Occupational cancer prevention in Scotland: a missing public health priority

Abstract

Aims. To explore and explain the significance of occupationally-related cancers in Scotland in the context of new estimates of the toll taken by such cancers when compared with other public health priorities such as road traffic fatalities and murders. Materials and methods. The paper examined the evidence base for the estimates through a range of databases, including employment, cancer mortality and morbidity statistics, records of government and other agencies, media databases and data on road traffic fatalities and murders. The paper analyses occupational cancers in the wider public health context. Results. The view that significant occupational cancer threats relate only to past exposures and that many cancers can be explained solely by socio-economic factors and deprivation without reference to work and wider physical environments is misconceived. Recent research indicates that occupationally-related cancer deaths may be running at 12% or more of all cancer deaths. Applying such estimates to Scottish cancer morbidity and mortality figures indicates a much neglected occupational cancer threat to Scotland’s public health. Figures that are available suggest higher levels of occupational ill-health overall in the Scottish workplace. Conclusions. Where high cancer mortality and morbidity exist, it has been argued in Scotland and elsewhere that this simply reflects age and lifestyle factors such as smoking, diet, exercise, sunbathing and factors other than work. This is incorrect. Some solutions are proposed that could readily be adopted in Scotland now and would relocate occupational cancer as a major strand in the public health agenda instead of being irrelevant to it.