Carga do câncer atribuível a fatores de risco ocupacionais - análise dos estudos Global Burden of Diseases, Injuries and Risk Factors 2019 e 2023

Abstract

Objective: This study aimed to analyze the burden of occupational cancer in Brazil and the Americas. Methods: This is a time-series epidemiological study with regional comparisons that used data from the Global Burden of Diseases, Injuries and Risk Factors (GBD) 2019 and 2023. For the first article, we considered age-standardized mortality and Disability Adjusted Life Years (DALYs) rates for lung cancer attributable to occupational risk factors in Brazil and its federation units between 1990 and 2019. A panel analysis was performed to assess the association between the rates attributable to the three most frequent carcinogens and the sociodemographic index (SDI) of each federation unit. For the second article, we considered age-standardized mortality and DALYs rates for cancer attributable to occupational asbestos exposure, as well as rates for specific age groups, in the regions that make up the Americas. Segmented Joinpoint regression analysis was performed to assess the trend in age-standardized rates and age-period-cohort analysis to assess specific rates for groups aged 50 years and older. Results: Exposure to asbestos, silica, and diesel fumes accounted for more than 85% of deaths and DALYs from occupational lung cancer in both sexes between 1990 and 2019 in Brazil. In women, an increase in both rates was observed for almost all occupational carcinogens evaluated, mainly in the North and Northeast regions of the country, and the relationship with SDI was positive for rates attributable to asbestos, silica, and diesel. In the Americas, lung cancer was the most frequent malignant neoplasm attributable to occupational asbestos exposure, followed by mesothelioma, ovarian and laryngeal cancer. Mortality and DALY rates were higher in the High-income North America region, but with decreasing trends in both sexes between 1990 and 2023. In women, higher risks for lung cancer and mesothelioma were observed in Tropical and Southern Latin America. Conclusions: The present study highlighted important regional and gender disparities, showing less favorable trends for women affected by occupational cancer in the Tropical and Southern Latin America regions and in the North and Northeast regions of Brazil. The findings intend to support occupational health and safety measures to effectively eliminate or control exposure to occupational carcinogens, as well as legislative advances to combat unhealthy workplace conditions.