Category archives: Shift work

Cancer all-clear for night work was based on ‘bad science’

An Oxford University study that concluded the classification of night work as a cause of breast cancer in women is no longer justified was based on ‘bad science’, top researchers have warned.

The large scale ‘meta-analysis’, published online on 6 October 2016 in the Journal of the National Cancer Institute (JNCI), concluded “night shift work, including long-term night shift work, has little or no effect on breast cancer incidence.” It added the International Agency for Research on Cancer’s (IARC) ranking of night work as a ‘probable’ cause of breast cancer in women “is no longer justified.”

But three of the most respected epidemiologists on night work and breast cancer have now said they “fully disagree” with this conclusion, noting a succession of methodological flaws in the research “invalidate” its conclusions.

Harvard Medical School epidemiologist Eva Schernhammer told Hazards magazine that given the Oxford study’s “bad science”, it was “not surprising” it found no effect. In a detailed criticism of the paper, published online on 15 December, she said the JNCI paper’s many shortcomings “preclude it from making the conclusion that there is no association between night work and breast cancer risk.”

Johnni Hansen, a researcher with the Danish Cancer Society, was equally unimpressed. “They base their conclusion on a poor study, but even worse is that their conclusion may hinder preventive initiatives for night workers,” he said.

Richard Stevens, of the University of Connecticut medical school, who has written influential papers on the topic with both Schernhammer and Hansen, was blunt. “Why was the paper written in the first place?” he asked.

The main cohorts in the Oxford study, which was financed by the Medical Research Council, the Health and Safety Executive (HSE) and Cancer Research UK (CRUK), were “worryingly old”, with many over retirement age, and the follow up was “unusually short”, Hansen said.

The risk of women developing breast cancer appears to wane in the years after night working ends, so studying retired workers without recent exposures misses the point and the cancers, said Schernhammer. She said the higher risk is seen in women with long exposures ­ at least 15 years ­ early in their careers. Hansen added the authors behind the JNCI study should have recognised the possibility of ‘truncation bias’ in their analysis.

Night work was sometimes defined so loosely in the study participants, a single night shift might have seen a worker added to the ‘exposed’ group despite facing minimal exposure and risk. The JNCI paper also discounted case-control studies and those exploring the mechanism behind a possible association. According to Stevens, the JNCI meta-analysis “excluded case-control studies, of which there are many, for no good reason.”

He added that studies considering the biological mechanisms give a valuable insight into why and where you might look for an association. Understanding the process, something integral to his own research, was important, he indicated.

Stevens, Schernhammer and Hansen, together with Scott Davis, a professor of epidemiology in the University of Washington’s School of Public Health, are the stand-out epidemiologists on night work and breast cancer.

Not one of them was asked to review the paper. “We are the four epidemiologists who have been working for by far the longest on the epidemiology of night work and breast cancer,” said Stevens, who is dismayed the Oxford study, led by molecular epidemiologist Ruth Travis, found its way in to a high visibility journal like JNCI.  “Any of the four of us would have quickly noticed the severe flaws of the Travis paper and pointed them out to the editors of JNCI.”

He said it was “absurd” that the night work association with breast cancer was being dismissed on the back of a “troubling” paper by “a distinguished group of experienced researchers who should have known better.”

The JNCI study’s lead author, Ruth Travis, declined an invitation from Hazards to address the detailed criticisms of the study.

*   Ruth C Travis and others. Night shift work and breast cancer incidence: Three prospective studies and meta-analysis of published studies, Journal of the National Cancer Institute, volume 108, number 12, published online 6 October 2016.

New Resource: Cancer Hazards

A new resource on cancer and hazards available in the form of a continually-updated, annotated bibliography of occupational cancer research. The resource is produced by  Hazards, the Alliance for Cancer Prevention and the International Trade Union Confederation (ITUC).

 

 

Press Release: Alliance re-echoes call for Cancer Action Plan

For immediate release
15/10/13

We must face the stark realisation that our cancer plans and strategies are grossly outdated. Despite gains in treatment and detection still almost 900 people will be diagnosed with cancer in the UK and about half that number will die from the disease each and every day.

What is needed is a new Cancer Action Plan which specifically addresses environmental and occupational risk factors (1) for breast and other cancers with targeted actions for those risk factors and specifically allocated funding. The plan needs to encompass social, economic and gender inequalities and would need to be rolled out across England, Scotland, Wales and Northern Ireland taking into account all countries specific cancer plans and strategies.

Current cancer strategies and plans target lifestyle factors but not ‘life circumstance’ factors. (2)  Not only do strategies and plans ignore the social, economic and gender inequalities but also the interwoven and intrinsically linked environmental and occupational risk factors for cancer. There is little or no consideration given to the fact that lifestyle factors are influenced by economic and social aspects. By not addressing these confounding risk factors, strategies to tackle cancer seek to place the onus at the feet of the individual by focusing on individual instead of institutional action.

There are many barriers to action on the primary prevention of cancer; cancer is also caused by lack of political will (3). Despite high levels calls for inclusion of environmental and occupational risk factors in all cancer plans, the cancer establishment (those involved in determining the dominant thinking from government, industry and the cancer charities and organisations on cancer) continue to maintain the status quo. The onus needs to be shifted away from the feet of individuals to the feet of the cancer establishment to stem the rising incidence of a largely preventable disease. A more balanced approach is needed from the cancer establishment.

The World Health Organisation (WHO) gives a very conservative estimate of up to 24% of all human diseases are at least in part due to environmental factors which includes chemical exposures. (4) Both the United Nations Environment Programme (UNEP) and the WHO report that the incidence of chronic disease such as cancer is now greater than that of communicable disease. Twenty six different cancers alone have been linked to occupational and environmental exposures. (5)

The Alliance calls for a Cancer Action Plan which includes:

  • Environmental and occupational risk factors (determinants) addressed as risk factors for cancer in a specific Cancer Action Plan and included in all cancer plans and strategies with definitive targets for action and appropriate allocated funding.
  • Phase out of all IARC classified Group 1 carcinogens and Group 2A potential carcinogens.
  • Targeted toxics reduction across all environments, the lived, worked and the first environment, the womb.
  • Government support for green chemistry and engineering. Hazardous substances should be replaced with safe alternatives utilising the substitution principle.
  • Elimination of all toxic and man-made chemicals which are found in breast milk and cord blood.
  • Inclusion of Just Transition principles in all toxics use reduction initiatives and product lifecycle management analysis.
  • Elimination of the future use of all types of asbestos and ensure proper management of the asbestos currently in place to protect workers from asbestos exposure and to prevent future asbestos-related deaths. (6)
  • Readdress the unsustainable costs of cancer in terms of prevention.
  • Education on environmental and occupational insults for all cancer specialists.
  • Bringing cancer policy into the 21st century, by embracing new and emerging science.
  • Use of relevant language and ensuring that references to the environment and primary prevention are universal and defined in terms of stopping cancer before it starts.
  • Factoring in environmental justice principles and the right to a clean and safe environment into all cancer plans. (7)
  • Equal consideration given to precautionary and preventive approaches to cancer alongside better treatment and care.

Considerable work has been done over the last few decades to try and get recognition for environmental and occupational risk factors but with little movement from the cancer establishment. We can only speculate why this 21st century disease is still being addressed with an 18th century solution, and question who is financially benefiting from breast and other cancers, while continuing to investigate the long-standing inaction on this issue by the cancer establishment.

Background Document: Background document for Cancer Plan

The Alliance is a multi-stakeholder group which includes representatives from: NGOs, Trade Unions, environmental and occupational health organisations, public health advocates and civil society groups, working together on cancer prevention. We aim to; challenge the existing perception of control and treatment of cancer being the only way forward; get equal recognition for primary prevention and ensure that the cancer establishment acknowledges the environmental and occupational risk factors for preventable cancers.

@Cancer_Alliance
Tel: 07960033687


(1) Definition of environmental and occupational risk factors: Environmental and occupational risk factors are potential risk factors for cancer from exposure (including environmental, occupational and pre-birth exposure) to certain chemicals, substances, or particles or through ingestion, inhalation or absorption or to certain behavioural work patterns such as shift work which contribute to a cancer outcome by nature of their carcinogenic, mutagenic, or endocrine disrupting properties and abilities.

2. Prof. Andrew Watterson from Toxic Tour Report (London)  Summer 2013. (Soon to be on the alliance website).

3. Donner, L and Chernomas, R. The Cancer Epidemic as a Social Event. 2004  Canadian Centre for Policy Alternatives. Manitoba.

5. Environmental and Occupational Causes of Cancer (New Evidence 2005 – 2007) Richard Clapp. Lowell Centre for Sustainable Production.

6. Zero Cancer/Occupational Cancer. International Trade Union Confederation (ITUC) and Global Unions.

7. Business and Human rights. A resource website. Why environmental issues are human rights issues.

Primary prevention of women’s occupational cancer does not mean taking a ‘3 monkeys’ approach.

SONY DSC
The Alliance for Cancer Prevention and the Hazards Campaign joined forces to create a photo op outside the HSE meeting on Tackling Occupational Disease -Developing New Approaches, to draw attention to the lack of focus on women’ occupational and environmental cancers.

Press release: Tackling occupational cancer should mean prevention it, not taking a ‘3 monkeys’ approach. 

Piece from the Safety and Health Practitioner: here

Video of the demo: here

Thought Provoking Questions Raised in Breast Cancer Debate


Pink ribbosn inc screening brighton

The Alliance for Cancer Prevention took part in a screening of Pink Ribbons Inc in Brighton on the 13th March 2013. The event organised for the Ngender seminar series by Ana Porroche-Escudero and Grazia de Michele was very well attended and there was a very thought provoking discussion afterwards.

Read the blog piece from the Ngender Seminar site below:

Thanks to all who participated in a lively and inspiring evening around breast cancer awareness. After the Pink Ribbons, Inc. film, our three panelists briefly introduced themselves, their experiences and their work.

Helen Lynn has been campaigning for 17 years for breast cancer. She believes breast cancer can be viewed as a form of violence against women; women are consigned to what could be a preventable disease as chemicals that are in everyday use remain largely untested, or even worse, they continue to be used after they have been linked to cancer. Hence, women are exposed needlessly and wilfully to chemicals which are linked to the disease. The organisation, Alliance for Cancer Prevention brings women and men together to work on these issues. More here.

 

Tackling occupational cancer should mean preventing it, not taking a ‘3 monkeys’ approach

Press Release

13/3/13

smaller poster copy (2)

Photo-op 8.30am Thursday 14th March, British Library, Gate No 5 Midland Road.

Campaigners against occupational and environmental cancer will hold a photo op outside the British Library, HSE conference on Tackling Occupational Diseases.  Women’s work-cancer is almost totally ignored by the HSE so campaigners will leave bras behind as a protest against the denial, delay and dithering that will kill more women from breast cancer especially.

Government, employers and the Health and Safety Executive are consigning thousands of workers to occupational cancer by their ‘3 monkeys’ approach to ‘tackling’ occupational disease.  Occupational cancer kills up to 18,000 men and women each year (1) yet action on prevention has been side-lined in favour of yet more research, and still work-related cancer in women is virtually ignored condemning more women to suffer and die.

HSE’s old fashioned, outdated approaches miss many modern workplace risks but especially ignore women’s cancers, specifically breast cancer, as researchers have recently shown (2, 3).  Campaigners will reinforce this point by leaving their bras outside the British Library as a protest against this approach.

“The Hazards Campaign has accused the HSE of dithering, denying and delaying over occupational cancer, and employers and government are also guilty of doing almost nothing on prevention for all work-cancers.  But this ‘3 monkeys’ approach is especially deadly for work-related cancer in women which has been completely ignored, under-researched and so much less likely to be targeted for preventative action.”  Said Hilda Palmer of the Hazards Campaign.

“Occupational and environmental breast cancer is largely preventable and we hope this strategic meeting organised by the HSE will call for that.  For female cancers, specifically breast cancer, not to act now in a precautionary way, applying existing knowledge to reduce the occupational and environmental risk factors could be viewed as an act of wilful neglect.”  Said Helen Lynn from the Alliance for Cancer Prevention.

Traditional approaches to try and regulate the amount of exposure to certain chemicals in occupational and environmental settings are unworkable in light of what we know about chemicals which interfere with our endocrine systems (the body’s messenger system).  These endocrine disrupting chemicals (EDCs) are intrinsically linked with cancer and act singularly and in combination to increase the risk of breast and other cancers.

WHO estimates that as much as 24% of human diseases and disorders are at least partly due to environmental factors including chemical exposures. The report states: “Many endocrine diseases and disorders are on the rise and the speed at which they are increasing rules out genetic factors as the sole plausible explanation” (4)

Recent research highlighting excesses of breast cancer in occupations such as agricultural, automotive plastics, and food canning industries found women workers had elevated breast cancer risk, up to 5 times higher than the controls in certain sectors such as automotive plastics (3)

And yet another paper on the issue stated: “Primary prevention of cancer of environmental and occupational origin reduces cancer incidence and mortality, and is highly cost effective; in fact, it is not just socially beneficial because it reduces medical and other costs, but because it avoids many human beings suffering from cancer.” (5)

The United Steelworkers union in the US has acted immediately on this research by alerting their members and calling for substitution, chemical law reform and health and safety improvements.(6)

Yet the UK cancer establishment continued to assure women there is no need to worry and falls back on the archaic and limited risk reduction strategy of better diet, more exercise and limiting alcohol. (7)

Hilda Palmer of the Hazards campaign says: “We want this HSE meeting to make publicly explicit the extent, and preventable nature, of all occupational cancers; that prevention must be prioritised by government, employers and the HSE; that exposure to all cancer risks must be eliminated or reduced to as low a level as possible, and that women’s cancer risks must now be targeted for prevention”

Helen Lynn. Alliance for Cancer Prevention 07960033687
www.allianceforcancerprevention.org.uk

Hilda Palmer. Hazards Campaign: 079298 00240
www.hazardscampaign.org.uk

Event photo here.

Notes to Editor:

  1. Burying the evidence Hazards Magazine.
  2. ‘This man knows all about cancer Article on the work of Simon Pickvance. Hazards 117, Rory O’Neill
  3. J. T. Brophy et al., “Breast Cancer Risk in Relation to Occupations with Exposure to Carcinogens and Endocrine Disruptors: A Canadian Case-Control Study,Environmental Health 11(87) (2012): 1-17, doi: 10.1186/1476-069X-11-87
  4. WHO/UNEP report on the State of the Science for Endocrine Disrupting Chemicals Report.
  5. Espina C, Porta M, et al. Environmental and Occupational Interventions for Primary Prevention of Cancer: A Cross-Sectorial Policy Framework. Environ Health Perspect. Advanced publication here.
  6. United Steelworkers Hazards Alert on occupational breast cancer.
  7. Does your job increase your breast cancer risk? Breakthrough comments on the recent research published in Canada that links occupation to an increased risk of developing breast cancer. Here.

 

Is The HSE Keeping Women In The Dark On Shift Work Breast Cancer Link?

Working night shifts more than twice a week is associated with a 40% increased risk of breast cancer, found a long term study published online on 28 May in Occupational and Environmental Medicine.

Yet the UK’s Health and Safety Executive (HSE) and the cancer establishment leave women in the dark by taking a “wait and see approach” to this occupational risk factor for breast cancer.

The Danish research found that working less than three night shifts a week doesn’t affect your breast cancer risk, but that frequent night shifts for several years may disrupt biological rhythms and normal sleep patterns, and curb production of the cancer protecting hormone melatonin. Shift work also increases your rate of developing type two diabetes and obesity.

In a recent article in Hazards magazine, Simon Pickvance, a researcher based at Sheffield University and founder member of the Alliance for Cancer Prevention, voiced concern about why the HSE presumes to know better than the UN’s International Agency for Research on Cancer.

The Alliance for Cancer Prevention wants to see action to reduce these cases of occupational breast cancer and calls on the HSE to follow the example set by the Danish Government who offered compensation for those already working up to four nights over several years.

UNISON safety reps should demand effective risk assessments on shift patterns and ensure the least unhealthy patterns are adopted. Workers need information about the risk from shift work so they can make an informed choice about what they can do to lessen the risk.

Women worried about the risk from shift work for breast cancer should contact UNISON for advice.

For further information regarding shift work see UNISON’s negotiating on shift work bargaining support guide for workplaces representatives.