Cancer in the Workplace!

Know the Risks! Manage and minimise!

Occupational cancers are a leading cause of work-related death and despite their devastating effects, cancer-causing agents are still used in the workplace. Developed nations are adopting innovative working practices and introducing stringent laws to control exposure to those substances or use less harmful ones. However, the same cannot be said for all of the developing nations.

Occupational cancer is caused wholly or partly by exposure to a cancer causing agent (carcinogen) at work, or by a particular set of circumstances at work.

Regardless of whether you work in the formal or informal sector, and whether it’s outside or indoors, both employers and employees, working in South Africa, should understand the cancer threats, risks and responsibilities associated with their occupation.

Cancer is not a single disease with a single cause or treatment. It develops when cells in the body grow in an uncontrolled and abnormal way. There are numerous types of cancer, each with its own name and treatment and different types of cancer have their different sets of causes. Many occupational cancers affect respiratory organs, or the skin or liver. An individual’s risk of developing a cancer is influenced by a combination of factors including personal habits such as smoking and alcohol consumption, genetics, personal characteristics such as sex, ethnicity, age, exposure to carcinogens in the environment and so on.


Thousands of people die each year from cancer due to occupational causes. It is estimated that occupational cancers are a leading cause of work-related death worldwide. Asbestos related diseases alone account for at least 100,000 deaths worldwide each year. In the United Kingdom, there are an estimated 2.5 million people living with cancer and over 700,000 are of working age. According to a study in Great Britain over one year, five per cent of cancer deaths (8,000 deaths) were attributable to occupational exposure. The number of workplace deaths caused by accidents in the same period was around 200 – so almost 40 times more deaths are attributable to occupational cancer than to accidents.

According to the Cancer Association of South Africa (CANSA) the World Health Organisation (WHO) estimated that 19% of cancers worldwide are caused by environmental factors such as the workplace, causing nearly 1.3 million deaths yearly. Therefore it is very important to reduce exposure to carcinogens and potential carcinogens.

According to CANSA, the South African Cancer registrar doesn’t differentiate between cancers; therefore, there are no specific statistics available for occupational cancers in South Africa.

But this doesn’t mean that occupational cancers are not recognised. CANSA says the following: “While individuals in the South African workplace are protected by staunch legislation, including the Occupational Health and Safety Act, the South African Hazardous Substances Act, as well as The Asturias Declaration, the South African Institute for Occupational Health also helps in informing and advising workers about safe and healthy working environments.

It is difficult to determine a true figure for occupational cancers because of the latent nature of the disease. An individual might be exposed to a cause of cancer and not develop any noticeable symptoms until many years later. With current people moving between different job roles and companies, it can be difficult to determine a specific exposure or cause.

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What causes occupational cancer?

Occupational cancer is caused by exposure to carcinogens in the workplace. Carcinogens are agents that cause the development or increase the incidence of cancer.

Occupational cancer is caused by exposure to carcinogens in the workplace. Carcinogens are agents that cause the development or increase the incidence of cancer.

There are three different types of occupational carcinogens:

Biological carcinogens – some micro-organisms such as viruses have been known to cause cancer, either by damaging cells directly or by decreasing the body’s ability to control abnormal cells, for example Hepatitis B, HIV viruses and so on.

Chemical carcinogens – a number of chemicals are known to be carcinogenic. These chemicals may occur naturally, such as asbestos, be manufactured like vinyl chloride, or be by-products of industrial processes, for example, polycyclic aromatic hydrocarbons.

Physical carcinogens – agents such as ionising and ultraviolet (UV) radiation have the potential to cause cancer. Examples of ionising radiation include X-rays and alpha, beta and gamma radiation. UV radiation can be divided into a number of bands such as UV-B, UV-C etc, some of which are known to cause skin cancer.

Certain occupational circumstances, such as working as a painter or as a welder are also associated with increased risks of some occupational cancers.

Occupational cancer can arise from exposure to many substances or from certain occupational circumstances such as:

  • Asbestos fibres (colorectum, larynx, lung, ovary, pharynx, stomach cancers, mesothelioma)
  • Wood dusts (nasopharynx, sinonasal cancers)
  • UV radiation from sunlight (skin cancers)
  • Metalworking fluids and mineral oils (bladder, lung, sinonasal, skin cancers)
  • Silica dust (lung cancer)
  • Diesel engine exhaust (bladder, lung cancers)
  • Coal tars and pitches (non-melanoma skin cancer)
  • Arsenic (bladder, lung, skin cancers)
  • Dioxins (lung cancer)
  • Environmental tobacco smoke (passive smoke) (lung cancer)
  • Naturally occurring radon (lung cancer)
  • Tetrachloroethylene (cervix, non-hodgkin’s lymphoma, esophageal cancers)
  • Work as a painter (bladder, lung)
  • Work as a welder (lung cancer, melanoma of the eye)
  • The International Agency for Research on Cancer (IARC) lists over 50 substances which are known or probable causes of workplace cancer, and over 100 other possible substances.

The workplace can greatly impact your health. We are at work more than we are at home and if your job involves chemicals and other dangerous hazards you need to be aware of how this can impact your health.

Here are a few ways we can help our employees be more aware of their health and potential problems that can become life threatening problems:

Harmful exposures in the Workplace

Asbestos, diesel exhaust and radon are examples of harmful substances that may be present in workplace settings. These substances can increase a person’s risk for certain types of cancer and should be eliminated or reduced as much as possible. Second hand smoke (from others smoking around you) increases risks of cancers for employees that don’t smoke themselves but are exposed to it in the workplace. Workers who are outside the majority of the day in the heat and direct sunlight are more at risk for certain types of skin cancer.

According to the Cancer Association of South Africa, South Africa has the second highest incidence of skin cancer in the world after Australia. The good news is that skin cancer can be prevented by respecting the sun. The three most common types of skin cancers are basal cell carcinoma (BCC), squamous cell carcinoma (SCC) and malignant melanoma. Overexposure to ultraviolet radiation can also lead to inflammation of the cornea and conjunctiva of the eye, and may cause and accelerate the development of cataracts.

Ways to help prevent

Provide face masks to help reduce the risk of inhaling dangerous fumes. Provide proper ventilation. Make your office a smoke free workplace, have designated areas if you need too, but eliminate any smoking in working areas. Provide protective clothing, shade when possible and sunscreen to prevent burning and too much exposure to the sun.

Unhealthy Behaviors

Certain behaviors can also increase the risk of cancer; tobacco use (including chewing tobacco), excessive alcohol consumption, poor eating habits and lack of physical activity.

Ways to prevent

Again stressing the importance of a smoke free workplace will greatly reduce this risk, Workplace wellness involving lunch and learns on certain key health topics such as eating healthy and stress management, walking programs and healthier choices in vending machines.

Chronic Conditions

Diabetes and obesity are examples of chronic conditions that increase risk for certain types of cancer, including breast, colon, endometrium and pancreas cancers.

Ways to Prevent

Workplace wellness programs with nutritional advice, weight management programs and preventive screenings can help employees be more aware and successfully manage or even prevent chronic conditions.

Control Measures

Thousands of people die each year from cancer due to occupational causes. According to the World Health Organization (WHO), 20-30% of males and 5 -20% of females in the working-age population could have been exposed to an occupational lung cancer risk during their working lives.
Therefore, it’s important to correctly identify carcinogens used in the workplace and put adequate control measure in place to reduce the risk of exposure and harm. This can be achieved by:

  1. identifying any possible carcinogenic substances being used in the workplace (look at the labelling material data sheets
  2. identifying the likely level of exposure and possible emissions or spread of carcinogenic substances determining whether a less harmful substance could be used or produced
  3. looking into engineering controls to completely enclose the process of using or handling of the carcinogenic substance if it can’t be substituted
  4. looking at engineering controls to reduce exposure such as partial enclosure and local exhaust ventilation if total enclosure isn’t possible
  5. developing a process or system of work to reduce exposure using PPE, Personal Protective Equipment (See our next blog: PPE – Is it enough?) this is an important part of the control programme, but it must not be the sole element and must be used in combination with other controls
  6. keeping stocks in closed and clearly labelled containers in secure areas
  7. ensuring any waste or emissions are correctly controlled.

Devise and Implement a Risk Management Programme

Control of carcinogens should sit with your risk management process. There are several ways of conducting risk assessments, but it’s essential that the process you use identifies the risks and those who might be harmed and that control measures are put in place to reduce the risk of harm.

Five steps to risk assessment:

  1. identify the hazards
  2. decide who might be harmed and how
  3. evaluate the risks and decide on precautions
  4. record your findings and implement them
  5. review your assessment and update if necessary.

The workplace is a key setting for efforts to reduce cancer risk among adults. Although some cancer risk factors have
garnered attention in worksite health promotion, others have been somewhat overlooked and may be worth
considering for future interventions. More could be done to take advantage of existing resources and prevention
networks. Efforts to promote cancer prevention in the workplace may need to take an integrated and comprehensive
approach by addressing individual behaviors, organizational culture, policies, and other environmental factors that
influence cancer risk.


  • Tinus Boshoff The South African Labour Guide
  • Peer reviewed by:Dr Lesley Rushton OBE, Imperial College London

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