Abstract

Cancer is the second leading cause of death in the US, accounting for 1 out of 4 deaths, and cancer incidence is over two-fold higher compared to cancer mortality. Occupational exposures are an important cancer risk factor, exceeded only by tobacco consumption, and infectious disease. However, it is estimated that only less than 2% of chemicals in commerce have been tested for carcinogenicity. In addition, many workers are exposed to multiple carcinogens at low levels, and the effect of exposure to these mixtures is unknown. Therefore, despite progress in understanding cancer aetiology, much is still unknown about the role played by work and workplace exposures. Without a better understanding of the occupational role in cancer aetiology, targeting public health interventions is fraught with difficulty. In October 2015 NIOSH began developing a multistate population-based occupational cancer surveillance system utilising cancer registry data from six states (California, Iowa, Kentucky, Massachusetts, New Hampshire, and Texas), and creating job exposure matrices (JEMs) for use with the cancer registry data. The occupational cancer surveillance system will be used to identify occupational cancer risks, and to explore dose-response relationships using JEMs. It builds upon the successes of a NIOSH pilot initiative begun in 2007 with the California Cancer Registry. By the end of the project in 2019, it is estimated that 3.8 million cancer cases from the six participating states will be available for analysis. For each of these cases, NIOSH will have information on their longest held job (i.e. industry and occupation titles and corresponding codes, and JEM scores for at least four exposures). This presentation will provide the latest findings from the NIOSH occupational cancer surveillance project.