Background We have estimated that approximately 6.5% of the Australian working population (n = 587,000) were exposed to respirable crystalline silica at work in 2012. A variety of interventions may be utilised to reduce this exposure and thereby decrease the future number of silica-related lung cancers. The current study aims to model the potential effect of interventions to reduce silica exposure on the future number of occupational lung cancers.
Methods We used the future excess fraction (FEF) method to estimate the future lifetime risk of occupational lung cancer (2012–2094) among Australian workers estimated to have been exposed to silica at work in 2012. This was used as the baseline. We then modelled changes in the prevalence of exposure to silica which might result from interventions at multiple levels (e.g. elimination, isolation, engineering controls) and reapplied the FEF method to estimate how many future lung cancer cases may be avoided.
Results Approximately 0.8% of future lung cancers (n = 5,700) in Australia were estimated to be related to occupational silica exposure among workers who were exposed in 2012. Completely eliminating silica exposure among workers in the construction industry would have the biggest effect on future lung cancer cases, with 3,700 future cases avoided. Other interventions would also be effective: for example, 600 cases would be avoided by restricting worker access to areas near mine site crushers and 200 cases by the use of well-fitted respiratory equipment during road construction tasks.
Conclusions Interventions at all levels of the hierarchy of control may be effective in reducing the future burden of occupational lung cancer due to silica exposure, although as expected we found that elimination would have the biggest effect. This may be realistic for some sectors in construction. These results can be used to show where resources for exposure prevention might best be targeted.
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