Impact case study database

Research to help identify the environmental causes of cancer has important consequences in terms of public understanding of risks and in official government policy, particularly in workplaces where people often experience higher exposure to carcinogens than the general public.

Epidemiological evidence is most influential in the process of hazard identification, with the IARC only categorising agents as proven human carcinogens when there is convincing evidence of risk from a number of different populations. Research studies, such as the work on lead metal and compounds undertaken by Cherrie, has influenced the recommendation to a future evaluation of the carcinogenicity of this metal and its compounds. This metal was last classified as a probable carcinogen in 2006, but recommended by IARC for re-evaluation as a high priority (October 2019) [5.1].

In addition to hazardous chemicals, there are other workplace exposures that may cause cancer, including for women working on night shifts. A number of epidemiological studies have shown an increased risk of breast cancer associated with long-term night work, although in a recent systematic review, in which Cherrie participated, the evidence in the literature was found to be limited. However, when IARC recently reviewed this topic, it was concluded that night shift work should continue to be classified as probably carcinogenic.

Cherrie contributed from 2015 onwards to reviews of carcinogens as part of the Workplace Health Expert Committee (WHEC) of the British Health and Safety Executive (HSE) [5.2]. These WHEC reviews have influenced government policy in relation to respirable crystalline silica, diesel engine exhaust particulate and welding fumes. In the case of welding fumes, advice from the WHEC reviews has resulted in much tighter legal constraints on employers carrying out this type of work (HSE, 2019). Workplace carcinogens are now clearly recognised by the HSE as the main cause of death from work activities; workplace cancer deaths are more than fifty-times the number of deaths from accidents at work [5.3].

The British cancer burden study findings increased pressure on the European Commission to act to update European legislation on occupational carcinogens and mutagens, which resulted in the SHEcan research, led by Cherrie. Between 2017 and 2019 the Commission updated the Carcinogens and Mutagen Directive in Europe with the SHEcan research results used as part of the justification for change, particularly in the legislative impact statement prepared by the Commission [5.4, 5.5] and subsequent political discussions between governments, employers and trade unions about the legislation, e.g. by the European Parliament [5.6]. Three sets of amendments to the Carcinogens and Mutagen Directive have been published by the Commission and these were all approved by the appropriate European institutions. The final Directive 2019/983 entered into force on 10^th July 2019 and has new binding occupational exposure limit values for twenty-five hazardous substances, including respirable crystalline silica, cadmium, beryllium, arsenic and formaldehyde, leading to an estimated 100,000 fewer deaths over the next 60 years.

The research has also increased the public attention on carcinogens at work, and the Institution of Occupational Safety and Health (IOSH), the leading workplace safety and health organisation around the world (44,000 members in 120 countries) has used the results to develop a campaign to reduce risk, leading to the “No Time To Lose” (NTTL). Cherrie advised on the key priorities for the campaign. Cherrie has also participated in specific initiatives in the NTTL campaign since its launch, e.g. a silica stakeholder summit to discuss action to reduce risks, and he has also spoken at specific campaign launch events and other events to provide information. By the end of 2019, the campaign had secured the formal support of over 360 employer organisations around the world. Campaign ambassadors and supporters have made presentations at over 250 events, reaching over 18,000 delegates. Almost 150,000 people have visited the project website and downloaded about 120,000 information resources [5.7].

The success of the grassroots IOSH campaign has encouraged further discussion, about the role of legislation in improving working conditions for carcinogen exposure. Cherrie has promoted the idea of continuous change (kaizen) though invited conference keynote presentations and networking as a more effective strategy than relying on just binding occupational exposure limits (OELS), the regulatory values which indicate levels of exposure that are considered to be safe (health based) for a chemical substance in the air of a workplace.

This is particularly important for substances such as diesel engine exhaust particulate, where the SHEcan research showed a large number of cancers being caused.