Only scarce data are available to document the burden of occupational factors on the population's health in France. While numerous diseases originate, at least in part, in the working environment, it is for cancers that the most data are available from the international and French scientific literature. This work is thus aimed to estimate the proportion of several cancers that are induced by occupational factors among the French male population. Attributable fractions were estimated for men in France for the year 1999 for lung cancer, pleural mesothelioma, bladder cancer, sino-nasal cancer and leukaemia. Lifelong prevalence of exposure among the population were estimated from French data when available (asbestos and wood dust), and attributable fractions were computed under various hypotheses about relative risks. When no exposure data was available for the French population, attributable fractions published in the international literature were used. Incidence in 1995 (estimated from data of the "Francim" French cancer registers network), and mortality data in 1999 (extracted from Inserm-CépiDC, the national causes of death database), were used to compute the numbers of cases attributable to occupational factors; the numbers of cases compensated by the Social security were compared to these estimations. The number of lung cancers induced each year by agents in the working environment was estimated to be between 2,500 and 5,000. Only for asbestos occupational exposure, the attributable fraction of lung cancers was estimated between 10% and 14% (from 2,000 to 3,000 incident cases). The yearly number of occupationally induced bladder cancers was estimated to be between 600 and 1,000. Even when using the most conservative hypotheses, under-compensation of this cancer seems specially important, since less than 10 cases were compensated by the Social security in 1999. Leukaemia and sino-nasal cancers are also under-compensated, but at a lower extent. It is probable that the main reason of under-compensation is under-reporting by the patients and their treating physicians. A better information about the potential occupational origin of these diseases, which occur mainly after retirement, is needed. (R.A.)
Auteur : Imbernon E
Année de publication
: 2005
Pages : 22 p.
