Occupational Cancer Exposure & Workplace Safety

Some cancers are caused by things people were exposed to at work, often decades before diagnosis. That delay is what makes occupational cancer easy to miss. By the time it shows up, the job may be long finished. The company may no longer exist. This page covers which exposures are known causes. It covers how workplace limits and health checks are meant to work. It covers what you have a legal right to know. And it covers why your work history belongs in your medical record.

The International Agency for Research on Cancer (IARC), part of the World Health Organization, reviews agents and sorts them into groups. The group tells you how sure the evidence is. It does not tell you how much your own risk goes up. Group 1 means "carcinogenic to humans" — the evidence is considered sufficient. Group 2A means "probably carcinogenic to humans." Group 2B means "possibly." Group 3 means the evidence does not allow a classification either way. Group 3 is not a clean bill of health. It usually means nobody has studied the agent well enough.

Group 1 agents that people meet at work include asbestos, benzene, respirable crystalline silica, formaldehyde, diesel engine exhaust, wood dust, vinyl chloride, hexavalent chromium compounds and ionizing radiation. The jobs are ordinary ones. Think of construction, demolition and renovation, foundries and metalworking, stone cutting and countertop work. Think of painting, rubber making, firefighting, farming, trucking, warehouse work, salons, and healthcare.

Dose and time matter. So does whether controls were in place. Two people with the same job title can have very different exposures. What counts is what you actually breathed, touched or carried home on your clothes. It helps to know how cancer develops. The damage builds up quietly for years before any disease can be found.

In the United States, OSHA sets permissible exposure limits (PELs). These are legal ceilings on how much of a substance can be in the air. They are usually averaged over an eight-hour shift. Employers can be cited for going over them.

There is a large catch, and OSHA says so plainly on its own site: "OSHA recognizes that many of its permissible exposure limits (PELs) are outdated and inadequate for ensuring protection of worker health." Most limits in the agency's Z-tables were adopted soon after the Occupational Safety and Health Act of 1970. They mostly reflect 1968-era values. OSHA notes that employers may want to look at other limits that protect more. NIOSH recommended exposure limits (RELs) are federal advice based on health. The ACGIH threshold limit values (TLVs) come from a private science group. Neither can be enforced. But both may be more current.

The upshot: obeying the law is a floor, not a promise of safety.

For some high-hazard substances, OSHA has separate, tighter standards. These add medical surveillance, meaning regular exams for exposed workers. Take the asbestos standard. Exams must be provided "without cost to the employee and at a reasonable time and place." A licensed physician must do them or supervise them. The employer must hand the worker a written copy of the physician's opinion within 30 days. These exams are meant to catch problems early. They do not replace cutting the exposure in the first place.

OSHA's Hazard Communication Standard covers what workers must be told. You have a right to know which chemicals you handle. You also have a right to know what harm they can do, in words you can follow. Employers with hazardous chemicals must keep labels and safety data sheets. They must train workers to read them. Makers of the chemicals must assess the hazards and pass that word down the chain. Safety data sheets follow a set 16-section format. Labels carry signal words, pictures, hazard statements and safety statements.

A separate standard, 29 CFR 1910.1020, covers access to your own records. Employers must let employees and their chosen representatives see relevant exposure records. Employees must also be able to see their own medical records. If access cannot be given within 15 working days, the employer must explain the delay and give an expected date. Medical records and exposure records must generally be kept for at least 30 years after the job ends. That is exactly the window in which an occupational cancer may appear.

You can file a safety complaint with OSHA. Federal law bars an employer from punishing a worker for doing so.

• Ask for your exposure monitoring records and your medical surveillance file. Do this for every employer where you worked with hazardous materials, and do it while the company still exists.
• Keep your own copy, for good, along with dates, job titles, sites and what you handled.
• Read the safety data sheet for anything you work with often. Ask for training if you cannot follow it.
• Do not take work clothes home unwashed if you handle asbestos, lead or similar hazards. Take-home exposure has harmed family members.
• If you develop symptoms, get them checked. Do not write them off as age or ordinary aches — see cancer symptoms.
• Tell every new doctor your full work history: every job, roughly how long, and what you were around. Most clinicians will not ask.

A clear work history can change what a doctor thinks to look for. For some exposures, such as asbestos, it may also qualify you for screening or surveillance programs you would not be offered otherwise. It can matter for workers' compensation, veterans' benefits and other claims too. In those claims, proving the exposure usually falls to the worker.

Most occupational cancer can be prevented, which is the frustrating part. The causes are known, and the controls exist. Are you still working around a Group 1 carcinogen? Cutting that exposure now is worth more than any monitoring program later.

• CDC / NIOSH — Occupational Cancer
• IARC Monographs — List of Classifications
• National Cancer Institute — Cancer-Causing Substances in the Environment