CIS Newsletter

No. 214
July 2007

CIS Newsletter celebrates 19 years & still going strong!
Bringing news to over 140 countries in the CIS Network!


  1. Editorial
  2. News from CIS HQ - CIS Annual Meeting 2007 information
  3. News from around the World - Central Africa, Chile, Germany, Ireland, Russia, Switzerland and the USA
  4. OSH News Briefs
  5. FOCUS NEWS FROM FINLAND - Increasing Awareness and Knowledge of Occupational Cancer: Summary Report of Workshop Held on the 27th April 2007 in Hanasaari, Finland by Dr Fabrizio Giannandrea


Dear CIS Colleagues

The CIS Annual Meeting 2007 is fast approaching - have you informed CIS HQ that you are attending? See also some more details regarding the Annual Meeting in this Newsletter.

You will see in this edition many activities and developments are taking place around the world that are informing, advising and training people of all ages, and especially the young people just starting their working lives or hoping to gain work experience during the summer holidays.

ACTION by you... If you wish to send any reports re your activities and events - please send for the next CIS Newsletter. Likewise if you wish to send notice of any of your future planned events please let me know. Anything you do - even the smallest event will bring safety and health to the forefront in your country. Don't forget to look at the web site

More information and early preparations are now taking place for our 2007 CIS Meeting - in Düsseldorf, Germany, on Wednesday 19 and Thursday 20 September 2007.

The Meeting is being organized jointly with the European Agency for Safety and Health at Work. The CIS Meeting will be held at the same time as the European Agency has its meeting of focal points, some of which are also our centres.

The Meeting will be held in conjunction with the A+A 2007 Congress and Trade Show, jointly sponsored by BASI (Bundesarbeitsgemeinschaft für Sicherheit und Gesundheit bei der Arbeit), the ILO, the European Agency and other safety and health bodies.

Please note that hotel accommodation is already getting booked up - so the advice is book early - like now! Some of us have booked at the Mondial Hotel, Graf-Adolf Strasse 82, Central Dusseldorf | Tel +49 0211 173 9920 | Fax:+49 0211 162 678 | | Email: Costs 125 euros per night. (Centrally located near stations and a little cheaper than the hotel near the Congress site)

And because of the joint meeting there will NOT be any Training Workshops for CIS members this year.

Thanks for the publications, emails and news received from you this past month - these are always gratefully received and are used as soon as possible. So now we can share the information worldwide...

Publicity... tell them, tell them and tell them again... Remember >>>>

Use the CIS Logo on your web site and publications!

Thriving in 2007... Keep promoting and telling the World at large that CIS and its network exists!

You know I welcome ideas for inclusion in the future editions of this Newsletter. It is amazing how much the CIS Newsletter content gets re-used around the world. Take advantage of free publicity! Remember you can see CIS Newsletter on the web site where back issues are stored.

Changed email number recently? Please let me know of any changes so that I can continually alert you to when the new edition of CIS Newsletter is available via this website

All good wishes to you, your families and your colleagues.

Sheila Pantry, OBE

85 The Meadows, Todwick, Sheffield S26 1JG, UK
Tel: +44 1909 771024
Fax: +44 1909 772829

Please consider the environment before printing this Newsletter
Feel free to use this Newsletter on your own web site/pages/e-news






Opening by the Representative of the ILO Director-General

Election of the Chairperson of the Meeting

Adoption of agenda; adoption of the 44th CIS meeting's report (Geneva, 2006)

Report on CIS activities and innovations, including new collaborative databases and future plans, by Gábor Sándi (Head of CIS)




Report of CIS Network activities, by Annick Virot (CIS Centres Coordinator)

Short presentations on individual Centres




Promotion of the XVIII World Congress on Safety and Health at Work (Seoul, 2008), including a short video presentation by the Korea Occupational Safety and Health Agency (KOSHA)

General discussion of the role and activities of the Centres network

Sharing of informational activities between CIS and its Centres

Shared promotional activities (Promotional Framework for Occupational

Safety and Health Convention; World Day for Safety and Health at Work)




Please also note that the Collaborating Centre of Chile has just advised of the change of the person in charge for CIS activities:

Sra. Adriana Moreno Fuenzalida (instead of Mr Perez), e-mail address:

This e-mail address as «second address», as is the main address for Unidad de Condiciones y Medio Ambiente de Trabajo


Dear Colleagues,

In view of the next annual meeting of CIS Centres (Düsseldorf, 19-20 September 2007), we invite all Centres, whether or not they will be attending the meeting, to prepare a PowerPoint presentation on their activities.

Please send your contributions by email:

This should be sent to CIS before 31 August 2007, so that a CD of all the presentations may be distributed to the meeting participants.

We thank you in advance for your collaboration and send you our best wishes.

Gábor Sándi
Head, CIS


Chers Collègues,

En vue de la prochaine réunion annuelle des Centres CIS (Düsseldorf, 19-20 septembre 2007), nous invitons les Centres qui le souhaitent, qu'ils participent ou non à la réunion, à préparer d'ici au 31 août 2007, une présentation PowerPoint de leurs activités. Nous pourrons ainsi réaliser un CD qui sera distribué aux participants. Nous vous remercions par avance de votre collaboration et vous adressons nos meilleures salutations.

Gábor Sándi
Chef, CIS

PS. Merci d'envoyer vos contributions par courrier électronique à:


Estimados Colegas:

En previsión de la reunión anual de los Centros CIS que se realizará en Düsseldorf, Alemania, los 19 y 20 de septiembre de 2007, invitamos todos los Centros que lo desean, que asistan o no a la reunión, a enviar al CIS una presentación PowerPoint de sus actividades to

Eso nos permitirá realizar un CD que será distribuido durante la reunión.

Mucho les agradeceríamos si pudieran enviarnos su presentación por

correo electrónico a antes del 31 de agosto de 2007.

Gracias por su colaboración y cordiales saludos.

Gábor Sándi
Jefe, CIS

News from Russia

Promoting sustainable enterprises: safe work is also good business

"Sustainable enterprises cannot afford to have injuries and diseases at work, which would not only interrupt operations but may have strong economic and reputational consequences". Eleven enterprises from the Leningrad region in Russia's North-West had a chance to check this statement from an ILO report to the International Labour Conference* against daily practice. Olga Bogdanova reports from North-West Russia.

"I will make no secret of it: practically all participants in our group were quite sceptical at the beginning", says Gennady, chief safety engineer at a pulp-and-paper mill. "Indeed, I have worked at this enterprise for almost 15 years and I thought I knew everything about it, especially on occupational safety. 'What can they teach me', I thought to myself..."

Gennady works for one of the 11 pilot enterprises selected under an ILO project funded by Finland to improve occupational safety and health (OSH) systems in North-West Russia. The pilots tested a new ILO methodology for recording and reporting the economic costs of occupational accidents.

Gennady and the other project participants soon realized that they were mistaken with their sceptical attitude towards the project. The new accident cost methodology, developed in Finland, Canada and the United Kingdom was adapted by the ILO project to the specific conditions in Russia.

Thanks to the new methodology, the Russian OSH experts realized that the real cost of accidents was in some cases four to five times higher than they previously thought.

"We always thought about accident costs only in terms of equipment damage and medical expenditures for injured workers. We have never considered indirect costs related to the interruption of the work process, investigation costs, additional measures to prevent similar accidents in future etc. Moreover, enterprises with high accident rate make higher payments to the Social Insurance Fund. When we summed up all our losses, we were literally shocked", says Gennady.

The pilot group applied the new methodology to 58 occupational accidents revealing considerable costs up to 700,000 roubles (US$ 28,000) in 33 cases.

Project participants further developed their newly acquired knowledge at a series of workshops organized by the project in cooperation with the Leningrad Regional Committee on Labour and Social Protection. With their calculators at hand, they learned that it can cost them up to four to five times less to prevent occupational accidents than to deal with their consequences.

"What's more, good working conditions improve productivity", explains Wiking Husberg, senior ILO OSH specialist in Moscow.

In addition, the project published a brochure entitled "Reduce Risks - Cut Costs" that presents the new methodology in a very simple way and may be used as a reference at the enterprise level.

The 11 pilot enterprises are now introducing the ILO-OSH 2001 management system which is based on a systematic approach to occupational safety and health.

"This project has a very good political and practical impact at all levels - from enterprises to decision-makers", says Husberg. "This clearly demonstrates that the ILO's systematic approach to OSH can be effectively applied to the concrete situation in Russia. We expect that the North-West experience will be further replicated - a number of Russian regions and even neighbouring countries, like Kazakhstan and Armenia, have already expressed their interest", he concludes.

The need to radically improve occupational safety and health in Russia is now recognized at the highest level of government. At a recent meeting with business leaders, Russian First Deputy Minister Dmitry Medvedev quoted alarming figures. "Every year 190,000 people die in our country as a result of hazardous working conditions. In 2006, one third of those who died in Russia were at an economically active age - 4.5 times more than in the EU. All this undermines the labour potential of the country", he said.

This is a view shared by the Committee on Sustainable Enterprises of the International Labour Conference. In its conclusions concerning the promotion of sustainable enterprises, the Committee states that protecting workers' health and safety at the workplace is a very important aspect of the promotion of sustainable enterprise development.

The conclusions of the recent Committee discussions also recognize, however, that occupational safety and health is only one in a large array of factors, the relative importance of which may vary at different stages of development and in different cultural and socio-economic contexts.

"Other factors at the enterprise level include social dialogue and good industrial relations, sound human resource development practices, conditions of work, productivity, wages and shared benefits, corporate social responsibility, and corporate governance. In addition a number of other factors that help shape a conducive environment are essential, including peace and political stability, good governance and the rule of law, social dialogue, respect for universal human rights and international labour standards, entrepreneurial culture, sound economic policies, fair competition and access to financial services, physical and technological infrastructure, education and training, and environmental sustainability are generally considered to be essential for the promotion of sustainable enterprises", says Michael Henriques, Director of the ILO's Job Creation and Enterprise Development Department.

As for the enterprises themselves, their position was probably best expressed by one of the pilot enterprise directors: "We are not rich enough to waste our money on accidents; we should better invest in prevention."

* The promotion of sustainable enterprises, report VI. International Labour Conference, 96th session 2007, Geneva. ISBN 978-92-2-118143-9.

News Briefs

ILO Standards Workshop

On 21 and 22 June 2007, the International Labour Standards Department of the ILO hosted a workshop to present the work in progress on a study of the economic dynamics of selected ILO standards. This project seeks to analyse the medium and long-term effects of the application of international labour standards in five areas, including social security, working time and occupational safety and health.

The study will take stock of the state of research on the economic impact of standards and describe the approaches and methodologies used, models and theories that underpin research, data used, notable case studies, and major findings.

News Briefs


The latest edition of KANBRIEF no.2/07 presents New KAN studies

KAN - Kommission Arbeitsschutz und Normung's latest edition of KANbrief has recently been published. KAN endeavours to exert influence upon standardization activity at the earliest possible opportunity. For this purpose, it commissions studies and expert reports in the run-up to standardisation activity proper that provides guidance during subsequent technical work.

This issue of KANBrief includes Standards and the Single Market; EUROSHNET; The Need for research and opportunities for co-operation in the area of vibration. There are details on the Seminar on Principles of Standardisation work in occupational safety and health to be held 7-9 November 2007.

KANBRIEF is available on the web

KANBRIEF is published quarterly contact: DR. Ing Joachim Lambert, Alte Heerstr.111. D-53757 Sankt Augustin, Germany | Tel: +49 (0) 2241 231 3463 | Fax: +49 (0) 2241 231 3464 | Email: |

News Briefs


The Centre for the Improvement of Working Conditions and Environment Lahore (CIWCE) and the Industrial Relations Institute Lahore, Pakistan Annual Report of Activities 2006 is available in English and shows a wealth of activities. The Centre is the focal training, advisory and information-providing institution. It is the only institution of its kind in the country. The contents highlight the range of research, training and education courses, monitoring work, publications and responses to the Centre.

Project approved for distribution of Award winning Ergonomic carpet weaving loom developed at the CIWCW

Of particular note is the newly designed ergonomic carpet weaving loom which was design at the Centre after extensive discussions with industry experts, workers, managers and design engineers. This loom gives an opportunity to the workers to stretch their legs and backs whilst working. Arms and footrests have been provided. A workbench instead of the traditional wooded plank has been provided.

Many employers are replacing the old model with new looms and better OSH controls with their own investments. The annual report states that so far over 30 model looms and working environment controls have been installed in a number of districts.

Saeed Awan, CIWCE, Lahore, Pakistan

Centre for the Improvement of Working Conditions and Environment | CIS Unit, Civic Centre Township (Near Chandni Chowk), LAHORE | Tel: +92 42 515 0042 | Fax: +92 42 512 3537 | Email: |

CIS Centre since 1997

News Briefs


Readers are reminded that the news portal CIS NEWS awaits your input.

It is a multilingual database containing news items related to events and developments in occupational safety and health worldwide.

News items are entered by authorized editors in the CIS National and Collaborating Centres worldwide and appear in the language of choice of each editor.

Launched some months ago the service really needs your news - so few have supplied anything. You will need your organisation's name and contact details that CIS HQ will have sent to you. If you do not have them contact Brenda Dardelin for help

You will be able to add a news item about events or publications see

News Briefs


The UK's Health and Safety Executive Information Services has produced the Summer 2007

Catalogue of all the HSE publications.

This 95 page catalogue is available from: HSE Books, PO Box 1999, Sudbury, Suffolk CO10 2WA, UK | Email: |

NEW BOOK - Essentials of Fire Safety Management, by Dennis Davis

Fire remains potentially the most damaging and disruptive event that any business has to face. Virtually every fire will result in disruption to workflows. A devastating fire will almost inevitably lead to loss of production or productive activity which can lead to a loss of orders, a loss of customers and a loss of jobs. A significant amount of businesses simply never recover from the effects of a large fire.

Essentials of fire safety management, written by Dennis Davis is designed as a comprehensive guide for those responsible for fire safety at work as a result of the recent changes to UK workplace fire safety legislation. It draws together and updates a wide range of Fire Prevention Association (FPA) advice and complements the official government guidance. Importantly, emphasis is also placed on business continuity planning and the principles and practices of property protection.

The publication explains in detail the legislative background to fire safety in the UK, outlining in each of the chapters the relevant management responsibilities. It comprehensively covers the process of fire risk assessment, describing what businesses need to do to fulfil their legislative duties and detailing methods they may wish to employ. Throughout Essentials of fire safety management, practical advice sections are included aimed at assisting fire safety professionals, as well as those without a detailed understanding of fire safety matters, to comply with the law and to improve business resilience after a fire.

The 116 pages contain 12 chapters. To obtain a copy of Essentials of Fire Safety Management, 2007. ISBN 1902790464. £34.95. Contact:

The Fire Protection Association, London Road, Moreton in Marsh, Gloucestershire GL56 0RH | Tel: +44 (0) 1909 812 500 | Email: |

NB. For those seeking further information, guidance and advice including the full text of the above book why not have a 15 day free trial of FIREINF - containing over 264,000 records including full text document click onto


Unite to tackle Ireland's work death toll

The new chief executive of the Health and Safety Authority (HSA) has said that he will be seeking to develop "co-operation and collaboration" to tackle Ireland's 58-a-year (based on figures for the period 1989-2005) average workplace death toll.

Martin O'Halloran told the Institution of Occupational Safety and Health's (IOSH's) Ireland Branch Conference at the Killashee House Hotel in Naas that he hoped to work closely with interest bodies to help reduce the 8,000 accidents that occur in Ireland each year.

He said that HSA would continue to operate in a "positive and proactive manner" under his leadership: "But there will be occasions where we have no option but to take enforcement action," he warned.

Mr O'Halloran said he was also concerned about the health and safety of young people, something which IOSH has campaigned heavily about in the UK through its Wiseup2work initiative (see He also stated the need to remember "the human dimension" to workplace accidents.

"I hope to infiltrate the minds of our young people. The Authority and its key partners will be actively working with education in all sectors and we will be driving home the message about the importance of health and safety.

"I hope that by the time children leave school and enter the workplace they will believe that they can go to work, have a good job and come home again to their families. We've had in the region of 40 cases this year where young people have left home, gone to work never to come home again.

"None of us like being part of accidents, but we had in excess of 8,000 accidents last year, of which 50 were fatal. In each of these, our research shows that three, four or five other people will be pretty badly affected socially, economically and in everyday life too."

Mr O'Halloran added that he also believed IOSH and its members had a critical role to play in helping reduce Ireland's accident rate: "IOSH is a particularly key partner for HSA. Well-intentioned amateurs are no substitute for competent professionals on health and safety matters.

"When the Safety, Health and Welfare at Work Act was introduced, there was only a handful of such professionals. We now have 1,600 of you in Ireland, and that's probably one of the most important groups of people we have. I look forward to working with you in future."

IOSH is Europe's largest body for health and safety professionals. It has over 30,000 members worldwide, including more than 10,000 Chartered Safety and Health Practitioners. The Institution was founded in 1945 and is an independent, not-for-profit organisation that sets professional standards, supports and develops members and provides authoritative advice and guidance on health and safety issues. IOSH is formally recognised by the ILO as an international non-governmental organisation.

IOSH's Ireland Branch was formed in 1982 and has over 1,600 members based throughout the country. The branch aims to help raise awareness of workplace health and safety issues throughout Ireland, as well as to inform key decision-makers on health and safety matters.


A victory for common sense

Health and safety professionals have said that common sense has prevailed following the recent European Courts of Justice verdict in support of UK workplace safety law.

The European Commission's claim that the UK had failed to implement the Framework Directive (EC 89/391) was dismissed by the European Court, meaning the tried and trusted phrase in UK health and safety law 'so far as is reasonably practicable' can remain.

President of the Institution of Occupational Safety and Health (IOSH), Lisa Fowlie, said: "In terms of health and safety law the clause 'so far as is reasonably practicable' means that employers don't have to take measures that are grossly disproportionate to the risk. In turn, the UK courts are able to objectively assess whether employers have done everything 'reasonably practicable' to manage the risk. The effectiveness of this system is supported by the UK's health and safety record, which is one of the best in Europe.

"Had the challenge against the UK been successful, employers in this country could have been treated more severely than those in Europe. Although, other member states' laws are written in absolute terms, the courts in those countries can apply flexibility and proportionality in their judgements."

Lisa added: "The UK explained that our whole legal system deals with health and safety duties and liabilities through a combination of criminal and civil law. We also operate a social security system to financially support victims of workplace accidents.

"The Commission failed to show how the UK system couldn't satisfy the Directive's object of the '...introduction of measures to encourage the improvement of the health and safety of workers at work'. We hope this will be an end to these sort of challenges from Europe.

"Health and safety professionals have worked long and hard to explain the risk-based approach and to win the support of workers and employers. We feel that had the UK lost so far as is reasonably practicable, this would have been a major set-back for our sensible risk message and could have had a negative effect on public confidence in the system."

IOSH is Europe's largest body for health and safety professionals. It has over 30,000 members worldwide, including more than 10,000 Chartered Safety and Health Practitioners. The Institution was founded in 1945 and is an independent, not-for-profit organisation that sets professional standards, supports and develops members and provides authoritative advice and guidance on health and safety issues. IOSH is formally recognised by the ILO as an international non-governmental organisation.

Judgement (Case C127-05): "Having regard to all the foregoing considerations, it must be concluded that the Commission has not established to the requisite legal standard that, in qualifying the duty on employers to ensure the safety and health of workers in every aspect related to the work by limiting that duty to what is reasonably practicable, the United Kingdom has failed to fulfil its obligations under Article 5(1) and (4) of Directive 89/391."


New ITUC report on core labour standards in the Central African Republic

The ITUC have released a new report on core labour standards in the Central African Republic. This report coincides with the country's trade policy review at the WTO and reveals shortcomings in the application and effective enforcement of core labour standards in the country. The report supports the long-standing demands of the ILO for the Central African Republic to comply with the international standards on freedom of association, collective bargaining, discrimination, child and forced labour.

The report states that many violations take place on a regular basis in the country, mainly regarding the exercise of the right to strike, wage negotiations and anti-union discrimination. The new ITUC survey adds that discrimination towards women and minorities, mainly Pygmies,

persists in the Central African Republic and highlights that child labour and trafficking of people are a common practice in the country. In that regard, the means of the government to tackle child labour in the country are wholly insufficient, given the degree of child work throughout the country. Trafficking is common both within the country and towards neighboring countries.

The report finishes with a number of recommendations and conclusions addressed to the government of the Central African Republic in an attempt to redress the situation of non-compliance with ILO core labour standards and aiming at encouraging and promoting effective policies that tackle the main labour and social difficulties the country faces today.

To read the full report:


Increasing Awareness and Knowledge of Occupational Cancer: Summary Report of Workshop Held on the 27th April 2007 in Hanasaari, Finland
By Dr Fabrizio Giannandrea


1.0 Introduction

2.0 Morning Presentations (9.00 - 12.20) - Chairs: Paolo Boffetta and Kirsti Husgafvel-Pursiainen

2.1 Occupational cancer - a moving target - Paolo Boffetta, International Agency for Research on Cancer (IARC), France

2.2 Cancer attributable to occupation: the HSE project - Lesley Rushton, Health and Safety Executive (HSE), UK

2.3 Exposure to carcinogens in Great Britain - John W. Cherrie, Institute of Occupational Medicine, UK

2.4 Use of cancer registries in occupational cancer research: the NOCCA project - Eero Pukkala, Finnish Cancer Registry, Finland

2.5 The role of biomarkers in risk assessment of occupational cancer - wood dust - Kirsti Husgafvel-Pursiainen, FIOH, Finland

3.0 Afternoon Presentations (13.20 - 15.45) - Chairs: Jorma Rantanen and Irja Laamanen

3.1 Genomics approach in search of biomarkers for occupational cancer: example of asbestos - Sisko Anttila, FIOH, Finland

3.2 Every third cancer can be prevented - Why is it not happening? - Harri Vertio, Cancer Society of Finland, Finland

3.3 EuroWorksafe: European multidisciplinary portal on occupational cancer risks and prevention - Gianni Viano, Softeco, Italy

3.4 Occupational disease burden - a global view - Jorma Rantanen, International Commission on Occupational Health (ICOH), Finland

1.0 Introduction

The Workshop was organized by the Finnish Institute of Occupational Health (FIOH) together with the EuroWorksafe project and consisted of presentations of 9 invited experts. It was attended by 48 participants from 7 different countries (Finland, UK, Italy, France, Poland, Bulgaria and Denmark). The invited experts were asked to provide an overview of relevant studies on occupational cancer burden or to focus on methods and tools that had been used to improve the knowledge on work-related cancer. The issue of 'Increasing awareness and knowledge of occupational cancer' was connected to the theme day of the World Health Organization, (WHO) and the International Labour Organization (ILO), on 28th April 2007.

This report is a thematic summary of these talks and presentations.

2.0 - Morning Presentations - Chairs: Paolo Boffetta and Kirsti Husgafvel-Pursiainen

2.1 Occupational cancer - a moving target. Dr Paolo Boffetta reviewed the methods that have been used by the International Agency for Research on Cancer (IARC) to classify carcinogens and emphasised that many human cancers are caused by occupational carcinogens. There is a large volume of epidemiological and experimental data concerning cancer risks in different work environments. IARC has used this large volume of data (augmented with additional information), to draw together a more systematic classification of occupational carcinogens, the industries in which they are found, and the target organs.

The criteria used by IARC Working Groups in evaluating human carcinogenicity are based on the synthesis of epidemiological, animal and other evidence. Substances are chosen on basis of human exposure and the suspicion of cancer risk and classified in 5 groups. Group 1: the agent (mixture) is carcinogenic to humans. Group 2A: the agent (mixture) is probably carcinogenic to humans. Group 2B, the agent (mixture) is possibly carcinogenic to humans. Group 3: The agent (mixture, or exposure circumstance) is not classificable as to carcinogenicity in humans. Group 4: The agent (mixture, or exposure circumstance) is probably not carcinogenic to humans. Within the occupational setting, 19 agents are recognised as definite carcinogens (IARC class 1). For the definite Class 1 human carcinogens the major target organs, apart from lung and bladder, are breast; bone; haematopoietic cancers (related to ionising radiation); and mesothelial cancers (related to asbestos and other mineral / organic fibres). For many of these cancers exposure to tobacco smoke is a major confounding factor.

The group of definite occupational carcinogens includes asbestos, silica, wood dust, arsenic, beryllium, cadmium, chromium, benzene and vinyl chloride. The occupations and industries where there is significant exposure to Class 1 major carcinogens comprise metalworking; fuel and solvent processing; the leather and rubber industries; the dye industry and woodworking. The group of probable occupational carcinogens includes polycyclic aromatic hydrocarbons; fossil fuel products; intermediaries in plastic manufacture; chlorinated hydrocarbons; pesticides and aromatic amines. The major target organs for these agents include the lung; bladder; kidney; cervix, and haematopoietic tissue. The industries where exposures to Class 2A may occur include artistic glass manufacture; hairdressing; cobalt manufacture; and petroleum refining. The Class 2B 'possible' human occupational carcinogens include refractory ceramic fibres; welding fumes; nickel alloys; petroleum combustion products; solvents; and some pesticides.

Dr Boffetta considered that it is likely that important occupational carcinogens are still not identified and that while current estimates of attributable fractions are questionable, there are undoubtedly many cases of cancer attributable to occupational exposure. The discovery of occupational carcinogens has implications for the general environment since it provides information relevant to the understanding of carcinogenesis. Knowledge on occupational cancer might be biased towards exposure circumstances prevalent in the past.

"Historical" occupational carcinogens seem to be rather different from the "new" ones. Potency and exposure levels of the latter are lower and a major role of co-exposure should be considered. The issue of tobacco smoke should be regarded as possibly important factor, particularly for female workers. In addition a large proportion of cancers are due to lifestyle factors, which might be influenced by occupation (e.g. reduced physical activity and low intake of fresh fruits and vegetables refer to the increased risk of colon cancer) whose impact would be possibly larger than traditional carcinogens.

2.2 Cancer attributable to occupation: the HSE project. Dr Lesley Rushton presented the HSE project whose principal aim is to develop measures to reduce occupational cancer in Great Britain (GB) by estimating current attributable risk and cancer numbers caused by work. This process could also facilitate planning for future needs and support decisions for priority actions and risk reduction. Since the Doll and Peto study (1981), several methods have been developed to estimate the global burden of occupational disease and that decisive work needs to be reassessed. The primary measure of burden on occupational cancer is to identify the attributable fraction (AF) which is the proportion of cases which would not have occurred in the absence of exposure occurring in either the exposed or total population.

AF could be estimated by several formulae depending on source of data. Levin's formula is the most commonly used and depends on knowing risk ratio (RR) and proportion of exposed in the target population. An update of burden in GB was made for the following 6 cancers: bladder cancer, leukaemia, lung cancer, mesothelioma, non-melanoma skin cancer and sino-nasal cancer. As regard to bladder cancer, 3113 male and 1629 female had dead for bladder cancer in 2004.

There was an established relationship with smoking and with several occupational risks such as aromatic amine manufacturing, dyestuffs manufacturing and use of dyes, occupation as a painter, leather work and aluminium manufacturing. Considering leukaemia 2267 male and 1839 female had dead in 2004 and its recognized occupational causes included ionizing radiation and benzene. Male AF for the established carcinogens in leukaemia was 0,63 % and 3,2 % for the total of established and uncertain carcinogens. Lung cancer caused 19013 male and 13238 female deaths. The major cause was smoking and 27 agents or exposure circumstances were classified by IARC as group 1 or 2A for lung cancer. Attributable fractions and numbers were estimated for 17 agents (established = uncertain) for lung cancer. There were 1969 mesothelioma deaths in 2004, of which 85% were males. Occupational AF estimated directly from case-control study by Peto was 85-90 % (1400-1500 deaths) and 10-20 % for females (30-60 deaths). The percentage of paraoccupational and environmental AF estimates were 10-15 % for males and 70-80 % for females. Non-melanoma skin cancer is the most common cancer in Caucasian populations and deaths in GB were of 323 males and 203 females in 2004.

The main occupational related causes were arsenic, mineral oils (including shale oils), solar radiation, coal tars and pitches (including soots, coal gasification, coke production, creosotes). AF established was 11.8 % for males and 3.0 % for females.

For HSE, the challenges are likely to be encountered in relation to the adequacy of data, i.e., its coverage, accuracy, and relevance. It needs to be decided how best to determine previous and current exposures, how to deal with multiple occupational and non-occupational causes (or confounding issues); co-morbidity; and the impact of any interventions on diseases which have long latency.

2.3 Exposure to Carcinogens in Great Britain. In this review John Cherrie discussed the different exposure databases and methods that could be used to assess the historical and sector exposures to occupational carcinogens. The exposure to hazardous agents may vary in time due to changing use, control measures, working practices, or differences within and between businesses and between different countries. No uniform monitoring systems have been employed in Great Britain to track changes in the use and exposure to most occupational hazards and this includes carcinogens.

Consequently, it is necessary to use different sources of data to review the cancers attributable to occupational causes and there are methodological assumptions behind the use of these sources of data. In this review, carcinogenic agents (or work circumstances) were identified from IARC class 1 and 2A lists. Exposure prevalence estimates were obtained from the CARcinogen EXposure or CAREX database. For those situations not covered by CAREX, the prevalence of exposure was estimated for four carcinogenic exposure circumstances. This resulted in a list of 64 agents/circumstances with ~7 million people in GB occupationally exposed to these agents. The first ten agents (and processes) made up 83% of the estimated total number of people exposed to carcinogens and included passive exposure to tobacco smoke and exposure to solar radiation. The other major factors include crystalline silica; radon; diesel exhaust; wood dust; benzene; ethylene dibromide; inorganic lead compounds; and chemicals used in hairdressing. The next 10 agents/processes included decorating paints; chromium VI compounds; tetrachloroethylene; coal tar products; iron and steel foundries; asbestos; formaldehyde; nickel compounds; acid mists; and cadmium containing compounds.

Together with the top ten agents this additional group accounted for 97% of those exposed occupationally to identified carcinogens.

Consequently the last ten agents (processes) added very little to this total. The agents included cobalt metal; arsenic; X-rays and gamma rays; styrene; trichloroethylene; rubber and beryllium compounds; cyclophosphamide; cisplatin and vinyl chloride. Together all 30 agents accounted for 99.5% of those occupationally exposed to IARC Class 1 and 2A carcinogens in Great Britain.

This review demonstrated problems with the use of the CAREX estimates for some of these agents for Great Britain. Estimated numbers from CAREX sometimes appear too high (lead, cobalt) or too low (aflatoxin, ionizing radiation) than the estimates derived from HSE. These differences may be due to different thresholds for inclusion of people as 'exposed' or 'non-exposed'. There were other examples where it was clear that the CAREX data were unrepresentative of the situation in Great Britain, but in general the ranking of these agents using CAREX data seemed broadly compatible with the expected estimates of the numbers exposed for Great Britain. It is also likely that the CAREX data do not properly reflect the historical prevalence of exposures in GB, but some information should be available from HSE and other sources for some of these agents.

Despite these limitations it was concluded that the CAREX database was the best starting point for estimating exposure prevalence.

Another source of information on exposure to these agents is the HSE National Exposure Database (NEDB) for which data are available for most identified substances. In addition, there are data published in peer reviewed papers and surveys and reports compiled by the Health and Safety Laboratory (HSL). Large amounts of data have been gathered by some sectors of industry on benzene and coke oven emissions. Unfortunately there are no systematic data for environmental tobacco smoke exposure or sunlight. At least 20 of these substances were identified in the NEDB database with the largest number of samples collected for crystalline silica; asbestos; chromium VI compounds; cobalt; rubber dust/fumes; and wood dust.

The year-on-year measurement of some of these agents has demonstrated reductions in the mean exposure over the last 20 years, e.g., crystalline silica. Furthermore when the mean exposure level was set as a ratio of the specific occupational limit (OEL), almost half of the agents e.g., arsenic, sulphuric acid, and tungsten, demonstrated evidence of control beneath the limit.

Exposure to rubber dust was more difficult to assess. An evaluation of reductions in exposure with time, which included data from other European countries, showed exposures substantially higher in Germany and Poland compared to GB and Sweden. However, in all countries there was an average eight-fold reduction in exposures from the 1970s to 2004. For exposure to coking fumes (comparing GB and the USA) there was a sharp reduction in exposure in the USA after the 1970's but just a steady less dramatic decrease in GB.

In conclusion, there is poor information about exposure and the prevalence of exposure for many of the carcinogens identified as relevant to the present work, and there has been little systematic collection of data for people exposed in GB since the 1990s. CAREX provides the best way of assessing number of people exposed in GB. In using epidemiological evidence from countries other than GB or from one region of the country to another, consideration must be given to possible differences in exposure, which may be large.

2.4 Use of registries in occupational cancer research: the NOCCA project. Eero Pukkala outlined the study entitled Changing work life and cancer risk in Nordic countries, (or Nordic Occupational Cancer, NOCCA). Earlier pooled analysis of census-derived job titles and cancer registry data from Denmark, Finland, Norway and Sweden has represented a successful and efficient approach to produce important results on occupational cancer. The large data and reliable information on occupation allowed identification of risk occupations even in rare cancers such as nasal cancer given an example of the results. The only confirmed occupational risk factors for nasal cancer are leather dust and wood dust, and the highest standardized incidence ratios (SIR) among all 54 occupations studied were seen among shoe and leathers workers (SIR 2.9, 95 % CI 1.5-5.3) and wood workers (SIR 1.9, 95 % CI 1.6-2.2).

In the ongoing NOCCA study, this work will now be updated and expanded. All Nordic residents will be characterised with estimated cumulative life-long exposure to about 30 occupational work-related agents. The combined data of about 4 million cancer cases, 10-1000 times more than in any of the earlier important surveys on occupational cancers.

Exposure to known and suspected carcinogens and other work-related hazards such as work stress, shift work, lack of physical activity and reduced/postponed parity do to the career planning can be estimated via the application of a job-exposure matrix. Nordic job-exposure matrix will be based on the national matrix develop in Finland, FINJEM.

Using the matrix, the cancer risk attributable to the occupation-related hazards and changes in the work-related risks over a period of three or four decades can be calculated in a dose-response manner for the entire Nordic population. NOCCA will especially focus on women, who todat consist a large fraction of economically active work-force but whose occupational hazards have been rarely studied.

The study started in 2005 and is expected to last about 3 years; however the series of the agent and cancer specific dose-response analyses will continue in 2008 and later.

2.5 The role of biomarkers in risk assessment of occupational cancer wood dust. Kristi Husgafvel-Pursiainen outlined the WOOD-RISK project which investigate health effects of wood dust exposure and reviewed the use of biomarkers in risk assessment of occupational cancer wood dust. At present 3,6 million (2,0 % of workforce) EU workers (EU25) are currently exposed to wood dust. 500.000 of them (16 % of the exposed) are exposed to high levels (>5 mg/m3), while 700.000 (21 % of the exposed) to lower levels. In Finland (2001-2003) 65.000 workers are exposed to wood dust (2,8 % of workforce), mainly constituted by construction and furniture workers; softwood and wooden board dusts predominate and the exposure levels are mostly below 5 mg/m3.

The general objective of the WOODRISK project is to improve assessment and characterization of health risks associated with exposure to wood dust. To achieve this goal, the study assesses wood dust exposure and creates a new WOODEX database. In addition, a molecular biomedical part of the overall WOOD-RISK project investigate health effects of wood dust exposure and biological mechanisms related to those ones.

Health effects associated with exposure to wood dust are multiple, including irritation and inflammation of the respiratory tract, asthma, and cancer. Based on epidemiological evidence, one of the main concerns is the causation of human cancer, sino-nasal cancer in particular. Sino-nasal cancer is a rare type of cancer with a wide geographical and regional variation in invidence, not explained by genetic factors (eg. susceptibility). More than 10 epidemiological studies indicated over 10-fold (up to 30-40 fold) excess risk of nasal cancer among woodworkers and high risks for adenocarcinoma among furniture makers in particular. IARC evaluation classified in 1995 wood dust as carcinogenic to human (Group 1), but this evaluation was based on the observation of marked increase in the occurrence of cancers of the nasal cavities and paranasal sinuses among workers exposed predominantly to hardwood dusts. Only in a few studies in which exposure was primarly to softwood, risk of sino-nasal cancer was elevated. Little is known about the carcinogenic mechanisms of wood dust-related cancer, with some data on DNA damage and mutations.

This study will examine mutations in the p53 gene and the ras genes as biomarkers of genotoxic pathways of carcinogenesis. TP 53 is a transcription factor that induces antiproliferative responses such as cell cycle arrest, DNA repair or apoptosis in response to DNA damage. Function of p53 is lost by mutation in more than 50 % of human cancers, which makes the mutation of TP53 gene the most common genetic alteration in human cancers. Cases of sino-nasal cancer, the cancer type for which the highest risk in association to wood dust exposure has been observed, will be identified in collaboration with the national cancer registries of Denmark, Finland and France. Paraffin-embedded tissue samples from cases with confirmed histology will be collected and analysed for mutation. Occupational exposure of the cases to wood dust will be assessed through questionnaires and used in final statistical analyses.The findings of this study provide evidence for involvement of genotoxic (mutational) mechanisms, in parallel with inflammatory response, in the carcinogenesis of sino-masal cancers associated with wood-dust exposure.

3.0 Afternoon Presentations - Chairs: Jorma Rantanen and Irja Laamanen

3.1 Genomics approach in search of biomarkers for occupational cancer: the example of asbestos - Asbestos is a pulmonary carcinogen known to give rise to both DNA and chromosomal damage, but the exact carcinogenic mechanisms are still largely unknown. The mechanisms behind these actions may be multiple. The main mechanisms are thought to be generation of reactive oxygen species (ROS) and reactive nitrogen species (RNS), alteration in the mitochondrial function, physical disturbance of cell cycle progression and activation of several signal transduction pathways. Asbestos-exposed workers have been reported to have increased levels of sister chromatid exchanges and DNA double-strand breaks in white blood cells. Elevated concentrations of 8-hydroxy-2-deoxyguanosine DNA adducts, a marker for ROS exposure, have also been detected in the blood of asbestos-exposed workers. Lung cancer is characterized by very complex patterns of both cytogenetic and molecular genetic changes. This high complexity, including many randomly appearing changes, makes it very challenging to determine the most essential lung carcinogenesis-associated alterations. Sisko Anttila's Group has, however, recently shown that asbestos exposure can be associated with a specific genomic aberration profile. The aim of this study was to investigate whether asbestos exposure causes a specific gene expression profile that correlates with the previously detected asbestos-associated genomic aberration profile. By combining the gene expression data with the comparative genomic hybridization (CGH) array data, they were able to detect six distinct chromosomal regions that harbor both gene expression and DNA level changes.

One of these, 19p13.3-19p13.1, was further characterized for allelic imbalance (AI) on lung carcinomas from 62 male patients chosen on the basis of their present or absent asbestos exposure determined by the work histories and pulmonary asbestos fiber counts. In this study, gene expression arrays were performed on lung tumor samples from 14 heavily asbestos-exposed and 14 non-exposed patients matched for other characteristics.

Using a two-step statistical analysis, 47 genes were revealed that could differentiate the tumors of asbestos exposed from those of non-exposed patients. To identify asbestos-associated regions with DNA copy number and expressional changes, the gene expression data were combined with comparative genomic hybridization microarray data. As a result, a combinatory profile of DNA copy number aberrations and expressional changes significantly associated with asbestos exposure was obtained. Asbestos-related areas were detected in 2p21-p16.3, 3p21.31, 5q35.2-q35.3, 16p13.3, 19p13.3-p13.1 and 22q12.3-q13.1. The most prominent of these, 19p13, was further characterized by microsatellite analysis in 62 patients for the differences in allelic imbalance (AI) between the two groups of lung tumors. 79% of the exposed and 45% of the non-exposed patients (P=0.008) were found to be carriers of AI in their lung tumors. In the exposed group, AI in 19p was prevalent regardless of the histological tumor type. In adenocarcinomas, AI in 19p appeared to occur independently of the asbestos exposure.

3.2 Every third cancer can be prevented - Why is not happening? - Harri Vertio, Secretary-General of the Finnish Cancer Organizations, considered that one third of cancers are preventable. According to this, the question is how we can avoid them. Just by stopping smoking it would be possible to prevent a quarter of cancers in men and 15 percent of cancers among women. A diet emphasizing vegetables, fruit, berries, and rye bread, as well as fish as an alternative to meat all help prevent the onset of cancer. Protecting skin against the sun also greatly reduces the risk of cancer. Most of people do not know that prevention can achieved also for heritable cancer. For example in the case of prostate cancer the relative risk (RR) is higher in 1st grade relatives and brothers of patients. For this reason Harri Vertio also highlight the need for people to undergo cancer checkups. In breast cancer screenings it is possible to detect cancer at a very early stage. Cervical cancer and colon cancer can be detected in advance, already before they break out. One in four Finnish eventually get cancer. The disease also affects 65 percent of Finnish through their family or circle of friends: about two out of three have a relative or a friend who has or has had cancer. The number of new cancers is expected to grow by one quarter during the next ten years. This is mainly the result of an ageing population. Harri Vertio notes that cancer grows slowly, but he urges people to monitor themselves, and to seek treatment early, which would lead to more frequent positive outcomes.

3.3 EuroWorksafe: European multidisciplinary portal on occupational cancer risks and prevention - Gianni Viano outlined the EuroWorsafe project which is a web portal on occupational cancer risks and prevention in Europe. Hundreds of different resources such as best practices, guidelines, articles, publications, information sources, database and websites are currently classified in the information system, allowing users to browse a large number of relevant original data from a single, easy-to-use web-based entry point. The portal provides enhanced functionalities for content browsing and searching, reducing sensitively the effort for information retrieval for generic users and occupational health and safety (OHS) professionals. This web aims at improving access to and use of large amount of data related to the sector of health protection of workers and workplace safety. These data are presently available in many European public sector organisations, including research institutes, public health institutions and hospitals. The wide diffusion of this information would be of crucial interest for many organisations, citizens, workers, companies to reduce risks from health hazards and to improve prevention and safety measure to contribute to the reduction of occupational cancer incidence. The target users include workers and citizens as well as professionals from private companies and public organizations, who will be attracted by consultancy and other added value services provided on payment. The consortium covers several countries from the enlarged Europe and comprise all roles in the service provision chain envisioned. Contents are provided and maintained by five scientific institutes dealing with cancer and occupational health from several EU countries: the Finnish Institute of Occupational Health (Finland), International Agency for Research on Cancer (France), National Institute for Research on Cancer (Italy), Jagellionan University Medical College (Poland) and National Center of Public Health Protection (Bulgaria).

The consortium is coordinated by Softeco, which is a technology provider.

3.4 Occupational disease burden - a global view. Estimation of the global burden of disease and injury due to selected occupational factors is a topic of interest to policy makers, governments, and international bodies. The World Health Organization (WHO) has implemented a Comparative Risk Assessment (CRA) to estimate risk to exposed populations. The WHO is now undertaking a new assessment of the GBD.

The GBD uses a summary measure - disability-adjusted life year (DALY) - to quantify the burden of disease. DALYs for a disease are the sum of the years of life lost due to premature mortality (YLL) in the population and the years lost due to disability (YLD) for incident cases of the health condition. The DALY is a health gap measure that extends the concept of potential years of life lost due to premature death (PYLL) to include equivalent years of 'healthy' life lost in states of less than full health, broadly termed disability. One DALY represents the loss of one year of equivalent full health. The WHO Comparative risk Assessment on Global burden of Disease is an ambitious programme to establish comparative health assessment method. It is an analysis of the contribution of 26 risk factors to the global burden of disease. This was created to provide decision makers with an understanding of the relative contributions of the risk factors to disease and injury outcomes ( for example x % of lung cancer is due to smoking, y % to air pollution, z % to work exposures, etc.) DALY's (Disability adjusted life years) for a disease are the sum of the years of life lost due to premature death to include equivalent years of "healthy" life lost in states of less than full health, broadly termed disability.

WHO regions serving as basis for calculations. Occupational hazards are highly prevalent and contribute substantially to global DALYs. Presented calculations are likely underestimates. Recognition of occupational diseases is poorly developed in both industrialized and developing countries. All the occupational diseases and injuries are in principle preventable (zero risk strategy). Prevention of Occupational disease and injuries is economically and socially highly profitable. Professor Jorma Rantanen considered that he magnitude of the occupational health burden in the world is overwhelming, and the causes and mechanisms are multiple and complex. Commitment from all stakeholders is imperative to translate economic progress into sustainable human development and well-being.

The author would like to acknowledge the EuroWorksafe project that organized the Workshop in close collaboration with the Finnish Institute of Occupational Health, to Irja Laamanen for making the practical arrangement for the workshop and chairing one of the discussion sessions, the precious assistance of Leena Isotalo for helping with administration. Thanks also to Dr Paolo Boffetta, Dr Kirsti Husgafvel-Pursiainen, Professor Jorma Rantanen, Dr John Cherrie, Dr Lesley Rushton, Dr. Gianni Viano, Dr. Eero Pukkala, Dr. Harri Vertio and Dr. Sisko Anttila for their presentations.

Dr. Fabrizio Giannandrea, Lifestyle, Environment and Cancer Group, International Agency for Research on Cancer, 150 cours Albert Thomas, 69008 Lyon France | Tel: +33-472738310 | Fax: +33-472738320