Challenges of Assessing the Occupational Cancer Burden in ... · PAHO / CAREX Network CAREX-update in Central America PAHO / CAREX Network UN GA 66/2 UN Declaration on Prevention

www.worldcancercongress.org

Disclosure of Interest: None Declared Abstract code:

Challenges of Assessing the Occupational Cancer Burden in Latin America and the Caribbean

The Americas’ Regional CAREX Challenge Julietta Rodriguez-Guzman, MD SOH MScA Regional Advisor On Workers’ & Consumers’ Health – PAHO/SDE

PS.4.115-4

Occupational Cancer milestones in the Americas

WHA65.8 Global Action Plan to

prevent NCDs 2013-2020

2008 2009

2010 2011

2012 2013

2014 2015

2016 2017

2020

WHA61.14 Global Strategy for Prevention of NCDs

2008-2013

Expert Forum Regional Plan to Prevent Occ-Ca World Day OHS

On line Occ.Cancer

Course PAHO/CCOSH

Advance assessment

towards CAREX

Asturias Declaration CALL FOR

ACTION

UN GA 66/2 UN Declaration on Prevention

& control of NCDs

Dr. J. Rodríguez Guzman, PAHO/SDE Melbourne, 5 December 2014

GBD 2004

PAHO Plan of Action for Occupational & Environmental Cancer Prevention and Control

Dr. J. Rodríguez Guzman, PAHO/SDE Melbourne, December 5, 2014

Policy: Plan of Action for Occupational Cancer Prevention and Control (Launched in 2008)

Activities done or in process ü  PLAGSALUD 2000-2004 ü  World Day for Safety and Health at Work 2008, 2014 ü  Americas Silicosis Initiative Started 2007… ü  Vaccination Week in the Americas Started 2009… ü  Occupational Cancer on-line course began 2010… ü  CAREX activities started in 2006… ü  Asbestos Atlas for the Americas started in 2009… www.paho.org/saludocupacional/cancer

Current cancer tendencies in the Americas 2nd cause of death in the region: 1.2 M deaths in 2008, 45 % in LAC*

Dr. J. Rodríguez Guzman, PAHO/SDE Melbourne, 5 December 2014

§  Increased mortality of women in most Latin American countries are caused by: §  Lung, breast & cervical cancers §  Colorectal & stomach cancers

§  Increased mortality on men in most Latin American countries are caused by: §  Lung, prostate & colorectal cancers §  Stomach & liver cancers

* No. of deaths could increase to 2.1 M by 2030*

Current cancer tendencies in the Americas

Dr. J. Rodríguez Guzman, PAHO/SDE December 5, 2014

Sources: PAHO Lung Cancer fact sheet, 2014:

Cancer registries

“No data = no problem” àGLOBAL Registries cover 1/6 of POPULATION

à  In the Americas few countries have registries that

cover all or part of the national populations

à Critical for occupational & environmental cancers

Source: American Cancer Society


0 10 20 30 40 50 60 70 80 90 100

Argen&na (2009) N=7.195 Trabajadores Centros de Trabajo

Colombia (2007) N= 924 Trabajadores Centros de Trabajo

Guatemala (2007) N= 4.026 Trabajadores Centros de Trabajo

Nicaragua (C. de León, 2007) N= 771 Trabajadores

Hogares

Chile (2009-‐2010) N= 9.503 Hogares

Prop

orción

de trab

ajad

ores expue

stos (%)

Ruido Vibraciones Gases y vapores/ Sustancias Químicas Materiales infecciosos Movimientos RepeFFvos Posiciones Incomodas /malas posturas Levantar y movilizar cargas pesadas Nivel de atención alto o muy alto Sin pausas de trabajo Acoso por supervisores o compañeros

sOURCES: ArgenFna: González, J. “Las Encuestas sobre condiciones de trabajo y salud son un instrumento para planificar y evaluar las políFcas en salud laboral”. IV Congreso de Prevención de Riesgos Laborales en Iberoamérica Nuevos Tiempos para la Prevención 2010; Colombia: Ministerio de Protección Social. 2007. Primera Encuesta Nacional de Condiciones de Salud y Trabajo en el Sistema General de Riesgos Profesionales; Guatemala: Consejo nacional de Salud y Seguridad Ocupacional (CONASSO), OIT. 2007. Encuesta Nacional sobre Condiciones de Trabajo, Salud y seguridad ocupacional; Nicaragua: Programa Salud y Trabajo en América Central (SALTRA). Perfiles de salud ocupacional en Centroamérica. 2009; Chile: ENETS CHILE 2010 MINSAL-‐ISL-‐MINTRAB.

WORKING CONDITIONS IN SELECTED LAC COUNTRIES


Other ranks: 18. Japan [16] 19.4; 37. Finland [15] 17.6; 55. U.K. [11] 16.0; 56. USA [10] 15.4


Years Life Lost (APYLL): Mesothelioma (years per person; 1994-2010)

Courtesy Prof. Ken Takahashi: Epidemiology & Trends of ARDs A global perspective

Helsinki, FINLAND - February 2014

Rank Country [years] Years 1 Egypt [9] 29.9 2 Cuba [10] 26.2 3 Philippines [6] 25.6 4 Colombia [13] 25.2 5 Ecuador [12] 23.8 6 Moldova [15] 23.6 7 Mexico [13] 22.2 8 Venezuela [12] 22.1 9 Chile [13] 22.0

10 Brazil [15] 21.8 World Average (59 countries) 17.1

Registry of Occupational Diseases LAC

Dr. J. Rodríguez Guzman, PAHO/SDE

Number and rate of Occupational Diseases (x 10,000 workers) in Insured (formal) populations in selected countries of the Americas, 2000 -2010.

5,557 4,101

333,800

224,500

600 394 23,858 17,693 895 9,410 4,274 4,171 5,576 22,872

4.4 2.97

36.7

21.3

9.3 6.2

11.03

5 2.3

13.78 16

11.6 12

18

0

5

10

15

20

25

30

35

40

-‐

50,000

100,000

150,000

200,000

250,000

300,000

350,000

400,000

2000 2010 2001 2009 2000 2003 2003 2009 2000 2010 2001 2009 2000 2009

México Estados Unidos Panama Brasil Colombia Chile ArgenFna

Tasas d

e En

ferm

edades Profesio

nales

por 1

0.000 Trabajado

res

N° C

asos de En

ferm

edades

Profesionales NoF

ficadas

Casos de EP (Numeros) Tasa EP (x 10.000)

European Union

Fuente: Solar, O. Elaboración con base en estadísticas disponibles en-línea de los países mencionados. Consultora OPS, 2011 Melbourne, December 5, 2014

CRITICAL ISSUES OF STATISTICS & QUALITY OF DATA IN THE AMERICAS

INFORMATION NOT RELIABLE BECAUSE: à  Varied & multiple sources cause:

à  Overlaps, overestimations and/or underestimations à  Poor quality, not robust

à Occupational injury rates with big ranges 0.8-34%: Variation & dispersion à Morbidity for OD almost inexistent (< 5%) à  Average No. of days lost due to medical absenteeism estimated 8-25.5? Days à  Very high under-diagnosis and under-registration of Occupational diseases

2006 & 2011: RPAà Balance & Results


WHA65.8 Global Action Plan to


2008 2009

2010 2011

2012 2013

2014 2015

2016 2017

2020


2008-2013


On line Occ.Cancer

Course PAHO/CCOSH

Advance assessment

towards CAREX


ACTION

REGIONAL CAREX Workshop training

OCRC/IDRC/INC/PAHO

CAREX-Peru Workshop

PAHO-MoH


& control of NCDs

GBD 2004

GBD 2010


TOOL KITS FACT-SHHETS

E-TOOLS PAHO / CAREX

Network

PAHO Guideline for building CAREX in

LAC countries


Occupational Cancer CAREX Strategy & Balance up to date


à  Country experiences: CAREX: COR – NIC- PAN 2006-2008, - GUA 2012 CAREX-Canada: 2009 à up to date CAREX-Colombia 2011 à up to date COL Public policy, Action Plan & surveillance system INC/UEB 2009 à up to date

Dr. Timo Partanen FIOH/IARC/IRET

Asturias, Spain 2011: Needs to act global/regional/country to: ü  improve data & registries ü  strengthen information systems ü  record exposure to carcinogens (CAREX) ü  Estimate burden of disease

Occupational cancer national profiles may vary according to:


ü Principal industrial sectors, defining carcinogen exposures ü Compliance of OHS Standards ü Access to Workers’ Social and legal Protection ü Access to OHS and healthcare services

à Exposure rates are expected to be greater for workers where workplaces do not comply with OHS & Wellbeing regulations, social protection (Workers’ Compensation & Health systems), and no preventive/control measures are taken for airborne carcinogenic contaminants.

Occupational Cancer Balance in the Americas

Occupational Cancer Balance in the Americas

How is the construction of the Regional CAREX advancing?


No CAREX

Exposure measures available

National labor

force stats available

Occupational hygiene & research capacity

Preliminary exposure estimates

Enhanced or refined

exposure estimates (Levels)

Burden of occupational

cancer

Knowledge translation Resources (Website)

Registries, information

systems, surveillance &

prevention plans

ARG BRA CHI CUB GRE MEX PER VEN ENG-CAR

FEW FEW

LABS & ESCARCE SERVICES University

ALL NATIONAL

STATS Institutes

CAN COL COR GUA NIC PAN

CAN COL COR

CAN CAN COL(p) CAN

REG

ION

AL

CA

REX

OF

TH

E A

MER

ICA

S 20

17

Source: Regional CAREX Workshop Proceedings. Draft report. 2014

TOOL KITS FACT-SHHETS

E-TOOLS PAHO / CAREX

Network WHA65.8 Global Action Plan to


2008 2009

2010 2011

2012 2013

2014 2015

2016 2017

2020


2008-2013


On line Occ.Cancer

Course PAHO/CCOSH

Advance assessment

towards CAREX


ACTION

REGIONAL CAREX Workshop training

OCRC/IDRC/INC/PAHO

CAREX-Peru Workshop

PAHO-MoH

CAREX-Workshops ARG / CHI / MEX Caribbean

PAHO / CAREX Network CAREX-update in Central

America PAHO / CAREX Network


& control of NCDs

GBD 2004

GBD 2010


CAREX-PAR-URU-BOL-ECU- SUR-VEN-USA

PAHO / CAREX Network

AMRO Regional CAREX-Report to WHA 2017

Regional Occupational Cancer Burden built Occupational Cancer

rates decreased Prevention enhanced

PAHO Guideline for building CAREX in

LAC countries


www.worldcancercongress.org

Disclosure of Interest: None Declared Abstract code:

Thank you! [email protected] – [email protected] - [email protected]

Julietta Rodriguez-Guzman, MD SOH MScA Regional Advisor On Workers’ & Consumers’ Health – PAHO/SDE

PS.4.115-4

Documents

Challenges of Assessing the Occupational Cancer Burden in ... · PAHO / CAREX Network CAREX-update in Central America PAHO / CAREX Network UN GA 66/2 UN Declaration on Prevention