Occupational carcinogens : assessing the environmental burden of disease at national and local levels

Overview

This guide provides practical advice for assessing the current burden of disease from past and current occupational exposures to carcinogens. The outcomes of such exposures include lung cancer, leukaemia and malignant mesothelioma. The disease burden is measured in terms of the number and proportion of deaths from these conditions, as well as in terms of total disability (using disability-adjusted life years, or DALYs).

Exposure at national level is estimated using workforce data for the country, as well as exposure data for carcinogens in different industries (based on European data). The relative risk for cancer for each carcinogen is estimated from international literature. This information is combined to estimate the impact in each country of occupational exposures to carcinogens. This figure is termed the population attributable fraction (AF), and AF estimates are presented as fractions of the deaths and disability that are caused by occupational exposures to carcinogens. The number of deaths attributable to the occupational exposures to carcinogens can then be estimated by multiplying the AF by the number of deaths in the country. The extent of disability can also be estimated by multiplying the AF by disease-specific estimates of DALYs.