Cancer is the occupational disease nobody wants to talk about

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The " C " word - Cancer is the occupational disease nobody wants to talk about

January 2002

Author: Millan

The chemical blaze in east-end Toronto was so out of control that clouds of

thick, black, acrid smoke could be seen from across Lake Ontario on the

spring Saturday afternoon.

Explosions rocked the U.S.E. Hickson industrial plant and rattled buildings

for blocks around, releasing a concoction of toxic substances that swirled

along the skyline. Residents were evacuated from their homes, and emergency

services such as ambulances, the Red Cross and the Salvation army were on

alert. About 350 firefighters were called onto the scene and ended up

spending the night and the next morning battling the fire.

Now, 18 months later, these firefighters are worried. With firefighters

there is no such thing as average exposure to toxic contaminants. A single

fire is all it takes for the combination of toxins, smoke and water to be

harmful, if not lethal. That's what happened 14 years ago when firefighters

began to die of cancer after fighting a spectacular chemical fire in

Kitchener, Ontario. Now firefighters fear the same thing could happen again,

particularly since U.S.E. Hickson is a chemical manufacturer that makes

specialty cements, foundation sealers, architectural coatings, roofing

products, caulking and adhesives.

The Hickson fire resulted in approximately 60 work injury claims, something

that Atkinson is hoping will not be an omen of things to come.

" When I saw that fire, the first thing that went through my mind was: Damn

it, I'm going to be in business for the next 20 years, " says Atkinson, head

of the workers' compensation group for the Toronto Professional Firefighters

Association.

" Seemingly every known carcinogen was present, and a lot of suspected ones

as well. "

Firefighting is a dangerous business, and ironically has become more so due

to technological advances. New chemicals and synthetics have changed the

nature of fires, making them more toxic than ever before.

In terms of toxicity, firefighters are most at risk after the fire is out.

After fighting a fire the majority are only too happy to remove their hot,

heavy and cumbersome breathing apparatus even though smoke, fumes and soot

may still be smouldering - in order to rip walls and tear down ceilings to

make sure the fire is not spreading. Akin to scuba gear, the apparatus

consists of a mask that is fed by a tank that supposedly contains about 30

minutes of air. But that's not the case, say firefighters. At most, the

apparatus is effective for 15 minutes so the tendency is to remove the

device as quickly as possible. That tendency, while understandable, is

dangerous.

There is a growing body of evidence that highlights a relationship between

firefighting and cancer. At least 15 studies show a statistical link between

brain cancer and firefighting. One study that examined the death reports of

6,000 Toronto firefighters led Canadian epidemiologist Aronson to

suspect toxins created by smouldering plastics as the prime culprit. Indeed,

the risk of getting leukemia or brain cancer is so pronounced among

firefighters that those cancers are now treated as a workplace injury in

Ontario: brain cancer is deemed to be a valid claim after 20 years on the

job, as is leukemia for 30-year veterans.

Cancer has become so prevalent that it is said that every Canadian

firefighter knows a colleague who has been afflicted with the disease. " Of

all of the people I've dealt with who developed cancer, not one has said

they regretted what they did, " says Atkinson. " We like what we do. There is

certainly an inherent risk in what we do. But sometimes you wonder. "

A widespread industrial risk

Firefighters, though, are far from being the only workers at risk of

occupational cancer. Traditional bastions of the Canadian economy such as

aluminium, mining, pulp and paper, and steel have always had to contend with

toxic substances - and still do. A recent study by the B.C. Cancer Agency

revealed that pulp and paper workers employed for 15 or more years in

British Columbia mills that used the Sulfite process for the production of

pulp developed more pleural and rectal cancers than men from the general

population.

But even sectors long perceived to be unfettered with hazardous material are

having to come to grips with the issue. Computer programmers, for instance,

are at increased risk of multiple myeloma and cancer of the connective

tissue, as are hairdressers. Teenagers, too, are at high risk. Entry-level

jobs in the restaurant trade are especially notorious as they involve the

frequent use of cleaning agents. Workers in auto repair shops are often

exposed to paint thinners, lead and benzene.

Not even family members are spared. In an overlooked but troubling

phenomenon known as take-home toxins, workers often unwittingly expose

family members of all ages to a slew of toxins brought home from the job.

Contaminants such as arsenic, asbestos, beryllium, lead, mercury,

pesticides, PCBs, and radioactive material have been, and continue to be,

unsuspectingly carried by workers in their briefcases, cars, clothes, and

body. While some family members may not develop medical problems, others pay

dearly. Children, not surprisingly, are the most vulnerable because of their

developing organs. The tragic story of Fitzsimmons is a case in

point.

Sixteen-year-old Fitzsimmons succumbed to mesothelioma, a rare and nearly

always fatal cancer of the lining of the lung virtually always associated

with workplace exposure to asbestos. The teenager developed the cancer from

breathing in the asbestos his father brought home from his job as a

maintenance worker at Holmes Foundry in Sarnia, Ontario. The father,

distraught when he found out how his son contracted the cancer and immersed

in a bitter custody battle over another son with an ex-girlfriend,

barricaded himself in his home and tossed Molotov cocktails into the street.

The three-day standoff came to an end when he was hosed out by firefighters.

" These people used to come out of the plant and their faces would be black

from the smoke and dust, " recalls Bill Hicks, president of Canadian Auto

Workers Local 456. " That stuff was all over the clothes. People didn't

realize the stuff was dangerous. Of course, you'd come home and pick up the

kids to play with. And some of the wives, from washing the clothes, have

fallen ill with cancer. They're what we call bystanders. "

Negative growth

Nobody knows how many bystanders there are. But cancer rates are on the rise

in Canada, accounting for nearly 33 percent of all deaths, an increase from

the 25 percent that was registered during the early '90s. Health Canada

estimates that nine percent of all deaths caused by cancer are contracted on

the job.

All told, an estimated 5,800 Canadians died last year from work-related

cancer. Asbestos, benzene, pesticides and other organic solvents, to name

but a few, have been identified as the principal malefactors behind

work-related cancers.

Also troubling is the rise of other work-related illnesses, such as

respiratory diseases. Occupational asthma, for one, has become a serious

health concern, accounting for up to 20 percent of all adult asthma in the

U.S.. The list of occupations associated with asthma is long and worrisome,

ranging from bakers to healthcare workers to employees handling paints,

plastics, and adhesives. More than 250 substances have been linked with the

development of occupational asthma. Some - like latex products and

isocyanates, a compound used to manufacture polyurethane foams,

thermoplastic elastomers, spandex fibres, and polyurethane paints - are far

more dangerous than others.

It's an ailment not to be taken lightly. People may continue to suffer from

occupational asthma long after the causal agent is removed. A follow-up

study of 75 patients with asthma caused by red cedar dust revealed that only

half the patients recovered, while the others continued to have asthma

attacks for a period of up to nine years after exposure to the culprit was

halted.

" There are still lots of carcinogens and toxic substances in

Canadian workplaces that we have to work to try to get rid of, " says

, director of health and safety with the Canadian Auto Workers. " We

have to identify them and get rid of them to whatever extent we can. "

Employers concur, as do scientists. But identifying the culprits is easier

said than done. While a mere, single incident can wreak havoc with the

health of firefighters, occupational disease induced by exposure to toxic

substances usually arises after a long latency period - a situation that

leads Dr. Nhu Le of the B.C. Cancer Agency to describe it as the " most

serious problem " afflicting occupational research. " Occupational assessment

is difficult because it may take decades of exposure for a disease

diagnosis, " says Le, co-principal investigator and leader of the agency's

oncology research program, one of the very few Canadian organizations to

conduct research on occupational hazards. " You have to go 20, 30 years in

the past and we usually don't have records. "

It makes for tough slogging. All the more so since more than 80 percent of

commercial chemicals have never been tested for toxicity. Of those that have

been tested, the long-term effects of most of these chemicals are largely

unknown, partially because scientists on the whole have concentrated their

efforts on investigating the acute effects of chemicals. The synergistic

effects of these substances also remain, for the most part, a mystery. As a

result, substances end up being identified as carcinogenic - or suspected of

being carcinogens - only after enough people have fallen ill or died.

Indeed, Le and his multi-disciplinary team identify " areas of concern "

essentially by interviewing cancer patients and sifting through death

certificates and then examining their occupations. That's how Le convinced

B.C.'s pulp and paper industry earlier this year to collaborate and support

a study that will examine the seemingly higher risk pulp and paper employees

have of developing Hodgkin's lymphoma.

But that approach is wanting, concedes Le. While indispensable, conducting

studies that identify occupational exposure does not necessarily provide

prompt assistance to workers on the floor exposed to contaminants. And

therein lies the challenge for occupational researchers, according to Claude

Ostiguy, head of research of chemical and biological agents with the

Institut de recherche en santé et en sécurité de travail (IRSST).

" Our challenge now lies in being able to anticipate the problems that may

take place before it happens, and that means always staying on top of new

chemicals and processes, " says Ostiguy.

Established 20 years ago, the IRSST is considered by many to be the premier

Canadian occupational research institution thanks to its down-to-earth

approach to research. The private, non-profit agency conducts fundamental

research but is much more sought after by industry and labour for its

efforts in applicable research.

" We do the kind of research that can be used in the workplace, that can

improve working conditions to prevent occupational injuries and diseases, "

explains Ostiguy. A research initiative, however, is not launched until it

receives the cooperation of industry and labour - not always the easiest of

tasks.

Employers, particularly small-to-medium-sized enterprises, are not always

inclined to change their ways, admits Renée Liboiron, head of health and

safety with the Conseil du Patronat du Québec, the province's largest

business group. " It's not always easy seeing eye-to-eye, " she says. " When

the scientific literature doesn't tell us much, we're less inclined to

change the norms. "

Trying to ban toxic agents or curb exposure limits involves changing

procedures and finding new solutions, all of which costs more than SMEs may

be ready to assume. But the biggest barrier, says Liboiron, is indifference.

Unlike large enterprises, many SMEs fail to keep up to date with the

evolution of the issue - never mind the regulations surrounding occupational

exposure.

Apathy, however, is not the exclusive domain of SMEs. Until recently, health

and safety issues such as toxins in the workplace were deemed as technical

issues and relegated to the backwoods by the Canadian labour movement.

" We can all take a good look in the mirror and ask whether we have been

doing as much as we can to protect our members or whether we were simply

more interested in bargaining for more money, " says of the CAW.

According to a recent report by the Canadian Labour Congress, the majority

of unions have limited provisions within their collective agreements and

have internal union structures which separate health and safety activists

from the executive of the union.

That is slowly beginning to change as the issue is becoming more mainstream,

says King, the national health and safety coordinator of the United

Steel Workers of America. Besides trying to curb or eliminate occupational

exposure through joint committees and collective agreements, labour is

forging alliances with the environmental movement.

" What we have really got to do is get the issue out of the backwater and

broaden it out so that it's a health concern, an environmental concern, "

says King. " It affects all of us, not just workers. "

Millan is a freelance journalist living in Anjou, Québec