Peters Cheryl E, Palmer Alison L, Telfer Joanne, Ge Calvin B, Hall Amy L, Davies Hugh W, Pahwa Manisha, Demers Paul A
Carleton University, 5411 Herzberg Laboratories, Ottawa, ON, Canada.
CAREX Canada, Simon Fraser University, Harbour Centre Campus, Vancouver, BC, Canada.
Saf Health Work. 2018 Jun;9(2):133-139. doi: 10.1016/j.shaw.2017.07.005. Epub 2017 Jul 20.
Selecting priority occupational carcinogens is important for cancer prevention efforts; however, standardized selection methods are not available. The objective of this paper was to describe the methods used by CAREX Canada in 2015 to establish priorities for preventing occupational cancer, with a focus on exposure estimation and descriptive profiles.
Four criteria were used in an expert assessment process to guide carcinogen prioritization: (1) the likelihood of presence and/or use in Canadian workplaces; (2) toxicity of the substance (strength of evidence for carcinogenicity and other health effects); (3) feasibility of producing a carcinogen profile and/or an occupational estimate; and (4) special interest from the public/scientific community. Carcinogens were ranked as high, medium or low priority based on specific conditions regarding these criteria, and stakeholder input was incorporated. Priorities were set separately for the creation of new carcinogen profiles and for new occupational exposure estimates.
Overall, 246 agents were reviewed for inclusion in the occupational priorities list. For carcinogen profile generation, 103 were prioritized (11 high, 33 medium, and 59 low priority), and 36 carcinogens were deemed priorities for occupational exposure estimation (13 high, 17 medium, and 6 low priority).
Prioritizing and ranking occupational carcinogens is required for a variety of purposes, including research, resource allocation at different jurisdictional levels, calculations of occupational cancer burden, and planning of CAREX-type projects in different countries. This paper outlines how this process was achieved in Canada; this may provide a model for other countries and jurisdictions as a part of occupational cancer prevention efforts.
选择优先职业致癌物对癌症预防工作至关重要；然而，尚无标准化的选择方法。本文的目的是描述加拿大职业致癌物暴露评估与信息交换系统（CAREX Canada）在2015年用于确定职业癌症预防优先级的方法，重点是暴露估计和描述性概况。
在专家评估过程中使用了四个标准来指导致癌物的优先级划分：（1）在加拿大工作场所存在和/或使用的可能性；（2）物质的毒性（致癌性和其他健康影响的证据强度）；（3）生成致癌物概况和/或职业暴露估计的可行性；（4）公众/科学界的特殊兴趣。根据这些标准的具体情况，将致癌物分为高、中、低优先级，并纳入了利益相关者的意见。分别为创建新的致癌物概况和新的职业暴露估计设定了优先级。
总体而言，对246种物质进行了审查以纳入职业优先级清单。对于致癌物概况生成，确定了103种物质的优先级（11种高优先级、33种中优先级和59种低优先级），36种致癌物被视为职业暴露估计的优先级（13种高优先级、17种中优先级和6种低优先级）。
出于多种目的，包括研究、不同管辖层面的资源分配、职业癌症负担的计算以及不同国家的CAREX类项目规划，需要对职业致癌物进行优先级排序。本文概述了加拿大是如何实现这一过程的；这可能为其他国家和管辖区提供一个模式，作为职业癌症预防工作的一部分。
