International conference on environmental and occupational determinants of cancer: interventions for primary prevention
Ivan Ivanov, WHO/HQ, IvanovI@who.int
Worldwide, cancer is the second leading cause of death. In 2008, there were 7.6 million deaths from cancer, alongside 12.7 million new cases. Roughly 19 per cent of all cancers are estimated to be attributable to the environment, including work settings. Environmental and occupational interventions are therefore vital to reduce cancer incidence; and decreasing exposure to carcinogens can be cost-effective and contribute to the overall well-being of communities.
Asturias Declaration: A Call to Action
Twelve million cancers are diagnosed each year worldwide, and each year over 7 million people die of cancer. The majority of all cancers occurs in low- and middle-income countries, and this proportion is increasing. A substantial percentage of all cancers is caused by environmental and occupational exposures. Pregnant women, fetuses, infants, children and workers are especially vulnerable.
Many cancers caused by environmental and occupational exposures can be prevented.
Primary prevention - prevention of the exposures that cause cancer - is the single most effective means of prevention. Primary prevention keeps cancer from ever occurring. Primary prevention saves lives and saves billions of dollars. Primary prevention depends absolutely on independent, publicly-funded research on environmental and occupational causes of cancer.
The Asturias Declaration calls for the primary prevention of environmental and occupational cancer in countries around the world. The following are key recommendations:
- Prevention of the environmental and occupational exposures that cause cancer must be an integral component of cancer control worldwide. Such prevention will require strong collaboration across sectors - the health, environment, labour, trade and financial sectors and among countries, and also with civil society and the media.
- WHO to develop a global framework for control of environmental and occupational causes of cancer that concentrates on occupational and environmental causes of cancer identified by IARC as proven or probable carcinogens.
- WHO to lead development of measurable indicators of exposure and disease to guide cancer surveillance in countries around the world.
- All countries to adopt and enforce legislation for protection of populations, especially the most vulnerable populations, against environmental and occupational cancers.
- All countries to develop communication campaigns that educate populations about environmental and occupational causes of cancer and about preventive strategies.
- Corporations to comply with all rules and regulations for prevention of environmental and occupational cancers and to use the same protective measures in all countries, developed and developing, in which they operate.
- Research to discover still unrecognized environmental and occupational causes of cancers so as to guide future prevention.
The first WHO international conference on the primary prevention of cancer through environmental and occupational interventions took place in Asturias, Spain, on 17-18 March, hosted by the Government of Spain and Government of the Principality of Asturias.
The Conference was opened by HRH Crown Princess Letizia of Spain who called for more health protection at the workplace. The conference attracted substantial political, media and expert attention to environmental and occupational risks factors for cancer and to the opportunities to prevent cancer though environmental and workplace interventions.
The WHO Director for Public Health and Environment Dr Maria Neira highlighted the fact that though there is compelling evidence about occupational and environmental causes of cancer and other chronic diseases, the investment in prevention of such causes remains far too low compared to the potential for saving lives and ill-health and that disease control remains remains disconnected from environmental and occupational health.
The resulting Asturias Declaration is an important milestone in the prevention of occupational and environmental cancer and is hereby transcribed.
All conference materials and the Asturias Declaration can be found at the WHO website: