TY - JOUR
T1 - Burden of lung cancer and predicted costs of occupational exposure to hexavalent chromium in the EU
T2 - the impact of different occupational exposure limits
AU - Chen-Xu, José
AU - Jakobsen, Lea Sletting
AU - Pires, Sara Monteiro
AU - Viegas, Susana
N1 - Funding Information:
This project received funding from the COST Action CA18218 European Burden of Disease Network, supporting the first author with a Short-Term Scientific Mission to the National Food Institute, Technical University of Denmark, with the aim of improving knowledge and applying the appropriate methodology on burden of disease on this project.The authors would like to thank the researchers from the Research Group for Risk Benefit from the National Food Institute, Technical University of Denmark for raising questions to improve the robustness of the research project, as well as the COST Action CA18218 European Burden of Disease Network for funding and supporting the project, and to the researchers Carla Martins from NOVA National School of Public Health and Ricardo Assunção from Egas Moniz Cooperativa de Ensino Superior for contributing to the initial brainstorming on the disease pathology.
Publisher Copyright:
© 2023 The Authors
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: Exposure to hexavalent chromium [Cr(VI)] occurs widely in occupational settings across the EU and is associated with lung cancer. In 2025, the occupational exposure limit is set to change to 5 μg/m3. Current exposure limits are higher, with 10 μg/m3 as a general limit and 25 μg/m3 for the welding industry. We aimed to assess the current burden of lung cancer caused by occupational exposure to Cr(VI) and to evaluate the impact of the recently established EU regulation by analysing different occupational exposure limits. Methods: Data were extracted from the literature, the Global Burden of Disease 2019) study, and Eurostat. We estimated the cases of cancer attributable to workplace exposure to Cr(VI) by combining exposure-effect relationships with exposure data, and calculated related DALYs and health costs in scenarios with different occupational exposure limits. Results: With current EU regulations, 253 cases (95%UI 250.96–255.71) of lung cancer were estimated to be caused by Cr(VI) in 2019, resulting in 4684 DALYs (95%UI 4683.57–4704.08). In case the welding industry adopted 10 μg/m3, a decrease of 43 cases and 797 DALYs from current values is expected. The predicted application of a 5 μg/m3 limit would cause a decrease of 148 cases and 2746 DALYs. Current costs are estimated to amount to 12.47 million euros/year (95%UI 10.19–453.82), corresponding to 39.97 million euros (95%UI 22.75–70.10) when considering costs per DALY. The limits implemented in 2025 would lead to a decrease of 23.35 million euros when considering DALYs, with benefits of introducing a limit value occurring after many decades. Adopting a 1 μg/m3 limit would lower costs to 1.04 million euros (95%UI 0.85–37.67) and to 3.33 million euros for DALYs (95%UI 1.89–5.84). Discussion: Assessing different scenarios with different Cr(VI) occupational exposure limits allowed to understand the impact of EU regulatory actions. These findings make a strong case for adapting even stricter exposure limits to protect workers’ health and avoid associated costs.
AB - Background: Exposure to hexavalent chromium [Cr(VI)] occurs widely in occupational settings across the EU and is associated with lung cancer. In 2025, the occupational exposure limit is set to change to 5 μg/m3. Current exposure limits are higher, with 10 μg/m3 as a general limit and 25 μg/m3 for the welding industry. We aimed to assess the current burden of lung cancer caused by occupational exposure to Cr(VI) and to evaluate the impact of the recently established EU regulation by analysing different occupational exposure limits. Methods: Data were extracted from the literature, the Global Burden of Disease 2019) study, and Eurostat. We estimated the cases of cancer attributable to workplace exposure to Cr(VI) by combining exposure-effect relationships with exposure data, and calculated related DALYs and health costs in scenarios with different occupational exposure limits. Results: With current EU regulations, 253 cases (95%UI 250.96–255.71) of lung cancer were estimated to be caused by Cr(VI) in 2019, resulting in 4684 DALYs (95%UI 4683.57–4704.08). In case the welding industry adopted 10 μg/m3, a decrease of 43 cases and 797 DALYs from current values is expected. The predicted application of a 5 μg/m3 limit would cause a decrease of 148 cases and 2746 DALYs. Current costs are estimated to amount to 12.47 million euros/year (95%UI 10.19–453.82), corresponding to 39.97 million euros (95%UI 22.75–70.10) when considering costs per DALY. The limits implemented in 2025 would lead to a decrease of 23.35 million euros when considering DALYs, with benefits of introducing a limit value occurring after many decades. Adopting a 1 μg/m3 limit would lower costs to 1.04 million euros (95%UI 0.85–37.67) and to 3.33 million euros for DALYs (95%UI 1.89–5.84). Discussion: Assessing different scenarios with different Cr(VI) occupational exposure limits allowed to understand the impact of EU regulatory actions. These findings make a strong case for adapting even stricter exposure limits to protect workers’ health and avoid associated costs.
KW - Burden of disease
KW - Health costs
KW - Hexavalent chromium
KW - Lung cancer
KW - Occupational exposure
KW - Public health
UR - http://www.scopus.com/inward/record.url?scp=85151743698&partnerID=8YFLogxK
U2 - 10.1016/j.envres.2023.115797
DO - 10.1016/j.envres.2023.115797
M3 - Article
C2 - 37001847
AN - SCOPUS:85151743698
SN - 0013-9351
VL - 228
JO - Environmental Research
JF - Environmental Research
M1 - 115797
ER -
