Occupational Cancer in France: Epidemiology, Toxicology, Prevention, and Compensation

Abstract

This article is a description of the current situation in France with regard to occupational cancer: research, prevention, and occupation. Toxicologic experiments are carried out using in vitro and in vivo tests, particularly using transgenic mice. Several epidemiologic studies have been conducted over the last decades: population-based case-control studies; mortality studies and cancer incidence studies carried out in historical cohorts of workers employed in the industry; and case-control studies nested in occupational cohorts. French ethical aspects of toxicologic and epidemiologic studies are described. The results thus obtained are used to establish regulations for the prevention and the compensation of cancers attributable to occupational exposure. This French regulation for prevention of occupational cancer involves several partners: a) the states authorities, including labor inspectors, responsible for preparing and implementing the labor legislation and for supervising its application, particularly in the fields of occupational health and safety and working conditions; b) the Social Security Organisation for the analysis of present or potential occupational risks based on tests, visits in plants, complaints or requests from various sources, and statistics. These activities are performed within the framework of the general French policy for the prevention of occupational cancer. This organization includes the National Institute for Research and Safety, particularly involved in research in the various fields of occupational risks-animal toxicology, biologic monitoring, exposure measurements epidemiology, psychology, ergonomy, electronic systems and machineries, exposure to chemicals, noise, heat, vibration, and lighting; and c) companies where the regulation defines the role of the plant manager, the occupational physician, and the Health, Safety and Working Conditions Committee (comprising the manager, employees' representatives, the occupational physician, and the safety department) in dealing with any problem regarding safety, occupational hygiene, and working conditions. These organizations along with medical practitioners are involved with the compensation of occupational cancers. The regulation for compensation includes the tables of occupational cancer, the possibility of recognition of a cancer case when the requirements of the tables are not met, and the postprofessional follow-up of workers exposed to a carcinogenic agent. -Environ Health Perspect 107(Suppl 2): 245-252 (1999). http.//ehpnetl.niehs.nih.gov/docs/1999/Suppl-21245-252aubrun/abstract.html

Occupational cancer in Italy: Evaluating the extent of compensated cases in the period 1994–2006

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Occupational Exposure to Carcinogens and Occupational Epidemiological Cancer Studies in Iran: A Review

“…Additionally, further systematic exposure monitoring surveys will help to identify potential high-risk occupational environments for future risk management planning and facilitate and can inform the exposure assessment and assignment of future epidemiological studies [64,66].…”

Reach: An Unprecedented European Initiative for Regulating Industrial Chemicals

“…Based on highly conservative and undocumented estimates that occupation is responsible for only 4 percent cancer mortality (72), the number of compensable cases in France in 1999 should have been approximately 7,000 (66). However, the 4 percent estimate was based on just a guess by a prominent U.K. epidemiologist, an undisclosed industry consultant (Table 8), and contrary to prior confidential industry estimates of more than 20 percent (69).…”

“…Not surprisingly, more and more workers are now suing their current employers or former employers to increase compensation or to obtain any compensation. Related considerations include the underreporting of occupational cancer by poorly informed workers, and physicians without occupational expertise, particularly pneumologists (66,67), and that most cancers are diagnosed after retirement, when their occupational causation tends to be unrecognized (66)(67)(68)(69).…”