Between 2020 and 2023, the European Agency for Safety and Health at Work (EU-OSHA) conducted a survey in six European countries (Germany, Spain, France, Finland, Hungary and Ireland) to assess workers’ exposure to occupational cancer risk factors, based on over 24,000 telephone interviews.

On the basis of this study, EU-OSHA recently published a report dedicated to workers in the health and social care (HeSCare) sector, representing around 3,040 of the participants. This report provides estimates of the exposure of workers in the sector to 24 occupational cancer risk factors, as well as information on working circumstances and preventive measures in place.

Focus on the health and social sector

Representing around 11% of all jobs, the health and social care sector is one of the largest employers in the European Union (Eurostat, 2022). According to the EU-OSHA report, almost 30% of professionals in this sector were exposed to at least one carcinogenic risk factor during their last week of work.

Doctors, nurses, orderlies and laboratory technicians are among the most exposed categories. Overall, men are more often exposed to at least one risk factor than women (34.3% vs. 24.3%).

The main risk factors for occupational cancer

According to the report, the most frequent risk factors in the healthcare and social sector, all levels of exposure combined, are :

• ionizing radiation (7.4%),
• diesel exhaust emissions (6.2%),
• solar UV radiation (6.1%).

With regard to the degree of exposure, the report estimates the percentage of workers probably exposed to a risk factor as follows:

Contexts of exposure to cancer risk factors

Exposure to a carcinogenic agent depends not only on its presence in the workplace, but above all on the concrete circumstances in which the worker is exposed to it: type of task performed, work environment, frequency and duration of exposure, use or non-use of protective measures, etc.

Ionizing radiation

Health and social care professionals are mainly exposed to ionizing radiation when using X-ray machines for diagnostic purposes (X-rays, mammography), radiology (fluoroscopy, angioplasty), or as part of treatments such as radiotherapy.

The most commonly used protective devices are shields (lead or Plexiglas) (85%) and radioprotective clothing such as lead aprons, gloves or thyroid protectors (between 67% and 87%, depending on the task). Use of a personal dosimeter varies according to the context, while observance of safety distances (more than 2 meters from the source) remains infrequent (7.6%).

Diesel exhaust emissions

Workers may be exposed to diesel emissions when they drive, maintain or travel in diesel vehicles as part of their duties (home visits, medical transport, etc.). Although exposure is generally of low intensity, it remains frequent.

Few specific protective measures are reported in this context. There is not always suitable ventilation, nor personal protective equipment dedicated to this type of exposure in the sector.

Solar UV radiation

Exposure to natural UV radiation concerns professionals working outdoors during the day, whether in the open air, in a vehicle with open windows, or near reflective surfaces (water, glass, metal, concrete). This is particularly true for those working in the home or in rural areas.

Protective measures reported include the wearing of covering clothing (93% to 99% depending on the case), sunglasses (up to 48.3%) and headgear (25% to 32%). On the other hand, the use of sun cream remains low (around 10%), probably due to an underestimated perception of the risk associated with such exposure.

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