As part of the 2014-2019 Cancer Plan, the National Network for Monitoring and Prevention of Occupational Diseases (RNV3P), coordinated by ANSES, has recorded and analysed data on more than 11,000 cases of cancer diagnosed between 2001 and 2016. This work, which is essential for improving knowledge of work-related cancers, led to a study of all the occupational situations associated with the diagnosis of 11 types of cancer: bronchus, urinary tract, breast, kidney, larynx, sinus, colorectal, skin excluding melanoma, central nervous system, mature lymphoid blood diseases and myeloid leukaemia.
The analysed data included the exposure circumstances (pollution, industry sectors and work stations), extra-occupational risk factors, and the strength of the link between exposure and disease as estimated by the expert physician. This dataset has given ANSES a precise view of the occupational exposures responsible for cancer, enabling it to contribute its expertise to improve worker health by identifying the exposures and situations in which preventive measures may be necessary.
Occupational cancers: a variety of exposure situations
For each type of cancer identified, ANSES provided a brief analysis of the current state of scientific knowledge on the occupational aetiologies, particularly the recent work of the International Agency for Research on Cancer, and a detailed descriptive analysis of the exposure factors associated with each type of cancer, observed in patients attending one of the centres of the RNV3P network. Exposures for which the link with cancer had been considered low by the practitioner, but for which there are assumptions about carcinogenicity, were analysed in greater depth in order to anticipate any "emerging" situations.
The results presented show that asbestos was implicated in 42% of the studied cases of cancers of occupational origin, far ahead of the polycyclic aromatic hydrocarbons (PAHs) implicated in 6.5% of cases. These cancers of occupational origin primarily occur in the sectors of specialised construction work (16.2%), metallurgy (6.1%), and trade and repair of motor vehicles and motorcycles (5.2%). They mainly affect individuals working in skilled metallurgy trades, mechanical construction and similar activities (22.9%), skilled construction trades and similar activities (22.1%), and drivers of machines and fixed equipment (7.3%).
All these results help complete the picture of the epidemiology of occupational cancers in France, as seen in a network of expert occupational disease referral centres, and strengthen ANSES's expertise in this area.
The RNV3P, a network for vigilance and occupational disease prevention
The RNV3P, coordinated by ANSES, is a network of occupational health professionals that includes the 30 occupational disease clinics (CCPPs) in metropolitan France and six occupational health services (SSTs) that are associate members of the network. Its purpose is to save the data from CCPP consultations and any new occupational health problems diagnosed by the SSTs within a national database (patient demographic data, diseases, exposures, industry sectors, occupations).
The RNV3P uses its data to perform a vigilance task: the early identification of emerging or re-emerging situations involving a risk of occupational disease. The network also works on prevention and the harmonisation of diagnostic practices for diseases related to work and the environment.