Why Certain Employees are at Risk for Developing Cancer – and What You Can Do to Help
Cancer will inevitably affect most of us in our lifetime, whether directly or indirectly, making it critical to have a good understanding of cancer risk factors and what we can do to mitigate them. While many people are aware of some of the most common personal risk factors, such as smoking or a family history of certain types of cancer, there are some lesser-known factors – like the work environment – that may be putting certain employees an at unknowingly higher risk for disease.
Employers can play a pivotal role in educating their employees regarding risk factors for cancer by taking a proactive role in cancer prevention and/or early detection – one of the greatest tools we have in limiting the impact of cancer – through employee awareness, wellness initiatives, and support.
The connection between occupational hazards and cancer
It is widely accepted that employees in certain industries, roles, or environments have an elevated cancer risk compared with the general population because of exposure to known carcinogens. While the National Institute of Safety and Health (NIOSH) has formally identified hundreds of potentially cancerous occupational hazards1, some of the more common examples of employees who are at greater risk of developing certain types of cancers than the average person include:
- Firefighters, who are 9 percent more likely to develop cancer and 14 percent more like to die from cancer and/or cancer-related complications2
- Steel and iron workers, who are 500 times more likely to develop lung cancer3
- Agricultural workers, who have an elevated risk of cancer as a result of exposure to pesticides, fertilizers, and other chemicals4
The prevalence of cancer among employees in certain roles, like firefighting, is so striking that many states have enacted so-called “presumption laws,” which trump the burden-of-proof argument that previously made it difficult, or even impossible, for employees to receive compensation and disability associated with cancer-related claims. In California, cancer presumption bills cover certain types of cancer in firefighters, some police and safety officers, peace officers with the State Department of Fish & Wildlife, and the Department of Parks & Recreation, to name a few.5 Even lifeguards who develop melanoma are entitled to benefits under California’s presumption acts.6 In Rhode Island, the relatively recent adoption of a cancer presumption bill means that firefighters who develop any kind of cancer are now eligible for disability pension – though there are some stipulations, like whether the employee has a history of tobacco use, the duration of their employment, and whether they underwent a pre-employment physical.7
The occupational cancer risk factors that may surprise you
While firefighters and industrial workers may be on the “front lines” as far as cancer is concerned, that doesn’t mean they’re the only ones at risk. Pilots, truck drivers, and even desk workers are all known to have some level of cancer risk associated with their jobs. For pilots, flying just one hour in the cockpit of a plane – closer to the sun than your average office – exposes them to the same level of UV radiation as spending 20 minutes in a tanning bed.8 Add up thousands of flights over the course of a career in the aviation industry, and it’s easy to understand why flight crews have an increased risk of developing melanoma and other skin cancers.
More evidence continues to emerge showing a correlation between night shift work and certain cancers.9 This is largely thought to be tied to the disruption of circadian rhythms, which play a critical role in controlling many of our body’s natural processes related to health and wellness, like hunger, body temperature regulation, metabolism, and others. Not only that, but melatonin secretion – which occurs at night and is also stimulated by our circadian rhythms – has actually been shown to slow tumor growth and the spread of cancer cells.10 In employees who work through the night, like truck drivers and warehouse workers, the interruption of important regulatory systems and a lack of adequate melatonin may be partially to blame for the increased incidence of cancer cases.
Another well-studied phenomenon is the adverse impact that sitting can have on a person’s health, with many people now living by the mantra, “Sitting is the new smoking.” Some smart watches have built-in “stand reminders,” and sales of standing desks have risen sharply in recent years. It is estimated that the global value of the standing desk market will rise from about $6 billion in 2022 to over $10 billion by 2028, demonstrating society’s growing understanding of the benefits of regular standing along with the dangers of continuous sitting.11 In addition to exponentially increasing a person’s risk of developing heart disease, diabetes, and hypertension – all of which may be risk factors for cancer on their own – some studies have shown prolonged sitting to be associated with a higher incidence of breast and colon cancers.12 For employees whose day-to-day responsibilities are performed primarily while sitting, like long-haul drivers and desk workers, this is an important consideration that may be underrecognized.
To cancer, age really is just a number
According to National Cancer Institute (NCI), age is the leading risk factor for cancer overall and the number one risk factor for many individual types of cancer, with patients over the age of 60 being 5000 percent more likely to develop cancer compared with patients aged 20 and under.13 Consider this in the setting of an aging workforce – with the median employee age set to creep up by a full year or more by 2031 – and employers may soon be facing rising costs, both direct and indirect, associated with cancer.14 Going back as far as 2010, employee cancer treatment accounted for about $125 billion of U.S. employers’ total medical spend, with another $139 billion amassed in indirect costs, like time away from work and early retirement.15
Despite being less likely overall to develop cancer, younger employees today may be at a greater risk for developing cancer than their counterparts from previous years. Colon cancer rates, as an example, have nearly doubled in patients under 55 – from 11 percent in 1995 to 20 percent in 2019 – and new cases of colon cancer in young people continue to make the news today.16,17 At the same time, colon cancer rates are actually declining in older groups18, and the suspected reason – early detection – is one of the most effective ways employers can support their employees in efforts to minimize the risk and impact of cancer overall.
Early detection remains key
Medical experts largely agree that early detection remains the most compelling tool in the fight against cancer.19 When cancer is detected in its earlier stages, treatment is often more successful and case outcomes are often better. For employers, early detection may also mean reduced costs (both direct and indirect) associated with employee cancer. With this in mind, employers and employees may benefit by incorporating early cancer screening solutions into a workplace health and wellness plan or supporting employees in their efforts to undergo routine cancer screenings as recommended by their health care providers. This may mean allowing additional time away from work for screening visits or implementing other supportive strategies.
Cancer prevention from every angle
Beyond supporting early detection efforts, there are many steps employers can take to educate their employees about cancer risks and keep their employees healthier overall. The Northeast Business Group on Health (NEBGH) and the American Cancer Society agree that combining early screenings with a holistic approach toward cancer prevention is key when it comes to discouraging employee cancer cases.20 As part of NEBGH’s popular resource on the subject, a guide entitled Delivering Value in Cancer Care: The Employer Perspective,21 employers are encouraged to incorporate some of the following strategies into their workplace wellness plans:
- Offer health insurance plans that cover recommended cancer screenings
- Create policies that encourage and support cancer screening, like paid time off for screening appointments
- Provide educational resources on cancer risks and prevention strategies
- Support patients who may develop cancer by offering access to a patient navigator and other resources
To more publicly display your commitment to educating your employees regarding early detection cancer, the Centers for Disease Control and Prevention (CDC) suggests employers consider joining the CEO Cancer Gold Standard,22 a workplace wellness accreditation program focused on five pillars of cancer risk reduction:
- Health education and navigation
- Prevention and early detection
- Advancing treatment
Employers with employees who work around carcinogenic substances or in hazardous environments should redouble their efforts in reducing exposure levels. In 2016, NIOSH stood behind the idea that there is “no safe level of exposure to a carcinogen” and emphasized to employers the importance of elimination, substitution, and engineering controls as the preferred means of occupational cancer risk reduction.23 For employees who are unavoidably exposed to hazardous materials on a regular basis, having an occupational health provider like Concentra provides access to critical surveillance tools, educational resources, and other preventive or protective means.
And finally, as always, employers should encourage healthy habits and behaviors overall through a comprehensive employee wellness plan that may include a gym membership, access to exercise and nutrition programs, weight management resources, non-smoking incentives, ergonomic training, counseling, and other services. Along with reducing certain cancer risks, this holistic, health-first approach can discourage the development of diabetes and cardiovascular disease, improve occupational illness and injury rates, and keep your employees healthier, happier, and more productive for longer.
Interested in learning more about how Concentra can help support your cancer risk reduction efforts? Contact us today.
- Occupational Cancer – Carcinogen List. The National Institute for Occupational Safety and Health (NIOSH). Last reviewed May 2, 2012.
- Daniels, Robert D, PhD, CHP. Firefighter Cancer Rates: The Facts from NIOSH Research. NIOSH Science Blog. May 10, 2017.
- Bezrutczyk, Destiny. Occupational Exposure in the Iron and Steel Industry. Lung Cancer Center. Accessed March 20, 2023.
- Kayo Togawa, et. al. Cancer incidence in agricultural workers: Findings from an international consortium of agricultural cohort studies (AGRICOH). Environ Int. 2021 Dec; 157:106825.
- Firefighter Presumptions. California Professional Firefighters, Health & Safety. Accessed March 20, 2023.
- Calif. Senate passes lifeguard skin cancer presumption, insurance fraud bill. Business Insurance. August 25, 2022.
- Machado, Steph. “Lawmakers vote to presume all cancers in RI firefighters are caused by their job.” WPRI. July 8, 2020.
- McDowell, Erin. “10 jobs that are linked to a higher risk of cancer.” Business Insider. July 27, 2020.
- Aishe Dun, et. al. Association Between Night-Shift Work and Cancer Risk: Updated Systematic Review and Meta-Analysis. Frontiers in Oncology. 2020 June 23; 10:1006.
- Christina Lawson, PhD, et. al. Recent News about Night Shift Work and Cancer: What Does it Mean for Workers? NIOSH Science Blog. April 27, 2021.
- Standing Desks Market. Credence Research. 2022.
- Sitting may boost cancer risk. CBC News. November 4, 2011.
- Age and Cancer Risk. National Cancer Institute. Updated March 5, 2021.
- Employment Projects: Median age of the labor force, by sex, race and ethnicity. U.S. Bureau of Labor Statistics. Last modified September 8, 2022.
- Shockney, Lillie. PAYING ATTENTION TO CANCER PAYS OFF FOR YOUR EMPLOYEES. Johns Hopkins Medicine. Originally published in The Self Insurer Magazine. September 2017.
- Siegel, Rebecca, et. al. Colorectal cancer statistics, 2023. CA: A Cancer Journal for Clinicians. American Cancer Society. March 1, 2023.
- “Why Is Colorectal Cancer Rising Rapidly among Young Adults?” by NCI Staff. National Cancer Institute. November 5, 2020.
- Key Statistics for Colorectal Cancer. American Cancer Society. Last revised January 13, 2023.
- Cancer Detection and Diagnosis Research. National Cancer Institute. Updated May 17, 2022.
- ACS Research Priority Area: Screening. American Cancer Society. Accessed March 20, 2023.
- Delivering Value in Cancer Care: The Employer Perspective. Northeast Business Group on Health. November 2019.
- CEO Cancer Gold Standard. Accessed March 20, 2023.
- Occupational Cancer – NIOSH Chemical Carcinogen Policy. National Institute for Occupational Safety and Health (NIOSH). Accessed March 20, 2023.