10th and 11th of

November 2016

2nd BALcanOSH

INTERNATIONAL CONFERENCE FOR REGIONAL

COLABORATION,

BLED, SLOVENIA

WORLDWIDE CANCER

2 World cancer report 2014

EUROPE

3 World cancer report 2014

OCCUPATIONAL CANCER

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• 4% of all cancer deaths are caused by work1

• more than 8% of all cancer deaths in men are due to

occupational exposures2

• several of the most important occupational carcinogens are

relevant beyond the workplace resulting in household (e.g.,

asbestos) and environmental exposures (e,g., diesel engine

exhaust) 2

• the evidence on occupational carcinogenic hazards is still

incomplete2

• 2010-2011 estimates by ILO: ~666,000 fatal work related cancers/year3

• (fatal occupational accidents: 353,000/year)

1 Doll and Peto, 1981 2 Kurt Straif, 2012 3 Nenonen et al 2014

OCCUPATIONAL CANCER IN EUROPE

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• 102500 deaths caused by

malignant neoplasms

(occupational cancers) per

year1

• 32% of the deaths in the

world related to work are

associated with cancers2

• In the EU, 53% of of

work related deaths are

due to cancer3

1 Takala J., 2014, Greek EU Presidency Conference Athens 2 Takala J., 2005, XVIIth World Congress on Safety and

Health at Work, Geneva 3 Takala et al, 2012

APROXIMATE BREAKDOWN OF OCCUPATIONAL

CANCERS BY EU28 MEMBER STATES (2011)

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Takala J, 2011

TITLE

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Text

TITLE

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Text

OCCUPATIONAL CARCINOGENS

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• Approximately 1 in 5 workers in the EU are affected by occupational carcinogens

(23%) 1

• For Canada, the figure is 43% 2 and Australia 37.6% 3

1 Kauppinen et al, 2000 2 Peters et al, 2014 3 Carey et al 2014

Most frequent carcinogens and exposures at work in the United Kingdom

Takala, 2014

CANCER IN ROMANIA

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2007 estimates:

• 42907 cancer cases

~ 1716 caused by occupational

factors 1

• By site: 1

- 5-10 occupational cancers of the

pleura;

- 600-900 occupational lung cancers;

- 100-150 occupational bladder

cancers;

- 20-30 occupational sinuses cancers;

- 20-30 occupational larynx cancers;

- 80-120 occupational leukemia.

Actually: only 6 lung cancers in the

previous 4 years

1 Mates et al, 2007 2 Ministry of Health of Romania, Info Note (Health

related indicators for 2015)

2015 annual report: 2

• 61703 new cancer cases

~ 2468 caused by occupational

factors

OCCUPATIONAL DISEASES IN ROMANIA

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Text

The evolution of verified/confirmed occupational diseases in Romania, 1989-2012

Morbiditatea profesionala in Romania, 2015

OCCUPATIONAL DISEASES IN ROMANIA

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The disease 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 2015 2016

Total number of cases 1002 910 1353 1286 1366 1065 929 879 982 1036 854 207

Occupational diseases

caused by occupational

overexertion

46 49 133 218 394 308 301 263 336 274 342

- osteomuscular 34 47 117 197 384 300 296 258 336 273 333 124

- visual 2 1 0 0 0 0 0 1 0 1 0

Silicosis 209 268 268 308 282 305 237 203 288 293 246 58

Chronic bronchitis 71 62 152 193 174 64 23 29 83 79 72 14

Asthma 98 105 119 90 149 43 32 26 29 17 30

Noise related

occupational diseases213 153 302 178 145 90 67 44 48 23 19

Intoxications 200 146 122 87 58 16 16 12 16 16 35 11

Occupational diseases

caused by exposure to

vibrations

56 32 35 43 30 28 5 4 7 5 3

Asbestosis 12 10 10 8 24 37 109 173 72 249 20

Occupational infectious

or parasitary diseases42 20 42 23 22 46 8 31 16 7 3

Dermatological diseases 23 10 25 19 8 12 5 13 9 8 8

Allergic rhinitis 0 3 4 3 8 3 4 9 8 4 9

Occupational cancer 1 3 1 3 2 7 7 3 5 4 7Diseases of the eye 0 5 6 3 2 3 1 2 0 3 2

Ulcer or perforation of

nasal septum1 1 0 0 1 2 0 0 1 0 0

Bisinosis 0 0 0 0 0 0 0 0 0 0 0

Other occupational diseases 30 43 134 109 67 101 115 67 8 50 67

Morbiditatea profesionala in Romania, 2015

Morbiditatea profesionala in Romania, semestru 1 2016

OCCUPATIONAL DISEASES IN ROMANIA

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National Institute of Statistics, 2016

OCCUPATIONAL DISEASES IN ROMANIA

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Causes:1

• Lack of knowledge or interest among medical doctors

• Lack of benefits

• Lack of information regarding occupational cancer risk

• Employees

• Employers

• Lack of proper “tools” to monitor the risks

1 Mates et al, 2007

VERIFICATION OF OCCUPATIONAL DISEASES

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Laws:

• 319/2006

• The methodology for the implementation of the 319/2006 law

Definition:

• Occupational disease = the disease that is caused by agents that are typical for

the workplace, as well as overexerting certain organs or systems of the body, while

performing tasks related to the workflow.

WORKPLACE RISK FACTORS SHEET

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VERIFICATION OF OCCUPATIONAL DISEASES

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Verification/recognition

• Reporting of suspected occupational diseases is mandatory

• Any medical doctor can report any disease that could be the result of

occupational exposure

• Report: via the “BP1” form

• “Occupational Disease 1”

• Report to: occupational health clinics

• Diagnosis is established

• Verification/confirmation: local public health authority

• “BP2” form (“Occupational Disease 2” form)

• The exposure-disease relation is verified/confirmed

THE OCCUPATIONAL DISEASE LIST

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19

TITLE

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text.

AZBESTOS IN ROMANIA

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• Starting January 2007, selling and using asbestos was banned in Romania

• Businesses were required to dispose of asbestos containing materials

• Products containing asbestos were to be used until finished or changed

According to data from the

National Institute of Statistics

ASBESTOS IN ROMANIA

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The number of employees exposed to asbestos

According to data from the

National Institute of Statistics

ASBESTOS IN ROMANIA

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Counties with asbestos exposure

According to data from the

National Institute of Statistics

OCCUPATIONAL DISEASES IN ROMANIA

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Causes:1

• Lack of knowledge or interest among medical doctors

• Lack of benefits

• Lack of information regarding occupational cancer risk

• Employees

• Employers

• Lack of proper “tools” to monitor the risks

1 Mates et al, 2007

CONCLUSIONS

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• Cancer represents a major public health issue (2 out of 10 deaths, 2nd place after

cardiovascular diseases)

• Scarcity of data on occupational cancer

• Limited resources and high cost of the disease management are arguments for an

involved collaboration between all stake holders

• Careful evaluation of workplace exposures and centralization of information

• Development of prevention programs

THANK YOU!

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• ovidiuene@yahoo.com