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The proportion of cancer attributable to occupational exposures
Open accessAbstract
Purpose To review the literature on the estimation of the population attributable fraction (PAF) of cancer due to occupational exposures and to describe challenges in the estimation of this metric. To help illustrate the inherent challenges, we also estimate PAFs for selected cancers diagnosed in the United States in 2010 attributable to work as a painter (causally associated with bladder and lung cancer) and shift work (possibly associated with breast cancer).Methods We reviewed and summarized previous reports providing quantitative estimates of PAF for total cancer due to occupational exposures. We calculated PAF estimates for painters and shift work using methodology from a detailed investigation of the occupational cancer burden in Great Britain, with adaptations made for the US population.Results The estimated occupation-attributable fraction for total cancer generally ranged between 2% and 8% (men, 3%-14%; women, 1%-2%) based on previous reports. We calculated that employment as a painter accounted for a very small proportion of cancers of the bladder and lung diagnosed in the United States in 2010, with PAFs of 0.5% for each site. In contrast, our calculations suggest that the potential impact of shift work on breast cancer (if causal) could be substantial, with a PAF of 5.7%, translating to 11,777 attributable breast cancers.Conclusions Continued efforts to estimate the occupational cancer burden will be important as scientific evidence and economic trends evolve. Such projects should consider the challenges involved in PAF estimation, which we summarize in this report.
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“The variability in these findings may be related to other contributing factors, such as individual differences in susceptibility to carcinogenesis, occupational exposure to carcinogenic agents, and lifestyle [68,69].”
From Shift Work: Disrupted Circadian Rhythms and Sleep—Implications for Health and Well-being (2017) · cites this paper as [69]
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“Previous studies estimated that the total occupation-attributable fraction for all cancer varies at 2–8% [1].”
BackgroundEuropean Code Against Cancer, 5th edition – occupational exposures and cancer
Jochems, S. H. J., Vilahur, N., van Tongeren, M., Albin, M. C., Baldi, I., Consonni, D., Crowley, Q., Fervers, B., Greinert, R., Hoek, G., et al. (2026) · Molecular Oncology · doi:10.1002/1878-0261.70174 · Cited by 4
“It has been estimated that occupational cancers account for approximately 2 – 8% of all cancer cases worldwide [24].”
Occupational exposure to carcinogens in Brazil: An approach
Guimarães, R. M., Muzi, C. D., Meira, K. C., dos Santos, R. D., Saraiva, M. M., & Rohlfs, D. B. (2021) · Archives of Environmental & Occupational Health · doi:10.1080/19338244.2021.1900044 · Cited by 3
“and intensity, assigning higher and lower categories of exposure.(30) However, national data usually do not assess the proportions of different levels of exposure.”
BackgroundCarga de câncer relacionado ao trabalho no Brasil e unidades da federação, 1990–2019
Dutra, V. G. P., da Silva, J. H. C. M., Jomar, R. T., Silveira, H. C. S., Muzi, C. D., & Guimarães, R. M. (2023) · Revista Brasileira de Epidemiologia · doi:10.1590/1980-549720230001.2 · Cited by 3
Ali, W. M., Xiao, W., Jacobs, D., & Kajdacsy‐Balla, A. (2023) · Genes · doi:10.3390/genes14101899 · Cited by 3
“Well-studied risk factors include cigarette smoking and occupational exposures especially in metal workers, painters, and chemical process workers [5,6].”
BackgroundMohamad, N., Rajendiran, S., Hasni, N. A. K., Hassan, N. M. N. N., Shaharudin, R., Bustamam, R. S. A., Bilang, N. L., Omar, M. A., Yazin, N. K. R. M., & Ismail, R. (2025) · BMC Public Health · doi:10.1186/s12889-025-24284-w · Cited by 3
“Based on a review done on the occupational cancer burden in Great Brit-ain, the population attributable fraction of total cancer as a result of occupational exposure ranged between 2% and 8% [28].”
Estimating 10-year risk of lung and breast cancer by occupation in Switzerland
van der Linden, B. W. A., Bovio, N., Arveux, P., Bergeron, Y., Bulliard, J., Fournier, E., Germann, S., Konzelmann, I., Maspoli, M., Rapiti, E., et al. (2023) · Frontiers in Public Health · doi:10.3389/fpubh.2023.1137820 · Cited by 3
“Occupation can be considered as proxy of occupational exposures and working conditions that may result in the development of occupational cancers (3, 6).”
BackgroundLv, F., Xiong, Q., Qi, M., Dai, C., Zhang, X., & Cheng, S. (2024) · Environmental Toxicology · doi:10.1002/tox.24123 · Cited by 3
Jain, A., & Leka, S. (2019) · Cited by 3
Nurses’ returning to work after cancer: A focus group study
You, K.-L., Wang, Y., Zhang, Y., Bender, C. M., Fennimore, L. A., Rosenzweig, M. Q., Dierkes, A. M., Terry, M. A., Raina, K. D., & Thomas, T. H. (2024) · Nursing Outlook · doi:10.1016/j.outlook.2024.102290 · Cited by 2
Almashat, S., Horch, M., Chen, B., & McDiarmid, M. A. (2025) · American Journal of Industrial Medicine · doi:10.1002/ajim.70029 · Cited by 4
Occupational exposure and cancer: an umbrella review
Guimarães, R. M., Dutra, V. G. P., Ayres, A. R. G., Garbin, H. B. D. R., Martins, T. C. D. F., & Meira, K. C. (2022) · Revista Brasileira de Saúde Ocupacional · doi:10.1590/2317-6369/37620en2022v47e14 · Cited by 2
Sedentary Behaviour and Cancer
Swain, C. T. V., Boyle, T., Mahmood, S., & Lynch, B. M. (2023) · Springer series on epidemiology and public health · doi:10.1007/978-3-031-41881-5_9 · Cited by 2
Öztürk, E. N. Y., & Ozturk, M. (2024) · Iranian Journal of Public Health · doi:10.18502/ijph.v53i11.16950 · Cited by 2
“The fraction of total cancer attributable to occupational risk ranges from about 2% to 8% (13).”
Kim, K., & Kim, J. (2020) · Annals of Occupational and Environmental Medicine · doi:10.35371/aoem.2020.32.e30 · Cited by 2
Occupation- and industry-specific cancer mortality among Japanese women from 1980 to 2015
Dhungel, B., Murakami, T., Gilmour, S., Ikeda, S., & Wada, K. (2022) · BMC Public Health · doi:10.1186/s12889-022-14304-4 · Cited by 2
Sharif, P. M., Khoshbin, A. P., Nasrollahzadeh, E., Keshavarz‐Fathi, M., & Rezaei, N. (2023) · Elsevier eBooks · doi:10.1016/b978-0-12-818006-8.00003-7 · Cited by 3
Counil, É., Henry, E., & Ismail, W. (2020) · Environnement Risques Santé · doi:10.1684/ers.2020.1456 · Cited by 2
Iles, K. E., & Dickinson, D. A. (2016) · Elsevier eBooks · doi:10.1016/b978-0-12-803678-5.00053-9 · Cited by 2
Roxo, L., Paiva‐Santos, A. C., Girvalaki, C., Geantă, M., 4P-CAN WP2 study team, & Sousa‐Uva, M. (2025) · Frontiers in Public Health · doi:10.3389/fpubh.2025.1550712 · Cited by 1
Occupations and Risk of Head and Neck Cancers: A Case–Control Study in Tanzania
Mwelange, L. P., Nyarubeli, I. P., Sakwari, G. H., Mamuya, S., & Moen, B. E. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22111643 · Cited by 1
“[10].”
Rygiel, K. (2021) · Archives of Breast Cancer · doi:10.32768/abc.20218268-79 · Cited by 1
Popov, S. V., Guseynov, R. G., Khizha, V. V., Yazenok, A. V., Сивак, К. В., Помешкин, Е. В., Perepelitsa, V. V., Bunenkov, N. S., & Lelyavina, Т. А. (2023) · Cancer Urology · doi:10.17650/1726-9776-2023-19-2-133-145 · Cited by 1
“До 8 % случаев РМП связывают с влиянием профессиональных факторов (обработка красок, резины, нефтепродуктов, работа с электротехническими и химическими процессами) [6].”
Foumani, O. A., Asri, Y., Atarchi, M. S., Esmaeili, S., Damavand, R. S., Sadeghi, G., Leyli, E. K., & Marefati, M. (2024) · Jundishapur Journal of Chronic Disease Care · doi:10.5812/jjcdc-145827 · Cited by 1
“Past publications have estimated that 2% to 8% of total cancer cases are attributable to occupational exposures (14).”
BackgroundPark, D., Zoh, K. E., Lee, Y., Seo, H., Choi, S., Koh, D., Yoon, J., Youn, K., Kang, M., Choi, E., et al. (2024) · Safety and Health at Work · doi:10.1016/j.shaw.2024.11.006 · Cited by 1
“To our knowledge, there has been a lack of research and government reporting on how occupation affects POIs incidence and economic burden in the Republic of Korea (Republic of Korea), which is common in several developed countries [4 e 7].”
Weinberger, S. E., Cockrill, B. A., & Mandel, J. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-52371-4.00023-4 · Cited by 1
Analysis of occupation skills on all cause mortality in Pakistan
Ali, M. G., & Husain, S. N. (2019) · International Journal of Community Medicine and Public Health · doi:10.18203/2394-6040.ijcmph20195833 · Cited by 1
A Working Semantic Model for the Integration of Occupation, Function and Health.
Adisesh, A., Bao, H., Manir, M. S. A., & Baker, C. J. O. (2019) · Cited by 1
Lung Cancer Among Asian Americans
Park, S., Stram, D. O., Rouen, M. D., Gomez, S. L., Wu, A. H., & Cheng, I. C. (2016) · Springer eBooks · doi:10.1007/978-3-319-41118-7_5
Werkgerelateerde kanker in maat en getal
Lenderink, A. F., Sorgdrager, B., & van der Molen, H. F. (2017) · Tijdschrift voor bedrijfs- en verzekeringsgeneeskunde · doi:10.1007/s12498-017-0068-6
Metadata
- Authors
- Purdue, M. P., Hutchings, S. J., Rushton, L., & Silverman, D. T.
- Affiliations
- Ontario Institute for Cancer Research (CA)
- Imperial College London (GB)
- National Cancer Institute (US)
- Corresponding author
- Purdue, Mark P.
- Venue
- Annals of Epidemiology
- Publisher
- Elsevier BV
- Published
- 2015-03
- Volume
- 25
- Issue
- 3
- Pages
- 188-192
- ISSN
- 1047-2797 (ISSN-L)
- PMC
- PMC4631263
- OpenAlex
- W1982873400
- Cited by
- 127
- References
- 41
- Citations by year
- 2026: 11 · 2025: 6 · 2024: 16 · 2023: 19 · 2022: 13 · 2021: 7 · 2020: 10 · 2019: 15 · 2018: 12 · 2017: 10 · 2016: 6 · 2015: 1
- FWCI
- 2.88
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Annals of Epidemiology (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institutes of Health
- National Cancer Institute (ZIACP010123)
- Topics
- Health Sciences › Medicine › Oncology › Global Cancer Incidence and Screening
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Occupational and environmental lung diseases
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Occupational Health and Safety in Workplaces
- Keywords
- occupational cancer, population attributable fraction, occupational exposure, painters, shift work, breast cancer, bladder cancer, lung cancer, cancer burden estimation
- MeSH terms
- Female, United Kingdom, Humans, Male, Neoplasms, Occupational Diseases, United States, Occupational Exposure, Risk Assessment
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