Cherrie J W, Hutchings S, Gorman Ng M, Mistry R, Corden C, Lamb J, Sánchez Jiménez A, Shafrir A, Sobey M, van Tongeren M, Rushton L
Institute of Occupational Medicine, Research Avenue North, Edinburgh EH14 4AP, UK.
Institute of Biological Chemistry, Biophysics and Bioengineering, Heriot Watt University, Edinburgh EH14 4AS, UK.
Br J Cancer. 2017 Jul 11;117(2):274-281. doi: 10.1038/bjc.2017.161. Epub 2017 Jun 13.
Work-related cancer is an important public health issue with a large financial impact on society. The key European legislative instrument is the Carcinogens and Mutagens Directive (2004/37/EC). In preparation for updating the Directive, the European Commission commissioned a study to provide a socioeconomic, health and environmental impact assessment.
The evaluation was undertaken for 25 preselected hazardous substances or mixtures. Estimates were made of the number of cases of cancer attributable to workplace exposure, both currently and in the future, with and without any regulatory interventions, and these data were used to estimate the financial health costs and benefits.
It was estimated that if no action is taken there will be >700 000 attributable cancer deaths over the next 60 years for the substances assessed. However, there are only seven substances where the data suggest a clear benefit in terms of avoided cancer cases from introducing a binding limit at the levels considered. Overall, the costs of the proposed interventions were very high (up to [euro ]34 000 million) and the associated monetised health benefits were mostly less than the compliance costs.
The strongest cases for the introduction of a limit value are for: respirable crystalline silica, hexavalent chromium, and hardwood dust.
职业性癌症是一个重要的公共卫生问题,对社会造成巨大的经济影响。欧洲的关键立法文件是《致癌物和诱变剂指令》(2004/37/EC)。为准备更新该指令,欧盟委员会委托开展一项研究,以提供社会经济、健康和环境影响评估。
对25种预先选定的有害物质或混合物进行评估。估算了当前和未来因工作场所接触导致的癌症病例数,包括有无任何监管干预的情况,并利用这些数据估算财务健康成本和效益。
据估计,如果不采取行动,在未来60年内,所评估的物质将导致超过70万例可归因的癌症死亡。然而,只有七种物质的数据表明,按照所考虑的水平设定具有约束力的限值,在避免癌症病例方面有明显益处。总体而言,拟议干预措施的成本非常高(高达340亿欧元),相关的货币化健康效益大多低于合规成本。
引入限值的最有力情形适用于:可吸入结晶二氧化硅、六价铬和硬木粉尘。