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Introduction . TABLE OF CONTENTS page Introduction .................................................... 1-2 Section 1-Definition and Identification of Workplace Carcinogens .... ....... 3-43 Introduction .................... 4 Occupational Cancer.............. 6 Cancer in the Work Environment .... 11 Cancer in the Workplace-Part 1. 16 Black Workers and Cancer.......... 20 OCAW Recordkeeping and Cancer ... 23 CIP Bulletin: Ames Test ........... 29 CIP Bulletin: Animal Test.......... 32 Human and Animal Carcinogens ..... 34 Common Occupational Cancers...... 42 Section 2-Risk Assessment and Policy Issues .... 44-50 Introduction ......................... .... 45 Estimating Potency of Carcinogens......... .... 46 How Safe is "Safe"'?.................... ......47 Risk Assessment ....................... .... 48 Section 3-Legislative Protection......... ....................... .51-69 Introduction ..................... .......................... 52 Regulation of Carcinogenic Substances. .......................... 53 Federal California List of Regulated Substances......... ............................... .56 Federal California Cal/OSHA Bulletin to Employers on Regulated Carcinogens. 57 Category 1 Substance List............................ 61 Additional Legislative Protection ...................... 63 Toxic Substances Control Act Federal Right to Know National Labor Relations Act Cal/OSHA Fact Sheets on........................... .............. .66 Hazardous Substances Information and Training Act Access to Medical and Exposure Records Section 4-Union Approaches to Workplace Cancer ................. ..... 70-90 Introduction .................................................... 71 Union Action to Fight Workplace Cancer .............................. 72 PMR Studies .................................................... 73 One Man Scoops the Experts...................................... 80 Medical Testing/Exams ............................................ 82 Controls and Monitoring Information ................................. 84 Occupational Toxic Exposure History............................... 89 References ...... 91-96 Cancer ranked in 8th place in 1900, but is currently the second most common cause of death in the United States. About one in every four people will develop cancer in their lifetime.1 More than 53 million people in the United States (more than a quarter of the population), will dIvelop some form of cancer, from which 20% of the United States population will die. The financial costs are also staggering. Treatment for one individual can range from $5,000 to $30,000; the average is in the area of $20,000 per person. 3 Total national costs from cancer were estimated to approximate $30 billion in 1978. In the past several years, various governmental and private sources have estimated that 70-90% of all cancer is environmentally induced. (This estimate includes cancer caused by cigarette smoking and by nutritional causes). In related studies, epidemiologists for the National Cancer Institute (NCI), the National Institute of Occupational Safety and Health (NIOSH), and the National Institute of Environmental Health Sciences (NIEHS), have estimated 10-38% of all cancer may be due to occupational exposures.5 Most estimates are around 10-20%. However, it is very difficult to make estimates of how much is occupationally caused or caused by any one factor. Although the estimates vary, it is agreed upon that chemicals and environmental factors are leading causes of the rising incidence of cancer in the United States today. Even more important is the fact that occupational cancers can be prevented, by controlling exposure in the workplace. It is known that sometimes cancer does not show up for 15, 20 or even 40 years after the first exposure to a cancer causing substance. Occu- pational exposures are generally involuntary and in many instances workers are never even aware of their exposure. But even brief exposures have been known to cause cancer and in too many cases, cancer cannot be cured. Therefore, the only solution is prevention, which can best be achieved by controlling workers' ex- posure to potentially carcinogenic substances. There have been various attempts at control and regulation of these substances. The issue is fraught with problems. One problem is the differing opinions as to determination and definition of what is carcinogenic (cancer causing). For example, there has been debate about the accuracy of animal vs. human studies as the basis for the determination of carcinogenicity. Once a substance has been identified as carcinogenic, there has been debate over how to incorporate substance regulation into industry. Feasibility issues (technical and economic) are raised and become enmeshed with scientific consideration so that determining a level of exposure which can be adhered to by industry becomes a political as well as a scientific and legal issue. It is in this area that decisions are made about worker exposure to occupa- tional carcinogens. The purpose of this packet is to provide information to individuals about occupational cancer. It is divided into four (4) sections. The first provides background knowledge about what occupational cancer is, what are some of its causes, and an explanation of the various tests which are used to provide evidence for labelling a substance carcinogenic. Included is a discussion of epidemiology, animal tests and short term tests. Section 2 discusses the risk assessment method used to determine the levels of risk associated with exposure to carcinogenic sub- stances. Section 3 contains information about carcinogen regulation on a federal level and in California. It also contains information about other legislative protections which can be used regarding carcinogens. Section 4 provides guidelines for union approaches to workplace cancer. 1 Each section is a complilation of articles and each section also has a list of references for further reading relevant to that section. At the end of the packet, there is a general list of references as well as agencies where infor- mation about cancer is available. FOOTNOTES 1 Part 1 of California Deptartment of Health Services, Cancer Policy Statement, "Carcinogen Indentification Policy; A Statement of Science as a Basis of Policy", July, 1982. Page 1. Available from DHS, 714 "P" Street, Room 599? Sacramento, California 95814. 2 Ibid 3 Epstein, Samual, Politics of Cancer, Sierra Club Books, 1978, Page 8. 4 Kriebel, David, "Cancer: Some Notes for Activists", Science For The People, Vol. 12, No. 3, May/June, 1980, Page 6. 5 Loechler, Ed, "Cancer And The Workplace", Science For The People, Vol. 12, No. 3, May/June, 1980, Page 14. 2 Section 1: Definition and Identification of Workplace Carcinogens SECTION 1 Definition And Identification Of Workplace Carcinogens This section provides some general background information about occupational cancer: what it is, what are some of its causes, and an explanation of the various tests which are used to provide evidence for labelling a substance carcinogenic. Also included are lists of chemicals which have been categorized depending on whether they are known to cause cancer in humans or animals, or are mutagenic in short-term tests. Articles in this section make the point that cancer is on the rise and occupational cancer is being increasingly implicated as playing an important role in the problem. One of the articles concentrates on cancer among blacks and convincingly ties this to workplace exposures. Other articles concentrate on explaining the pros and cons of human tests, animal tests and short term tests as ways of determining the potential for carcinogenicity. Placing chemicals into certain categories based on this determination is a scientific decision. However, the decision about what regulation is demanded by each category is a political decision. IARC, EPA, and OSHA have all established various categories of substances based on test results. The way in which these results are used to decide cancer risk and to determine regulatory action will be discussed further in Sections 2 and 3. For Additional Reading 1) Part 1 of California Department of Health Services Cancer Policy Statement "Carcinogen Identification Policy: A Statement of Science as a Basis of Policy", July, 1982. 2) Moses, Marion, "Cancer And The Workplace", American Journal of Nursing, November, 1979. 3) Goodman, Al, "Epidemic Cancer May Be The Political Issue of The 80's". 4) Polakoff, Philip, "Environmental Cancer...A Closer Look", Hazard Prevention, September/October, 1979. 5) Agran, Larry, The Cancer Connection, Houghton Mifflin Company, Boston, 1977; Chapter 2. 4 Definition and Identification of Workplace Carcinogens Section 1: Additional Reading (continued) 6) Epstein, Samuel, The Politics of Cancer, Sierra Club Books, 1978; Chapters 1, 2, and 3. 7) Association of Scientific, Technical and Managerial Staffs (ASTMS) Document No. 3, "The Prevention of Occupational Cancer", 1980. 10-26a Jamestown Road London, NW1 7DT, England Sections on Epidemiology, Animal Testing and Short Term Tests, Pages 27-32. 8) United States Department of Health, Education and Welfare, "Everything Doesn't Cause Cancer". 9) International Association of Fire Fighters, Department of Research, Health and Safety, "Occupational Cancer And The Fire Fighter", 1982. 10) Bridbord, K., M.D., Wagoner, J., and Blejer, H., M.D. "Chemical Carcinogens", Occupational Diseases: A Guide To Their Recognition, June, 1977. 5 Labor Occupational Health Program "MONITOR" Vol. 8 No. .2, March-April,
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