Burden of cancer attributable to six occupational exposures in the Netherlands, 2021: a health impact assessment study
Tosca O E De Crom, Iris Eekhout, Ellian Lebbink, Caren Lanting, Susan Peters, Anjoeka Pronk, Calvin GeIntroduction
Although numerous occupational exposures are known to be carcinogenic, the extent to which they contribute to the cancer burden in the Netherlands remains unclear. We estimated the annual cancer burden attributable to six occupational carcinogens in the Netherlands for 2021.
Methods
We selected occupational exposures and related cancer sites classified as group 1 human carcinogens by the International Agency for Research on Cancer, focusing on the six with the highest cancer burden in a UK study. These exposures include asbestos, respirable crystalline silica, diesel engine exhaust, solar ultraviolet (UV) radiation and painter- and welder-related occupational exposures. Population attributable fractions (PAFs), representing the proportion of cancer cases attributable to these exposures, were calculated using Levin’s equation. Input data included the proportion of the population exposed during the relevant exposure period (1971–2011), derived from data from Statistics Netherlands; and relative risks for each exposure-cancer site combination, obtained from existing literature. Cancer incidence data in 2021, obtained from the Netherlands Cancer Registry, were multiplied by the PAFs to estimate the total numbers of attributable cases.
Results
In 2021, an estimated 3932 cancer cases (3.1% of all cases) were attributable to the six occupational exposures, with a greater proportion in men (5.4%) than in women (0.5%). Solar UV radiation contributed to the most cases (1720 squamous cell carcinomas of the skin), followed by asbestos (925 lung cancers, 463 mesotheliomas, 10 ovarian cancers, 9 laryngeal cancers), painter-related exposures (156 lung cancers, 83 bladder cancers), welder-related exposures (201 lung cancers, 11 ocular melanomas), respirable crystalline silica (233 lung cancers) and diesel engine exhaust (187 lung cancers).
Conclusions
Occupational exposures contribute to the cancer burden in the Netherlands, especially among men. Solar UV radiation and asbestos result in the highest numbers of attributable cancers. Targeted exposure control could substantially reduce this preventable cancer burden.