Attributable Fraction of Cancer Related to Occupational Exposure in Italy

We estimated the number of cancersdue to exposure to occupational carcinogens in Italy. To calculate the attributable fraction of cancer, we used as counterfactual scenario the absence of exposure, and considered prevalence of exposure from 15-20 years prior than cancer to account for the latency. Large-scale studies and meta-analyses were the source of data on relative risk and exposure prevalence. We found that UV radiation, diesel exhaust and wood dust and silica dust were the most prevalent occupational carcinogens. About 60% of cancer in Italy were attributable to asbestos, and mesothelioma had the largest attributable fraction to occupational exposure. Overall, 0.9% of cancer cases and 1.6% of cancer deaths were attributable to occupational carcinogens in Italy, indicating the importance of maintaining a high level of surveillance of carcinogens at the workplace.Abstract: Background: Exposure to occupational carcinogens is an important and avoidable cause of cancer. We aimed to provide an evidence-based estimate of the burden of occupation-related cancers in Italy. Methods: The attributable fraction (AF) was calculated based on the counterfactual scenario of no occupational exposure to carcinogens. We included exposures classified as IARC group 1 and with reliable evidence of exposure in Italy. Relative risk estimates for selected cancers and prevalences of exposure were derived from large-scale studies. Except for mesothelioma, a 15-20-year latency period between exposure and cancer was considered. The data on cancer incidence in 2020 and mortality in 2017 in Italy were obtained from the Italian Association of Cancer Registries. Results: The most prevalent exposures were UV radiation (5.8%), diesel exhaust (4.3%), wood dust (2.3%) and silica dust (2.1%). Mesothelioma had the largest AF to occupational carcinogens (86.6%), followed by sinonasal cancer (11.8%) and lung cancer (3.8%). We estimated that 0.9% of cancer cases (N similar to 3500) and 1.6% of cancer deaths (N similar to 2800) were attributable to occupational carcinogens in Italy. Of these, about 60% were attributable to asbestos, 17.5% to diesel exhaust, followed by chromium and silica dust (7% and 5%). Conclusions: Our estimates provide up-to-date quantification of the low, but persistent, burden of occupational cancers in Italy.