ObjectivesTo estimate the numbers of workers exposed to known and suspected occupational carcinogens in Canada, building on the methods of CARcinogen EXposure (CAREX) projects in the European Union (EU).MethodsCAREX Canada consists of estimates of the prevalence and level of exposure to occupational carcinogens. CAREX Canada includes occupational agents evaluated by the International Agency for Research on Cancer as known, probable or possible human carcinogens that were present and feasible to assess in Canadian workplaces. A Canadian Workplace Exposure Database was established to identify the potential for exposure in particular industries and occupations, and to create exposure level estimates among priority agents, where possible. CAREX EU data were reviewed for relevance to the Canadian context and the proportion of workers likely to be exposed by industry and occupation in Canada was assigned using expert assessment and agreement by a minimum of two occupational hygienists. These proportions were used to generate prevalence estimates by linkage with the Census of Population for 2006, and these estimates are available by industry, occupation, sex and province.ResultsCAREX Canada estimated the number of workers exposed to 44 known, probable and suspected carcinogens. Estimates of levels of exposure were further developed for 18 priority agents. Common exposures included night shift work (1.9 million exposed), solar ultraviolet radiation exposure (1.5 million exposed) and diesel engine exhaust (781 000 exposed).ConclusionsA substantial proportion of Canadian workers are exposed to known and suspected carcinogens at work.

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results interpretation, and original drafting of the work. Authors #45-48 contributed to the original conception of the project and secured project funding. Authors 7-48 participated in data acquisition and data analysis design of the project. All authors participated in critical revision of the manuscript and provided approval of the finalized submitted version.

The majority of current research assesses exposures in the population with similar methods as studies did decades ago. Though there is evidence for the development of newer approaches, more concerted effort is needed to better adopt exposure assessment methods with more transparency, reliability, and efficiency.

Rationale and objectives:We expanded upon a previous pooled case-control analysis on diesel engine exhaust and lung cancer by including 3 additional studies and quantitative exposure assessment to evaluate lung cancer and subtype risks associated with occupational exposure to diesel exhaust, characterized by elemental carbon (EC) concentrations. Methods:We used a quantitative EC job-exposure matrix for exposure assessment.Unconditional logistic regression models were used to calculate lung cancer odds ratios (ORs) and 95% confidence intervals (CI) associated with various metrics of EC exposure.Lung cancer excess lifetime risks (ELR) were calculated using life-tables accounting for allcause mortality. Additional stratified analyses by smoking history and lung cancer subtypes were performed in men.Results: Our study included 16,901 cases and 20,965 controls. In men, exposure-response between EC and lung cancer was observed: ORs ranged from 1.09 (95% CI 1.00, 1.18) to 1.41 (95% CI 1.30, 1.52) for the lowest and highest cumulative exposure groups, respectively. EC-exposed men had elevated risks in all lung cancer subtypes investigated; associations were strongest for squamous and small cell carcinomas and weaker for adenocarcinoma. EC-lung cancer exposure-response was observed in men regardless of smoking history, including among never smokers. ELR associated with 45 years of EC exposure at 50, 20, and 1 μg/m 3 were 3.0%, 0.99%, and, 0.04%, respectively, for both sexes combined.

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This is the first study to quantify the burden of lung cancer attributable to occupational DEE exposure in Canada. Our results underscore a large potential for prevention, and a large public health impact from occupational exposure to low levels of DEE.

These evaluations demonstrated that automatically assigned modules can reliably reproduce an expert's module assignment without the direct involvement of an industrial hygienist or interviewer. The feasibility of adapting this framework to other studies will be language- and exposure-specific.