Cancer (2005)
Workplace Carcinogens – Contributing to a Deadly
Disease
Few diseases cause as much concern and fear as cancer, and
for good reason. Despite major investment in research and
treatment, the number of people contracting cancer continues to
increase and many still die from cancer. The most recent
statistics (2005) from the National Cancer Institute of Canada
suggest that 38 per cent of Canadian women and 44 per cent of
men will develop cancer during their lifetimes, and 24 per cent of
women and 29 per cent of men will die from cancer. That is one
out of every four Canadians.
Lung cancer remains the leading cause of cancer deaths
claiming 86 per cent of its victims, but incidence of cancer in
other parts of the body continues to grow especially breast
cancer in women and prostate cancer in men. Once considered
rare to non existent, we are also seeing more and more cancer
among children.
Although we know a lot about workplace carcinogens – cancercausing chemicals, heavy metals, and minerals used by or
produced by industry – there are still many carcinogens widely in
use in industry, released into the environment, and being used in
consumer products. Some experts still debate how many
cancers are due to these exposures compared to other known
carcinogens such as tobacco smoke, diet, and physical inactivity
ignoring the fact that for many workers and their communities the
exposure to carcinogens at work is much higher than that faced
by the general public. There is no disagreement that the majority
of cancers are preventable.
Despite decades of study, debate, and public concern, Canada
still does not have national or provincial policies to prevent
cancer due to occupational or environmental sources, nor does it
have in place the system necessary to identify exposure to these
carcinogens or track the cancers that result.
Despite decades of study, debate and public concern, Canada
still invests very little in the prevention of cancer compared to the
money spent on treatment.
Recently, however, there are some signs of change. The Federal
government adopted a National Strategy for Cancer Control in
June 2005. A national committee struck as part of the strategy
recently produced a report on Best Practices in Preventing
Occupational and Environmental Cancers outlining a number of
key areas where improvements are needed. Provincial cancer
registries in Quebec, British Columbia, and Ontario have slowly
begun to develop programs to identify and track occupational
cancers. Local public health authorities have begun turn their
attention to environmental health in their communities. Even the
Canadian Cancer Society, perhaps the most conservative of
advocacy bodies, acknowledges the significance of occupational
carcinogens for workers whose jobs expose them.
Much of our knowledge that these carcinogens cause cancer
comes from studies done on the workers who had been exposed
and were dying more frequently of cancer as a result. Today we
are discovering that those same carcinogens can cause cancer
at much lower levels than was seen in workplaces, and our
children’s lives are at risk.
The Steelworkers Union throughout its history has worked to
protect its members from cancer. Throughout the ‘60s, ‘70s, and
‘80s, leading in the steel and mining industry because of the
conditions there at the time, the union campaigned nationally
against industrial disease and cancer in particular. Among the
most well known are those of the uranium miners in Eliott Lake,
Ontario, where cold war demand and unscrupulous owners
required miners to unknowingly work under hazardous levels of
exposure to radiation and silica resulting in a plague of cancers
the effects are still being felt even now almost 15 years after the
mines closed; and of the asbestos miners in Quebec and Baie
Verte, Newfoundland who were never told by their employer of
the hazards they faced. Our union mobilized Steelworkers across
the country to convince an often unbelieving public and to force
government to take action as the death toll of workers mounted,
much as it did years later to change the Criminal Code of
Canada to prosecute unsafe companies that kill their workers, a
recommendation of the Public Inquiry into the explosion at the
Westray mine that killed 26 people in 1992.. These earlier
struggles lead to Royal Commissions, to new occupational health
and safety laws, workers’ rights to know the hazards they face,
the Workplace Hazardous Materials Information System, and
major improvements in our workplaces.
Since then, however, restructuring, new technology, and
management policies that they created have changed
substantially the exposures, reducing them in some cases and
intensifying them in others. More efficient engines, for example,
produce much less of the old fumes and soot that workers
choked on, but much larger amounts of ultra fine particles that
slip less noticed down our throats. Chemical exposures have
become less visible, but no less potent. And more and more of
our exposures are also in the air we breathe, in the water and
land that produce our food which itself is exposed to higher
amounts of and more complex chemicals. These workplace
carcinogens are everywhere.
When unions protested in the ‘60s, ‘70s, and ‘80s, they were told
that our economy would shut down, jobs would be lost, that
pollution was not the culprit, and nothing could be done about it.
The union with the support of its members persisted and
conditions were changed and many of those business thrived as
a result. The economy did not shut down, and it is the companies
that failed to change to address these concerns that had difficulty
surviving. Today environmentally sustainable industries are
becoming more and more a priority of the Federal and provincial
government as the costs of environmental damage increases.
We build on our past experiences and triumphs. All across
Canada, Steelworker local unions are involved in helping past
and present members address concerns about occupational
cancer. Workers’ compensation boards are receiving an
increasing number of claims from our efforts and recognition of
these claims helps survivors cope as well as increases the
pressure on government and industry to act to reduce
exposures.
What Is Cancer?
Cancer is a general term for abnormal cell growth and describes
a wide range of diseases. These diseases start from damage to
the DNA (deoxyriibonucleic acid) within the nucleus of the cell.
The structure of DNA provides the blueprint or plan for growth
and specialization of the cell. Certain chemicals and substances
can damage the structure of DNA so that it no longer controls
growth and cell specialization (referred to as initiators) and/or
may cause already damaged cells to mutate, triggering the
uncontrollable growth of cells that characterize cancer
(promoters). These chemicals and substances are called
carcinogens.
The term for uncontrolled growth is malignancy, and the hard,
solid masses produced are tumors. Not all cancers produce
tumors. Leukemia is an example of such a cancer because it
develops in the bone marrow and is found through the circulatory
system. As well, not all tumors are cancerous.
There are many types of cancer. Carcinomas are cancers that
affect the surfaces of organs, like the skin, lungs, and stomach.
Sarcomas affect the muscles, cartilage, or internal portions of the
organs. Neoplasm (new growth) and malignant tumor are
synonyms for cancer. Metastasis occurs when clumps of cancer
cells break away and spread to other parts of the body via the
blood stream. This results in secondary deposits of cancer,
known as metastases (standing in an abnormal place). These
secondary cancers are responsible for up to 90 per cent of
cancer deaths. They are not easily removed by surgery, and may
spread to various locations in the body where they invade and
destroy surrounding tissue. Cancer does not develop
immediately on exposure to a carcinogen but only after a latency
period of twenty, thirty, or even forty years or more.
Cancer treatment has improved a lot over the past two decades,
and survival rates have improved as a result. But make no
mistake about it, cancer is a very deadly disease, and no victim
and their family escape unscathed. It robs people of years from
their lives, and more and more snuffs life out before it is barely
underway as childhood cancers increase.
How Do We Know What Causes Cancer?
The science that is used to determine if something is a
carcinogen is not exact. With very few exceptions, you cannot tell
what caused a cancer simply by looking at it. And since cancer
takes a long time to develop, scientists cannot observe cause
and effect. Instead we have to rely on indirect approaches.
One test or study is seldom sufficient to answer the concern. In
the end we cannot be certain so public policy, prevention, and
the law in Canada relies upon the precautionary principle which
promotes action to protect human health in the face of
uncertainty. National and international organizations exist whose
job it is to review studies and tests and to provide authoritative
advice on what is carcinogenic.
Methods Of Identifying Carcinogens
There are three methods that are commonly used to identify
carcinogens:
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Mutagenesis Testing
Animal Testing
Epidemiological Studies
Bacterial Testing
Bacterial testing, an example of muta–genesis testing, is the
observation (in a testing laboratory) of how the DNA of bacteria
reacts to chemical exposure. A common example of this type of
testing is the Ames test. Because nearly all proven carcinogens
are also mutagens (that is, act directly upon DNA), this test
screens substances for mutagenicity as an indication of potential
carcinogenicity.
In essence this test only proves that a substance results in a
mutation of bacteria. But a growing number of reputable
authorities are insisting that a mutation in bacteria can help
predicts the substance’s effect on other organisms. There is also
growing evidence that the bacterial testing does not recognize all
carcinogens such as some chemical carcinogens (e.g.,
Urethane, Carbon Tetrachloride) that depend on the body’s own
chemical system to cause the damage.
Animal Testing
These tests expose test animals to a suspect substance. The
tester then watches the animal over a definite length of time for
changes to its body. The animal's organs are then examined for
unhealthy change. The animals we are most familiar with are
laboratory rats and mice. All such animals are especially bred for
research and are the same genetically. Test animals are all
healthy before testing. Strict breeding is important. The
experiments will use many animals and they must be very like
one another. An average test could require hundreds of such
animals.
The real point of such a test is that a measured dose of a
substance caused damage to the cell structure of a living animal.
There are strong similarities in the cell structure of all animals.
Whether rat or human the damage was done, and in animal
testing, this is cause for concern and further investigation. To
classify a substance as carcinogenic, scientists must find
tumours in two or more experiments with animals.
Labour’s position has long been that no new substance should
enter the workplace without thorough knowledge of its toxicology
and possible hazards. It is in the pretesting period where
mutagenesis and animal testing play a large part. All substances
in use in the workplace should be tested and retested. Any
indication that a substance is carcinogenic should mean that it is
removed from the workplace, or strictly regulated. This opinion,
unfortunately, is not shared by those responsible for regulation of
chemicals in the workplace. In many cases, we are forced to rely
heavily upon a third type of study – the epidemiological study.
Epidemiological Studies
Epidemiology is the study of diseases in humans and the factors
that influence them. Unlike bacterial and animal testing,
epidemiological studies do not take place before the substance
enters the workplace. They require a disease to track, and
sickness or death to record. Their only preventive value is in
providing evidence to get the substance out of the workplace so
future workers are not injured.
Epidemiological studies, when done thoroughly, can help to
pinpoint the cause or causes of a health problem. They attempt
to match the occurrence of a specific illness such as cancer with
an exposure to a suspected carcinogen. The relationship is
measured statistically and the higher the correlation, the more
likely there is a causal association. The relationship is measured
often by comparison to another group of workers that is
considered similar except for the exposure being studied or to
the general population. Because of the considerable
uncertainties involved, scientists often require higher levels of
statistical proof before they are willing to accept there is a
reliable association.
These studies are fraught with uncertainty – the exposures may
not be properly measured or there may not be enough people
studied to produce reliable statistical results. The process of
checking the information and linking databases of worker
histories with death certificates can take a long time.
Nonetheless, epidemiology has proven to be a major source of
information showing the link between cancer and exposure to
carcinogens at work.
The International Agency for Research on Cancer (IARC)
There are a number of national and international agencies who
critically review the scientific literature in order to make
judgements on carcinogens. The most well known and
recognized body is IARC and, in particular, the IARC Monograph
Program which provides critical reviews of epidemiological and
experimental data for chemicals, groups of chemicals industrial
processes, other complex mixtures, physical and biologic agents.
Between 1972 to 2003, IARC reviewed more than 880
substances of which 89 were classified as definite human
carcinogens, 64 as probable, and 264 as possible human
carcinogens. In that group, there are
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28 definite human occupational carcinogens
27 probable human occupational carcinogens
113 possible human occupational carcinogens
18 occupations and industries that possibly, probably, or
definitely entail excess risk of cancer.
The IARC lists are helpful in identifying carcinogens because of
the reputation of the agency that conducts the reviews. At the
end of this document is a published article by Jack Semiatycki
and others titled "Listing Occupational Carcinogens" which gives
a detailed description of the IARC program and its results,
including lists of occupational carcinogens. While the IARC lists
are not exhaustive, they are an important source of information
about known carcinogens. IARC is relied upon by government,
workers’ compensation boards and others.
Other Sources of Information
There are many sources of information about carcinogens. If you
have a computer and access to the internet, all you have to do is
google "cancer causing chemicals" or "occupational carcinogens"
or similar phrases to retrieve all sorts of information, some of it
reliable and some of not.
As workers, we have a legal right to know what we are exposed
to at work Health and safety legislation in each province,
territory, or Federal jurisdiction sets out obligations of employers
to disclose information and the rights of workers and their health
and safety representatives to know what they are exposed to and
the limits on exposure. Most chemicals have labels and material
safety data sheets (MSDS) which should include information on
whether or not components of the mixture contain carcinogens.
CCOHS was set up to provide free and independent information
on occupational health and safety. These days not everything at
CCOHS is free, but it does still provide good information. Contact
CCOHS at www.ccohs.ca or by phone
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How do you tell if you have a problem?
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Are there concern about the chemicals you are using? Are
there worries about your health and the health of those you
work with?
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Do you know what you are working with?
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Do you notice the number of people you work with who
have cancer?
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Do you have friends and relatives who have cancer and
whether their jobs played a role?
You have a right to know.
Investigating Your Own Workplace
There are a number of simple tools that can help you investigate
whether or not you have a problem in your workplace. If your
concern is that too many people who you worked with seem to
be developing cancer, start making a list. As the list grows, you
identify where people worked, how long, and what kind of
chemicals they were exposed to. Even when you don’t know
what people were exposed to, detailed descriptions of the work
they did can help identify what they were exposed to. How long
ago the exposures occurred are also important because cancer
occurs only after a long delay called the latency period that can
range from 15 to 25 years or more. Even when your workplace
has little information left, there may be reported studies of similar
workplaces where similar processes were used. Its is very much
like being a detective and following the trail.
Although we often do not realize it, we are our own best sources
of information in many cases. Bringing together groups of
workers often generates lots of useful information and identifies
common concerns and problems that otherwise go unnoticed. A
simple and useful method is called mapping which uses large
drawings of bodies and workplaces to allow participants to
document their health concerns as well as the work exposures
collectively on a common outline. The patterns that emerge
allows for further investigation to take place.
Similarly if you are concerned about being exposed to
carcinogens, you can compile information and utilize the joint
health and safety committee as a way to convince the employer
to find alternatives. There are lots of tools available to help you
get started and to plan what needs to be done. Contact your
local union president or staff representative for information on
Steelworker area health and safety committees near you and on
how to contact members of the USW Health Safety and
Environment Department in your district.
The Steelworker web site has lots of information and the health
and safety information is growing regularly. Check us out at
www.usw.ca.
Provincial Federations of Labour have health and safety staff
who are available to assist you as well. There are worker
occupational health clinics in Alberta, Ontario, and Manitoba that
provide free advice and have access to all sorts of technical
resources if they are needed.
Safe Exposure Levels
Damage to the DNA structure of a single cell is enough to start
the cancerous process. Even very brief exposure to low levels of
a carcinogen can result in cancerous growth. Exposure of the
lining of the lung to asbestos for as little as one day can result in
a rare cancer known as mesothelioma. The only safe level of
exposure to a carcinogen is no exposure at all.
Of course, not every person exposed to a carcinogen will
develop cancer – some coke oven workers have worked forty
years or more in the mills and have died of causes completely
unrelated to their work. No all smokers die of lung cancer. It is
impossible; however, to predict in advance who will develop
cancer and who will not. Perfect health, fitness, and strong
willpower provide no defense against carcinogens.
Control Measures
Legislation gives workers the right to know of workplace hazards
that could affect their health or safety. Information is singularly
important when dealing with carcinogens. This information is
available in the form of Material Safety Data Sheets, labeling,
regulations, or work practices. It should include the methods of
control necessary to reduce or eliminate exposure.
Elimination
If at all possible, carcinogenic substances should be eliminated
completely from the workplace. This may be done by redesigning
the work process to cut out the need for such chemicals.
Redesign is a long-term measure, however, and other methods,
such as retrofit, may have to be implemented in the meantime.
Substitution
When elimination of the substance is not possible, carcinogenic
substances should be replaced with non-carcinogens. At the slab
caster, replace a mold powder that contains silica with one,
which contains no silica. It is important not to exchange a
carcinogen for another hazardous, even if non-carcinogenic,
substance. The substitution of toluene for benzene, or ceramic
fibre for asbestos is the substitution of one hazard for another,
somewhat less serious, hazard that still requires other control
measures.
Isolation
Where substitution is not possible, isolation is the next
consideration. Isolation reduces exposure to carcinogens by
separating them from direct contact with workers. It may take the
form of remotely operated systems, glove boxes, or positive
pressure control booths, for example. Positive pressure in a
control room keeps the contaminants outside.
Local Ventilation
Sometimes, the mobility of work processes, such as welding,
gluing, painting and degreasing make isolation impossible. Local
or immediate ventilation, coupled with protective equipment, is
suitable in this case. The use of local ventilation does not restrict
the need for a well-maintained general ventilation system. The
local ventilation should be independent of the general system
and of the closed filtering type
Personal Protective Equipment
Personal protective equipment must never be the first line of a
worker's defense. It should be used as one part of an overall
control program to provide an extra measure of protection.
However, used to meet the minimum requirements of legislation,
or as a stopgap arrangement for health and safety, it becomes a
burden on the worker. It can also be a stumbling block to
progress in decontaminating the workplace of carcinogens and
other hazards. Where a regulation or work practice prescribes
personal protective equipment, its use must include proper fitting,
training and maintenance.
Doesn't Everything Cause Cancer These Days?
Carcinogens are often encountered differently in workplace
settings. The chemical benzopyrene seems to be the most
potent carcinogen in cigarette smoke. It is present in the fumes
from roofing tar, in a concentration high enough to expose
roofers to the equivalent of seven hundred cigarettes per
average working day. This same carcinogen is found in coke
oven emissions in a concentration equivalent to smoking one
thousand cigarettes a day. On the other hand, governments
prohibiting smoking from the workplace because of the risk of
lung cancer for non-smokers from second-hand smoke. Yet
many more workers are exposed to similar levels of "second
hand" smoke form carcinogens like diesel emissions which also
contains many of the same components as tobacco. Our
responsibility is to help Public Health and government
understand that exposure to diesel emissions and other
workplace carcinogens is as serious a problem as second-hand
tobacco smoke. Most provinces currently do not even have an
exposure standard for diesel emissions!
Effects Of Workplace Carcinogens Beyond The Gate
The effects of workplace carcinogens do not stop at the
workplace door. The contamination moves out into the very
fabric of our society. Workers exposed to hazardous workplace
substances often carry them home on clothing, hair and shoes,
exposing their families to the danger. Polluted exhaust from the
workplace often spews into the surrounding community and into
the vegetation and waterways we depend on for life itself.
Pesticides and other agricultural chemicals move from the fields
and farms into the plants and stores, and from there home in our
food.
Effects On The Community
There are growing public health concerns about environmental
health – the impact of pollution, toxic chemicals and emissions
on human health. As smog increases in urban areas, there are
increasing warnings especially about the impact on the elderly,
people with asthma and other respiratory problems, and, of
course, children. While experts and government regulator are
often reluctant to acknowledge the impact of pollution on cancer
rates, the fact that a growing number of known occupational
carcinogens are being found in the environment raises concerns.
Pesticides have recently received considerable attention
resulting in the ban of their use land contamination impacts on
property values. Revival of community right to know and
consumer education as a vehicle for community and unions to
encourage their employers to address these issues proactively.
This is a short list, and admittedly incomplete. To it add the
economic burden on the health insurance system, over-crowding
of chronic care facilities, and overwhelming pressure on the
health care system in general. All of these costs and more result
in part from the poisons, pollutants and contaminants generated
by the workplace.
Primary Prevention is the Strategy
Over the past decade, the Canadian Labour Congress has
argued that we need a new public policy to address the
continuing problem of workplace carcinogens and toxic
chemicals. We need a comprehensive approach of pollution
prevention as an alternative to occupational and environmental
exposure limits that have been described as "licences to poison"
because of their ineffectiveness. The only option is to find an
economic process to transform industries dependence on
carcinogens into more environmental sustainable activities. In
that process, some industries will close down, industries whose
closure was inevitable because they were not fundamentally
sustainable. By planning for this, an active program of job
transition would lessen the blow and allow families and
communities to move on with dignity.
What is the Steelworkers Union fighting for?
Through resolutions passed at our union’s National Policy
Conference and policies adopted by the Canadian Labour
Congress, the Steelworkers Union is committed to three major
objectives to prevent cancer,
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The creation of a national exposure registry which would
document toxic workplace exposures over the lifetime of a
worker.
To eliminate or control exposure to workplace carcinogens.
To assist victims and their survivors receive just
compensation.
Some of the activities our union has been involved in:
1. At the local level, Steelworkers have been active in
different ways from lobbying their employer to conduct
epidemiological studies, to holding injured workers clinics
to encourage identifying occupational cancers and
assisting victims with their compensation claims. Without
this local activism, the rest of our unions activities to
support prevention of occupational cancer would not be
effective or possible.
2. At the provincial level, Steelworker health and safety staff
are part of the network of activists lobbying government,
compensation boards, public health, and environment
ministries for stronger laws to prevent cancer as well as
effective policies for the compensation of victims and their
families under workers’ compensation. Recently we have
added the role of lobbying Cancer agencies and Canadian
Cancer Society to make prevention a priority and to
recognize importance of occupational and environmental
exposures. The European Union has already developed a
data base of exposures for industries based on surveys of
workplaces in Finland called Carex. A pilot program to
apply this database to Canada was conducted in both
British Columbia and Ontario.
3. As a participant in the National Committee on Occupational
and Environmental Carcinogens along with representatives
of others from industry, government, non-governmental
organizations, and labour, our Union is part of a
comprehensive review of existing best practices for the
prevention of occupational and environmental carcinogens
and contributed to a set of recommendations to Federal
and Provincial governments regarding a national program.
4. We work with researchers and demand that universities
and government support independent research and
science to identify problems and develop solutions.
One of our most effective tactics has been to negotiate with our
employers either through the Joint Health and Safety Committee
or collective bargaining to reduce exposures to carcinogens and
to conduct necessary research to identify problems and develop
solutions.
Some people argue that we need today to take an entirely new
approach that emphasizes pollution prevention – constructing
work process and products that do not require toxic and cancer
causing exposures. Pollution along with other environmental
challenges such as global warming and acid rain is starting to
have a serious negative economic consequence for both society
and business.
Where do I go from here?
As an active Steelworker member and member of the Canadian
Labour Congress, you have access to as wealth of materials and
opportunities for training and education. Contact your local union
president or staff representative for information.
Our union has opportunities for involvement and networking
among health and safety activists at a regional, district, and
national level. Check us out on the web at www.usw.ca.
Take this information back to where you work and see what
others are willing to do.