1759 The iarc monographs and the burden of occupational cancer

Abstract

This presentation will be about the triad of historical insights, scientific evidence and preventive action. By way of introduction, the history of chemical carcinogenesis (from Pott’s soot to the IARC evaluation of benzo[a]pyrene as a Group 1 carcinogen based on a mechanistic upgrade) showcases the important role of occupational carcinogens in understanding the causes of cancer and related paradigm shifts, primarily over the last century. Similarly, the history of radiation carcinogenesis has significantly learned from occupational exposures and served as a foundation of environmental epidemiology. The IARC Monographs programme is not only the longest running program of cancer hazard identification, it is also on the cutting edge of the latest scientific developments. A short history of the evolution of the program with a focus on causal inference and changing contributions from the different scientific domains (cancer bioassays, epidemiology and toxicology) will be followed by the latest developments in terms of systematic review, key characteristics of carcinogens, high through-put/high content data, and quantitative risk characterisation. The integration of evidence streams into an overall evaluation will be illustrated with a selected carcinogen. The Monographs’ evaluations often serve as the basis for the estimation of the burden of occupational cancer. Important milestones in burden estimates (from Doll and Peto, 1981, to the ongoing joint WHO/ILO undertaking) will be presented. These results are not for debates in an ivory tower of science, but here to inform public health actions, and particularly a vision of zero occupational cancers. Data on the adverse economic impact of occupational cancer together with evidence that out-phasing of occupational carcinogens like asbestos does not have negative economic impact will further support implementation of control measures and should be employed more often. Finally, the presentation will name significant challenges on our roadmap, such as the need for better exposure data and exposure assessment, shift of funding to prevention research including occupational cancer prevention, access to data for research and management of conflict of interests.