Prevention of occupational cancer: a different approach.

The dominant strategy for preventing occupational cancer in the United States is agent-based. An alternative set of preventive strategies based on a more healthful workplace can replace this approach, and not only provides practical guidance on what to do, but also criteria for the prevention of cancer from known or suspected agents and from suspected occupations, not now covered by agent-oriented strategies. The strategy is based on preventing the occurrence of any unfavorable health effect from known or possible carcinogenic exposures. All known occupational carcinogens have other effects detectable earlier than cancer and usually at a lower dose. The proposed strategy is built on the assumption that yet-to-be identified carcinogens will also have this property. Strategies for prevention once exposure to known carcinogens has occurred are also proposed. The benefits include the prevention of other diseases. One large industrial complex has already embarked on such an approach.