br pational agent overlapped the agent exposure prevalence

pational agent overlapped, the agent exposure prevalence was calcu-
Painters
lated excluding workers with such similarly exposed profession. As an Polychlorinated biphenyls
example, in the calculation of the PAF for 322455-70-9 cancer, exposure as a Rubber manufacturing industry
hairdresser was subtracted from the estimation of the exposure to Silica dust, crystalline
aromatic amines (See Table S2 for a list of overlapping situational and Trichloroethylene
Wood dust
chemical exposures). Secondly, in cases where multiple exposures in-
Group 2A agents
creased the risk of a speci c cancer, the combined PAF (PAFT) was Art glass manufacture
fi
dependence between risk factors and assuming the RRs were multi- Diazinon
plicative (see Formula 2).
Hairdressers
n
Lead compounds, inorganic
Malathion
(2) Shift work involving circadian disruption
Perchloroethylene
for benzene to 0.06% for ethylene oxyde, while among women, it
The projected number of new cancer cases by age, sex, and cancer ranged from 1.3% for formaldehyde to 0.01% for lindane and poly-
chlorobiphenyls.
and cancer type specific incident rates obtained from the French Cancer
Registries Network (FRANCIM) (Santé Publique France, 2017). These 3.2. Cancer cases attributable to occupational carcinogens and population
incident rates were then applied to 2015 population data to estimate attributable fraction by cancer sites
the number of new cancer cases in 2015 (Institut national de la statis-
tique et des études économiques 2015).
exposures led to 7905 new cancer cases, representing 2.3% of all new
3. Results
cancer cases (for occupational agent and cancer site pairs with suffi-
cient evidence of a causal relationship; see Table 3). Men were dis-
3.1. Prevalence of French population ever exposed to occupational
proportionately affected, with 7336 new cancers cases (3.9% of all
carcinogens during the REP
cases) that can be attributable to occupational exposures as compared
In general, the prevalence of being ever exposed to occupational However, the major cancer types that can be associated to occupational
carcinogenic agents over the REP in France in 2015 was higher among agents were similar in both sexes: the most common cancers caused by
men than among women (see Table 2 for the prevalence of exposure to occupational agents were lung cancers (5621 in men and 294 in
occupational carcinogens). Over the REP relevant for solid cancers women) and mesothelioma (652 in men and 133 in women). In men,
omethylether. Among women, the highest estimated prevalence of ever The PAF of cancer caused by occupational exposure also varied by
exposure over the REP was observed for shift work (6.3%), which is cancer site. Mesothelioma was the cancer site which was impacted the
classified as 2A, to 0.01% for exposures to bischloromethylether, io- most by occupational exposures to asbestos among both men
chlorobiphenyls. Furthermore, over the REP relevant for hematological cavity (PAF = 32.9%), nasopharyngeal (PAF = 19.9%) and lung
cancers, the prevalence of ever exposure among men ranged from 1.3% (PAF = 19.3%) cancers were the sites most impacted by occupational
C. Marant Micallef et al. International Journal of Hygiene and Environmental Health 222 (2019) 22–29
Table 3
The number of new cancer cases and population attributable fraction (PAF) in France in 2015 attributable to exposure to occupational carcinogenic agents, by cancer site.a
Cancer (ICD10) Men
Women
Total
Number of attributable cases PAF (%) Number of attributable cases PAF (%) Number of attributable cases PAF (%)
a These results are for carcinogenic agents (IARC Monograph Group 1) where there is sufficient evidence of a causal relationship between exposure and the development of cancer in humans.
agents among men. Similarly, although at different level among women nasal cavity (PAF = 7.9%), nasopharyngeal (PAF = 5.4%) and lung (PAF = 2.6%) cancers were the sites most impacted by occupational agents (Table 3).
3.3. Population attributable fraction and cancer cases attributable to occupational carcinogens by agents
The number of new cancer cases attributable to occupational agents varied between agents (see Fig. 1 and Table 4). Among both men and women, asbestos exposure caused the largest number of cancer cases (3489 cases in men and 344 in women). In men, asbestos was followed by Chromium VI (1133 cases), working as a painter (780 cases) and silica (429 cases). In women, asbestos was followed to a much lesser extent by Chromium VI (42 cases), nickel compounds (40 cases), and beryllium (26 cases).