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191 SHECAN - Methodology for the health impact assessment: the strengths and weaknesses of this approach
  1. L Rushton,
  2. Hutchings
  1. Imperial College London, London, United Kingdom


Objective To provide current estimates of occupational cancers in the EU associated with the relevant substances and future trends under different scenarios of change of exposure; these data provide the input into the socioeconomic assessment.

Methods We calculated attributable fractions together with numbers of deaths and cancer registrations, Disability Adjusted Life Years (DALYs) and Years of Life Lost using risk estimates from published literature and national data sources to estimate proportions exposed.

Results More than 1,000 attributable cancers were estimated to occur in the next 60 years for each of eleven substances if no action is taken; total estimated attributable deaths over this period were >700,000. Respirable crystalline silica (RCS) and diesel engine exhaust were particularly important giving an estimated 470,000 and 430,000 incident cancers between 2010 and 2069. There were only seven substances or mixtures where there was a health benefit in terms of avoided cancer cases over the 60 years from introducing an OEL giving between 0.2% and 39% reduction in deaths from the baseline estimate. The largest benefits arise from the introduction of OELs for RCS, hardwood dust, hexavalent chrome and rubber fume. The highest percentage reduction in incident cases was for the OEL for rubber fume (39%), followed by hardwood dust at 1 mg/m3 (28%) and RCS at 0.05 mg/m3 (23%).

Conclusions Assumptions made in our methodology and uncertainties and inaccuracies in the data may have introduced biases into our estimates. Potential sources of bias include inappropriate choice of risk estimates, imprecision in the risk estimates and estimates of proportions exposed, inaccurate risk exposure period and latency assumptions and a lack of separate risk estimates in some cases for women and/or cancer incidence. However, the results form a robust basis on which to carry out a socio-economic comparison of the health benefits and costs of compliance.

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