LAUSR

Background and objectives Construction workers are exposed to several carcinogens at work. Implementing intervention methods may reduce workers’ exposure, which should subsequently reduce the number of cancer cases attributable to the exposure. The current study estimates the future lung cancer burden due to respirable crystalline silica (RCS) exposure among Ontario construction workers, and assesses the impact of implementing interventions on this burden. Methods The annual number of new cancer cases attributable to RCS was estimated from 2030 to 2060 using Levin’s equation based on the prevalence of exposure (PrE) and the risk of cancer (RR) associated with RCS exposure. The RR was selected from a review of the epidemiologic literature. The PrE was estimated using CAREX Canada’s estimates of prevalence and level of exposure, combined with historical and projected employment data, labour force characteristics, and survival probabilities. The intervention methods (personal protective equipment, wet cutting) were assumed to be fully implemented from 2020, and incorporated into the model by adjusting prevalence and level of exposure downwards. Results We estimated that without intervention, 107 lung cancers would be attributable to RCS exposure in Ontario construction workers in 2030.This number increased to 181 in 2060. If intervention methods were applied, the reduction in the attributable cases became evident from 2040 onward, with a maximum reduction of 51 cancers in 2060. Overall, 481 cancers would be prevented between 2030 and 2060, which is 11% of the total cases if the interventions were not implemented. Conclusions Future work-related cancers can be prevented by reducing workers’ exposure. Combining the economic assessment of both the cancer burden and the costs of implementing exposure controls will help to assess the cost-benefit of different intervention methods, which can be used to direct intervention strategies in construction workplace.