkin’s and Hodgkin’s lymphoma aswell as multiple myeloma in collaboration with the U.S. NCI‐ Ontario uranium miner cohort‐ Reanalysis after linkage with national mortality and cancer incidencefiles in collaboration with CNSC‐ Toronto lung cancer case‐control study‐ New analyses and collaboration with the international Synergyproject coordinated by IARC‐ Occupational exposure to diesel and gasoline engineemissions and the incidence of colorectal and bladdercancer in Canadian men‐ New analyses using data from the National Enhanced CancerSurveillance System
Effect of exposure to multiple pesticidesoverall and by pesticide type on NHL2012 to 45 Odds ratio1.61.20.80.40Any pesticideHerbicidesInsecticidesFungicides
Surveillance of Occupational Cancer & Carcinogens‐ Linkage of 1991 Census (20% sample) with tumour registrydata in collaboration with Statistics Canada‐ Development of an Occupational Cancer surveillanceProgram for Ontario‐ Mesothelioma patterns and projections in Ontario andCanada‐ Sinonasal cancer surveillance and exposure to sinonasalcarcinogens in Ontario‐ Cancer Among Nordic Firefighters in collaboration with theNordic Occupational Cancer Group (NOCCA)‐ Analyses of the Ontario MoL exposure database (MESU) incollaboration with CAREX Canada
Creation of National OccupationalCancer Surveillance Cohort 1991 Long‐Form Census– Representative 20% sample of population Linked to:– Canadian Mortality Database Vital statistics– Canadian Cancer Database Cancer incidence registry– Tax Summary Files Derived from personal tax returns Follow‐up: 1991 – 2003 (to be extended to 2005)
CanadianCensus CohortN 2,734,800MenWomenN 1,342,100N 1,392,700WorkingWorkingN 1,123,500N 953,600
Other OCRC Research Projects‐ Determining human and economic burden of occupationalcancers for Ontario/Canada‐ Identifying optimal methods of occupational history takingand referral for workers compensation‐ A comparison of Ontario Occupational Exposure Limits forCarcinogens to other jurisdictions in Canada and elsewhere‐ An examination of trends in occupational cancerepidemiology research in Canada and internationally‐ Systematic review of selected occupational cancerprevention efforts‐ Historical review on occupation cancer research in Ontario
CAREX Canada - OVERVIEW The objectives of CAREX Canada are to:–develop estimates of the number of Canadiansexposed to IARC carcinogens in their workplace &community environments,–identify how & where people are exposed, and–when possible, determine their level of exposure. Estimates are generated using existing Canadianexposure data, census population data & the bestexposure estimation procedures available.34
Potentially Exposed Workers: Initial EstimatesKnown or suspected carcinogen (IARC)ExposedShift work with circadian disruption (2A)2,800,000Solar radiation (1)1,500,000Diesel engine exhaust (2A)804,000Silica (crystalline) (1)349,000Other PAHs (2A/2B)307,000Benzene (1)297,000Wood dust (1)293,000Lead (2A)202,000Ionizing radiation (1)153,000Asbestos (1)152,000UV radiation (artificial sources)(1)150,000Chromium (VI) compounds (1)83,000Nickel compounds (1)53,000Formaldehyde (1)41,600
Canadian Workplace Exposure Database(CWED)36
Workplace Regulatory Agencies in Canada37
Provincial Workplace MeasurementsOntario (81-96)BC (81-04)Quebec (01-05)Wood 51662Asbestos1,7874,7181,385Beryllium29212817,864* plus 5,200 blood-lead & 17,400 urine-lead biological measurements
Mean benzene exposure over time inBC and Ontario workplaces98[Benzene] (mean, ppm)765BCOntario4321080-8485-8990-94* current ACGIH TLV is 0.5 ppm, NIOSH PEL is 0.1 ppm95-02
Mean Concentration of Asbestos Fibresby Province and Year[Asbestos fibres] (mean, 495-02
Mean Asbestos Levels in Ontario MotorVehicle Parts Manufacturing (n 491)Mean [asbestos fibres] (f/cc)65Area samplesPersonal samples4321080-8485-89Year
Mean Concentration by Sampling YearWood Dust Concentration 119921993199419951996
Levels of Exposure to Benzene by IndustrySector, Ontario 1981-1996Industry Sector (measurements)Gasoline stations (12)Iron and Steel Mills (29)Printing industry (38)Pharm. & Medicine Mfr. (128)Rubber Manufacture (192)Plastics Manufacture (137)Mean ppm (range)13.0 (0.01-55.8)2.3 (0.01-16.0)0.9 (0.01-7.8)0.7 (0.01-19.5)0.1 (0.01-5.2)0.05 (0.01-2.5)Electrical Components Mfr. (21)0.03 (0.01-0.2)
Benzene exposure to service stationattendants: Personal long-term samplesSourceLocationMean (ppm)n samplesCPPI-PACE 1996Canada0.0478CPPI-PACE 1990Canada0.38280PACE Pilot 1987Canada0.0342Rappaport 1987USA0.249Halder 1986USA0.321Kearney 1986USA0.118Runion 1985USA0.061478Weaver 1983USA0.0614McDermott 1979USA0.0984Compiled from Verma et al., 2001. ‘Benzene and Total Hydrocarbon Exposures in theDownstream Petroleum Industries’, AIHAJ, 62:2, 176-194
Number of People Exposed to IonizingRadiation by Industry in OntarioNumber monitored byNDR (2005)Number exposed*Nuclear power18,6007,320Medicine27,7004,280Professional, scientificservices6,9502,570182Public administration2,500475Other13,0002,900Industrial groupUranium mining*Exposure is defined as having an annual ionizing radiation dose of 0 mSv45
Night, Evening & Rotating Workers in OntarioIndustries with the Highest Prevalence46
47
Estimated Number of Farm OperatorsPotentially Exposed to Chlorothalonil
Estimated Number of Farm WorkersPotentially Exposed to Chlorothalonil
Golf Course Pesticide Applicators by N2493QC1083NFL66PEI84NB174YT6NT3NU0Canada701751
Registered Nurses (RNs), Licensed Practical Nurses(LPNs), and Laundry Workers with Potential for Exposureto Antineoplastics Drugs in 20100040020050702080 10NT, NU701010*
Building Capacity: the CAREX Canada TeamA young, inter-disciplinary staff(epidemiology, occupational hygiene,geography, environmental sciences,information sciences, journalism)3 PhD Students with awards fromCCSRI, CIHR, MSFHR, otherOver a dozen other students workingon pieces of the project, many usingCAREX data as part of the researchCAREX Canada is an excellent research platform for occupational &environmental cancer studies in population health & exposure sciences
Insert screen shots for CAREX Canada site here (noworries for translation since available in bothlanguages)
Exhaust Diesel, gasoline 14 . IARC Evaluation Priorities 2010 . Report of the Advisory Group to Recommend Priorities for IARC Monographs during 2010–2014. IARC, Internal Report 08/001. Lyon, France, 2008. Epidemiologic Studies the Causes of Cancer
Silat is a combative art of self-defense and survival rooted from Matay archipelago. It was traced at thé early of Langkasuka Kingdom (2nd century CE) till thé reign of Melaka (Malaysia) Sultanate era (13th century). Silat has now evolved to become part of social culture and tradition with thé appearance of a fine physical and spiritual .
May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)
̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions
Dr. Sunita Bharatwal** Dr. Pawan Garga*** Abstract Customer satisfaction is derived from thè functionalities and values, a product or Service can provide. The current study aims to segregate thè dimensions of ordine Service quality and gather insights on its impact on web shopping. The trends of purchases have
On an exceptional basis, Member States may request UNESCO to provide thé candidates with access to thé platform so they can complète thé form by themselves. Thèse requests must be addressed to esd rize unesco. or by 15 A ril 2021 UNESCO will provide thé nomineewith accessto thé platform via their émail address.
Chính Văn.- Còn đức Thế tôn thì tuệ giác cực kỳ trong sạch 8: hiện hành bất nhị 9, đạt đến vô tướng 10, đứng vào chỗ đứng của các đức Thế tôn 11, thể hiện tính bình đẳng của các Ngài, đến chỗ không còn chướng ngại 12, giáo pháp không thể khuynh đảo, tâm thức không bị cản trở, cái được
Ovarian cancer is the seventh most common cancer among women. There are three types of ovarian cancer: epithelial ovarian cancer, germ cell cancer, and stromal cell cancer. Equally rare, stromal cell cancer starts in the cells that produce female hormones and hold the ovarian tissues together. Familial breast-ovarian cancer
Food outlets which focused on food quality, Service quality, environment and price factors, are thè valuable factors for food outlets to increase thè satisfaction level of customers and it will create a positive impact through word ofmouth. Keyword : Customer satisfaction, food quality, Service quality, physical environment off ood outlets .
