Tài liệu THE WORLD HEALTH ORGANIZATION''''''''S FIGHT AGAINST CANCER doc

LINK DOWNLOAD MIỄN PHÍ TÀI LIỆU "Tài liệu THE WORLD HEALTH ORGANIZATION''''''''S FIGHT AGAINST CANCER doc": http://123doc.vn/document/1037035-tai-lieu-the-world-health-organizations-fight-against-cancer-doc.htm

care
manage
3
Cancer killed 7.6 million people
in 2005, three quarters
of whom were in low- and
middle-income countries
www.who.int/cancer/en/
Backed by World Health Assembly resolution 58.22 of 2005 on
cancer prevention and control, WHO is committed to a Global Action
Plan Against Cancer that will enhance synergies both across WHO
and with our international partners to reduce the physical, social
and economic burden of cancer worldwide.
Dr Margaret Chan
Director-General
These strategies, requested by the World Health Organization’s own
Member States, provide a strong foundation for a determined fight
against the disease. Jointly, they will form the basis of our Global
Action Plan Against Cancer.
Despite these efforts, WHO and its Member States still face great
challenges to defeat the global burden of cancer. Greater investment
in prevention, cure and care, closer collaboration with international
partners and stronger determination to defeat cancer are needed to
fuel what must be a continuous, sustainable campaign.
Cancer is the world’s second biggest killer after cardiovascular dis-
ease, but one of the most preventable noncommunicable chronic dis-
eases. Cancer killed 7.6 million people in 2005, three quarters of whom
were in low- and middle- income countries. By 2015, that number is
expected to rise to 9 million and increase further to 11.5 million in
2030.
Up to 40% of all cancer deaths can be avoided by reducing
tobacco use, improving diets and physical activity, lowering
alcohol consumption, eliminating workplace carcinogens
and immunizing against hepatitis B virus and the human
papillomavirus.
A large proportion of cancer can be cured and
all cancer patients deserve care. WHO provides
support to strengthen health services to cure
and care for cancer patients by improving pri-
mary and specialized health care. WHO makes
essential medicines and technologies available
for cancer treatment and palliative care. Our
strategies and policy guidelines help govern-
ments in all countries to improve population
health standards and reduce national cancer
burdens.
Years of work have resulted in global strategies
being crafted and implemented to improve health, and
prevent and control cancer.
of all cancer deaths can be prevented
40%
cure
4
global aCTion Plan againsT CanCer
Can save millions oF lives
WHO knows how to stop millions of people dying needlessly from cancer.
Our task is to support Member States to make this happen.
WHO’s Global Action Plan Against Cancer combines the organization’s
existing strengths and strategies to increase its capacity to face this
global public health problem.
It provides guidance to governments, health providers and other
stakeholders on how to prevent and cure this chronic disease, as well
as care for those for whom palliation is the only option.
“It is possible, even in very economically-constrained environments,
to be effective in preventing cancer and improving access to quality
services for patients who need such services,” says Dr Catherine
Le Galès-Camus, WHO’s Assistant Director-General for Noncommu-
nicable Diseases and Mental Health.
Every year, at least 7 million people die from cancer, more than HIV/
AIDS, malaria and tuberculosis combined. And almost half of these
deaths are avoidable. The high prevalence of cancer is ominously
shifting from developed nations to poorer, less medically-equipped
countries.
Tobacco use and exposure causes 1.5 million cancer deaths
annually.
Chronic hepatitis B infection kills 340 000 from liver cancer and cir-
rhosis. A quarter of a million women die from cervical cancer. Vaccines
exist to prevent most of these deaths.
Occupational carcinogens kill at least 152 000 people. Some
274 000 people who are overweight, obese or physically inactive die
from cancer. Harmful alcohol causes 351 000 cancer deaths. Indoor
and outdoor air pollution leads to 71 000 cancer deaths, according
to WHO’s Comparative Risk Assessment publications (www.who.
int/healthinfo/boddocscra).
The human price is not the only loss caused
by cancer. It is responsible for immense costs
to health systems, insufferable economic and
emotional burdens on families and irreplace-
able losses for communities.
But WHO’s many departments and experts have developed a wide
range of strategies to end this needless suffering. These measures
prevent and cure many cancers, provide palliative care for the termi-
nally ill, and measure and manage the disease’s impact and services
to fight it. All these efforts are being consolidated in WHO’s Global
Action Plan Against Cancer.
This multi-faceted approach will ensure that these strategies are
addressed at country levels within national cancer control programmes
(NCCP), which are blueprints governments can use to frame legislation,
design health services and raise awareness to fight cancer.
To ensure that these strategies succeed, WHO must keep work-
ing closely with global partners, ranging from collaborating centres
(whocc.who.int) to governmental and nongovernmental organizations
in cancer-related fields like tobacco and immunization.
We also work hand-in-hand with a host of UN bodies, like the Inter-
national Atomic Energy Agency on the joint-Program of Action for Can-
cer Therapy (PACT) in Albania, Nicaragua, Sri
Lanka and the United Republic of Tanzania.
WHO has also formed a Commission on
Social Determinants of Health to promote
equal access to preventive and curative health
services for all people, irrespective of their
social or economic backgrounds.
Dr Andreas Ullrich, a WHO cancer control
medical officer within the Department of Chronic Diseases and Health
Promotion, says the Action Plan can help governments prevent deaths
from cancer by advocating prevention and control programmes at the
highest political level.
“Every country, regardless of resource level, can confidently take
steps to curb the cancer epidemic,” Ullrich says. “They can save lives
and prevent unnecessary suffering caused by cancer.”
Who CanCer fighters
Dr Andreas Ullrich, Medical Officer, Cancer Control
Who CanCer fighters
Dr Catherine Le Galès-Camus, Assistant Director-General for
Noncommunicable Diseases and Mental Health
care
prevent
manage
cure
5
global aCTion Plan againsT CanCer
Can save millions oF lives
Reading this brochure, you’ll be given
a dynamic glimpse of the many cancer
control activities WHO performs. Each
activity fits within the four broad
approaches WHO takes to fight cancer:
Prevention, Cure, Care and Manage.
WHO’s intensive efforts have produced
dozens of strategies, recommendations
and technical programmes to combat
hoW WhO FighTs CanCer
Prevent
WHO devotes vast amounts of effort to prevention activities,
which can reduce cancer deaths by 40% and prevent untold
suffering and cost to communities, increasingly in the develop-
ing world. This brochure examines each WHO programme deal-
ing with cancer prevention and how they go about it. Reducing
tobacco and alcohol use are key goals, as are improving diets
and physical activity. Safeguarding workplaces against car-
cinogens, and advancing immunizations against the hepatitis B
virus play enormous roles in reducing the cancer burden. They
are all discussed in the Prevention section.
Cure
Through early detection, screening and adequate treatment,
many cancers can be cured. WHO helps countries scale up
these areas. WHO provides countries, particularly in the devel-
oping world, access to the most appropriate technologies,
medicines and training to perform potentially life-saving treat-
ment. This brochure looks at what different programmes are
doing to build this cancer-fighting capacity in the field.
Care
WHO provides vital support and guidance to care for can-
cer sufferers for whom cure is not an option. Guidelines,
technical support and training are all offered to provide the
best possible palliative care services. WHO’s work in pal-
liative care – from headquarters to the field – is reviewed
in this brochure.
Manage
Providing information on cancer burdens for strengthening
evidence-based policy is a core WHO function. We assist
countries to plan, implement and measure the success
of their NCCPs. Such work also helps identify challenges
and direct resources towards effective cancer prevention
and control activities. This brochure examines the differ-
ent, yet coordinated, departments playing crucial roles in
developing necessary data and providing policy options to
ensure people benefit from NCCP.
cancer, prevent needless deaths
and provide appropriate care for the
terminally ill. WHO has consolidated
these tools for countries in a
framework known as the national
cancer control programme (NCCP),
which focuses government attention
and services on all facets of the fight
against cancer.
6
Tobacco use is the world’s leading prevent-
able cause of death, killing more than 5 million
people annually. About one third die from can-
cer. Left unchecked, global tobacco-related
deaths could rise to over 8 million by 2030.
The landmark WHO Framework Convention
on Tobacco Control (WHO FCTC) came into
force in 2005. It adresses tobacco control from supply and demand
standpoints and aids countries in handling civil and criminal liability
issues linked to tobacco use and manufacturers.
“We highlight the global problem of tobacco use and the many
serious diseases it causes, cancer being a main one,” says
Dr Douglas Bettcher, Acting Director of the Tobacco Free Initia-
tive (TFI), which drew up the Convention.
More than 140 countries have ratified the legally-binding WHO
FCTC and WHO is urging more states to follow suit. Parties to the
Convention are obligated to introduce effective tobacco control
policies based on rigorous scientific evidence. Nongovernmental
www.who.int/tobacco/frameworkwww.who.int/tobacco/framework
Who TobaCCo ConvenTion
CruCial To CanCer PrevenTion
Quitting tobacco is the best way to reduce cancer. To help make this happen, WHO
develops and helps implement powerful tobacco controls.
organizations, such as the International Union Against Cancer (UICC),
play pivotal roles in helping WHO curb tobacco use.
Of the 7 million annual cancer deaths, 40% are preventable. Of these
avoidable cancer deaths, tobacco accounts for 60%. Lung cancer is
the leading form of tobacco-caused cancer, followed by tumours of
the larynx, pancreas, kidney and bladder.
WHO assists countries develop legislation to raise cigarette prices
and ban tobacco advertising and smoking in public places.
Implementing the Convention’s controls could cause a 50% reduc-
tion in tobacco uptake and consumption, saving up to 200 million lives
by 2050.
TFI and WHO’s Oral Health Programme have also worked together
to produce information material for health professionals like den-
tists on oral cavity cancer, 75% of which is related to tobacco.
Who CanCer fighters
Dr Douglas Bettcher, Acting Director, Tobacco Free Initiative
Brazil’s approach to tobacco control is causing smoking prevalence and
related cancer deaths to fall among men.
Studies show that WHO-backed tobacco control measures have caused smok-
ing rates in Brazil to fall from 32% in 1989 to 19% today, says Vera Luiza de
Costa e Silva, WHO’s former Tobacco Free Initiative director.
“We can see that cancer mortality, particularly from lung cancer among men,
is declining due to our programmes, which makes Brazil a true success story,”
says de Costa e Silva, now the senior advisor on tobacco to Brazil’s Minister
of Health.
Brazil was a key architect of the WHO FCTC and has passed a wide range of
laws to fight tobacco use.
The WHO FCTC has banned tobacco product advertising, promotion and spon-
sorship and smoking in all public places in Brazil. Tobacco manufacturers must
display clear pictorial health warnings on packaging and remove misleading descriptive words like
“mild” and “light” cigarettes.
Brazil now targets low prices for tobacco products, tobacco smuggling rackets and the high rates of
young girls smoking to further cut smoking rates and reduce future cancer burdens.
“WHO’s support has been essential to this entire tobacco control process,” says de Costa e Silva.
BRAZIL’S ANTI-TOBACCO CAMPAIGN
CUTS CANCER DEATHS
PrevenT
Who dieT, PhysiCal aCTiviTy and
healTh sTraTegy TaCkles CanCer
Numerous countries in all WHO regions plan to implement or
have implemented DPAS independently or as part of existing
programmes.
WHO has conducted its Fruit and Vegetable Promotion Initiative since
2003 to increase global fruit and vegetable consumption.
Who CanCer fighters
Dr Timothy Armstrong, Acting Team Leader,
Global Strategy on Diet, Physical Activity and Health
Eating well and staying
active are keys to leading
healthier lives and
eliminating the risks of
chronic conditions like
cancer.
WHO works with countries to spread this simple
message and craft straightforward approaches to
promote healthy diets and physical activity.
WHO’s Global Strategy on Diet, Physical Activ-
ity and Health (DPAS) sets a range of policy
options for two major chronic disease risk fac-
tors: unhealthy diet and physical inactivity.
“DPAS implementation can save many can-
cer-related deaths through increasing population
levels of physical activity and improving dietary
habits,” says Dr Timothy Armstrong, Acting
Team Leader, Global Strategy on Diet, Physical
Activity and Health.
Poor diet, physical inactivity and being overweight
or obese can lead to higher risk of people suffering
common cancers, including oesophagus, colorec-
tal, breast, endometrium (uterus) and kidney.
Such risk factors have emerged through vast lifestyle changes
in developed and developing countries.
Overweight and obesity alone account for 40% of endometrial
cancer. Collectively, overweight and obesity, and physical inactiv-
ity account for 159 000 colorectal cancer deaths each year, and
88 000 breast cancer deaths each year.
Studies show 19% of breast cancer deaths and 26% of color-
ectal cancer mortality are attributable to increased weight and
physical inactivity.
DPAS is a tool for Member States to develop and implement
policies, plans and programmes to reduce risk factors linked to
unhealthy diets and physical inactivity in homes, schools and
workplaces.
OMAN EMBRACES WHO APPROACH TO
DIET AND EXERCISE
About half of Omanis over 20 years of age are overweight or obese.
This puts them at increased risk of suffering from oesophagus,
colorectal, breast, endometrial and kidney cancer, says al-Lawati.
Rapid development in the past 30 years has drastically changed
Omani lifestyle, resulting in more people becoming sedentary, eat-
ing more fast-food and exercising less.
Omani health authorities will disseminate WHO’s DPAS strategy
to all ministries for feedback and support in implementing its diet
and physical activity goals. Al-Lawati says the strategy is flexible
enough to be matched to Oman’s cultural requirements.
Oman has turned to WHO to defeat the growing burden of overweight
and obesity, and in doing so reduce cancer.
By implementing WHO’s Global Strategy on Diet, Physical Activity
and Health, Omani health policymakers have ready-made guidelines to
reduce risk factors that cause high rates of chronic disease.
“There is strong political will in Oman to implement DPAS because
noncommunicable diseases like cancer are seen as this country’s next
big challenge,” says Dr Jawad al-Lawati, Director of Noncommunicable
Diseases for Oman’s Ministry of Health.
“One of the avenues to address these issues is through DPAS.”
www.who.int/dietphysicalactivity
At just 5 years old, Malri Twalib is obese. Community health workers
spotted his weight problem last year during a health monitoring activity
in his village in Kilimanjaro, United Republic of Tanzania.
7
8
Who highlighTs
CanCer risks
oF alCohol
ConsumPTion
Reducing alcohol consumption leads
to a wide range of health gains,
including reduced cancer deaths.
WHO works with governments to introduce policies that reduce
the negative health consequences of hazardous and harmful alcohol
use, identify risky drinking patterns and improve public health.
Harmful alcohol use causes 351 000 cancer deaths annually and
is a risk factor for many cancers, including oral, pharynx, larynx,
oesophagus, liver, colorectal and breast.
“Putting more focus on cancer and alcohol and strengthening the
evidence base can help the health sector become more involved
in reducing alcohol-related harm and the risk of cancer,” says
Dag Rekve, a technical officer working on the management of
substance abuse.
In 2005, the World Health Assembly adopted a resolution on
“public health problems caused by harmful use of alcohol,” urging
countries to develop, implement and evaluate effective strategies to
reduce the health and social problems associated with alcohol.
WHO offers governments policy frameworks that recommend
effective strategies and interventions to reduce alcohol-related
harm. WHO wants to increase awareness, particularly among
national policymakers, of the risks to health of hazardous
and harmful drinking.
WHO has released manuals for physicians and other
health professionals to help hazardous and harmful drink-
ers with a brief intervention strategy to reduce danger-
ous drinking.
“For hazardous and harmful drinkers or people
with a dependence, effective treatment and brief
interventions exist to reduce the risk of can-
cer by reducing exposure to alcohol,” Rekve
says.
www.who.int/substance_abuse www.who.int/substance_abuse
Who vaCCine drives sToP
heP. b-linked liver CanCer
WhO helps hep B
immunizatiOn rates
sOar in China
WHO-backed immunization drives
against hepatitis B prevent hundreds of
thousands of people from succumbing
to liver cancer, a scourge in many
developing countries.
Chronic hepatitis B virus infection causes about half the world’s liver
cancer deaths, killing 340 000 people annually. But vaccinating children
can protect against the virus and prevent liver cancer.
With the GAVI Alliance, formerly known as the Global Alliance for Vac-
cine and Immunization, WHO promotes the introduction of hepatitis B
vaccine in many poor countries.
“We now have a very safe and effective vaccine that works when you
give it to children,” says Dr Thomas Cherian, coordinator of WHO’s
Expanded Programme on Immunization, part of the Department of
Immunization, Vaccines and Biologicals.
www.who.int/immunization/topicswww.who.int/immunization/topics
Who CanCer fighters
Dag Rekve, Technical Officer, Management of Substance Abuse
WHO is helping increase hepatitis B vac-
cinations across China, where up to 13 mil-
lion people have been immunized against
the liver cancer-causing disease since
2003.
WHO is a major partner of a five-year
$76 million immunization drive funded
by the GAVI Alliance and China targeting
5.5 million infants annually.
“Current estimates show approximately 90%
of infants born in GAVI Project-funded counties
are receiving the required three doses of vaccine, and
70% are getting it within the first 24 hours of life,” says
Dr Steven Hadler, a technical officer with the Expanded
Programme on Immunization in WHO’s Representative
Office in China.
9
“The vaccine’s rate of success is 95% for preventing chronic infec-
tion of hepatitis B.”
WHO estimates more than 2 million child deaths were averted
through immunization in 2003, plus another 600 000 hepatitis B-
related deaths that would have occurred in adulthood from liver cancer
and cirrhosis.
By late 2005, the vaccine had been introduced in 158 WHO Member
States. Global coverage is estimated at 55% and as high as 86% in
the Americas. This contrasts with 27% in South-East Asia and 39%
in Africa.
“In countries where hepatitis B infection is highly endemic it is one
of the top three cancer killers. It is up there with tobacco as a cause of
cancer in places like China,” says Dr Craig Shapiro, a medical officer
with the Expanded Programme on Immunization.
Poor countries needing vaccines receive WHO’s assistance to apply
to GAVI for funding and medicines. WHO has developed guidelines to
improve access to vaccines for children.
Who vaCCine drives sToP
heP. b-linked liver CanCer
Who leads vaCCine
inTroduCTion
againsT CerviCal
CanCer
New vaccines are not only preventing
infection but helping reduce cervical
cancer, which kills more than a quarter of
a million women annually.
WHO’s Initiative for Vaccine Research (IVR) leads efforts to intro-
duce vaccines for girls and young women to immunize them against
human papillomavirus (HPV), a sexually transmitted infection causing
cervical cancer.
One new vaccine prevents HPV infection and is
licensed in several countries, while another has
been undergoing late-stage clinical testing.
“These HPV vaccines are a tool to fight cervi-
cal cancer and sexually-tranmitted HPV infections
and can be used with sexual risk reduction edu-
cation and screening programmes in our fight against the disease,”
says Dr Teresa Aguado, coordinator of IVR’s Product Research and
Development unit.
WHO is focusing its fight in the developing world, where 80% of
global cervical cancer deaths occur.
More than 250 000 women die annually from cervical cancer, 99%
caused by HPV. WHO projects cervical cancer deaths will rise to
320 000 in 2015 and 435 000 in 2030.
Two HPV types cause 70% of cervical can-
cer and existing vaccines are more than
90% effective against these types.
IVR backs applied research into HPV
vaccines and advises governments on
introducing them into cancer screening,
immunization, adolescent, reproductive,
and sexual health programmes.
WHO provides evidence for decision-
makers on introducing HPV vaccines in
countries through its partnerships with
donors, such as the Bill and Melinda Gates
Foundation, and nongovernmental organi-
zations, like the Program for Appropriate
Technology in Health (PATH).
IVR works with country and regional
stakeholders to evaluate the acceptability
of HPV vaccines and strategies to integrate
the vaccine into cervical cancer prevention
programmes.
WHO funds the WHO Information Cen-
tre on HPV and Cervical Cancer. This is
an online database for decision-makers
that includes country-specific information
relevant to cervical cancer prevention and
HPV vaccine introduction.
IVR is creating an HPV Laboratory Net-
work to enable vaccine licensing and qual-
ity monitoring in developing countries.
Who CanCer fighters
Dr Thomas Cherian, Coordinator, Expanded Programme on Immunization
Who CanCer fighters
Dr Craig Shapiro, Medical Officer, Expanded Programme on Immunization
Some 120 million Chinese are
chronically infected with hepatitis B,
according to a 1992 national hepatitis
epidemiological survey. Liver cancer is
also the No. 1 cancer type in China.
Newborns are a main target of the
“China Ministry of Health/GAVI Hepa-
titis B Vaccination Project,” because
immunization within the first 24 hours
of birth prevents an infected woman
passing the virus to her child.
The drive is focussed on China’s
poorer western provinces where it
is preventing about 400 000 children
annually becoming disease carriers,
averting hundreds of thousands of liver
cancer deaths.
China aims to reduce the frequency
of chronic hepatitis B infection in chil-
dren to under 1% by 2010. Before the
immunization project started, up to 10%
of Chinese children became chronically
infected with hepatitis B.
10
Who guidanCe on
ChemiCals loWers
CanCer risks
WHO lowers cancer burdens by urging
reductions in exposure to numerous
carcinogens, including asbestos,
arsenic, dioxins and aflatoxins.
WHO produces standards, policies and recommendations with UN
partners, such as the United Nations Environment Program (UNEP),
for Member States to reduce exposure to carcinogens through air,
food and drinking water.
“We conduct science-based risk assessments
on chemicals to establish how much would be
tolerable without any health risks or, if possible,
determine what the health risks are at certain
exposure levels,” says Dr Angelika Tritscher, a
scientist with WHO’s Department of Public Health
and Environment.
Asbestos is one of the main occupational carcinogens, and expo-
sure occurs through inhaling contaminated air both in workplaces
and living environments. WHO works closely with the International
Labour Organization (ILO) and International Trade Union Confedera-
tion to reduce asbestos exposure. WHO recently published a series of
recommendations on eliminating asbestos-related diseases (whqlib-
doc.who.int/hq/2006/WHO_SDE_OEH_06.03_eng.pdf).
Arsenic is one of few carcinogenic chemicals in drinking water.
WHO, with other UN agencies, has produced a state-of-the-art review
on arsenic in water. It has also issued Guidelines for Drinking Water
Quality (www.who.int/water_sanitation_health/dwq/arsenic) that
recommend a guidance value for arsenic in drinking water.
WHO and the Food and Agriculture Organization (FAO) also produce
safety standards for chemicals in food, including cancer-causing
contaminants like dioxins or aflatoxins.
Food consumption is responsible for over 90% of exposure to
dioxins – chemicals that rank among the most dangerous and car-
cinogenic of the so-called “Dirty Dozen” – of persistent organic
pollutants.
The Joint FAO/WHO Expert Committee on Food Additives has
established a monthly tolerable intake level for dioxins and advises
on the effects of maximum dioxin limits in food.
WHO gives governments, particularly in developing regions, rec-
ommendations to reduce exposure to aflatoxins, organic chemicals
produced by mold that contaminate food in hot and humid climates,
mostly grains, corn and nuts.
Who Works To
make WorkPlaCes
CanCer Free
Thousands of workers could die from
cancer due to exposure to avoidable
carcinogens, like asbestos, and
unhealthy practices in factories,
fields and building sites.
To protect employees, WHO urges governments and industry to
ensure workplaces are equipped with adequate health and safety
standards and free from dangerous pollutants.
Each year, occupational carcinogens cause at least 152 000
cancer deaths, including lung, larynx and skin, leukaemia and
nasopharyngeal.
“We promote awareness that cancer can be pre-
vented through improving working environments,”
says Dr Ivan Ivanov, a scientist with WHO’s
Department of Public Health and Environment.
Unlike people who contract cancer by knowingly exposing them-
selves to carcinogens like tobacco, many workers have little say in
workplace health and safety measures and fall prey to poor health
protection standards, Ivanov says.
Most workplace cancer deaths occur in the developed world, but
numbers are growing in developing nations where safety standards
are often poor.
WHO provides policy recommendations to help numerous coun-
tries stop using carcinogens in the workplace.
Asbestos is one of the main occupational carcinogens and expo-
sure kills over 90 000 workers through lung cancer and mesothe-
lioma annually. Exposure occurs through inhaling contaminated air
both in workplaces and living environments.
Thousands more die from leukemia caused by exposure to ben-
zene, an organic solvent widely used by workers, including in
chemical and diamond industries.
WHO works closely with the International Labour Organization
(ILO) to reduce asbestos exposure and prevent other occupational
cancers. In 2006, WHO warned countries to stop using asbestos
or face a cancer epidemic. It also provided a series of recommen-
dations on eliminating asbestos-related diseases.
WHO also arms health ministries with up-to-date information to
frame health arguments and legislation to rid workplaces of car-
cinogens. Kenya used this information to help to replace all school
roofs containing asbestos with non-asbestos material.
www.who.int/occupational_healthwww.who.int/occupational_health
www.who.int/occupational_health/publications/asbestosrelateddiseasewww.who.int/occupational_health/publications/asbestosrelateddisease
Who CanCer fighters
Dr Angelika Tritscher, Joint Secretary to the FAO/WHO Expert Committee on
Food Additives and FAO/WHO Meeting on Pesticide Residues
Who CanCer fighters
Dr Ivan Ivanov, Scientist, Occupational Health
11
Who Works To
make WorkPlaCes
CanCer Free
Thousands of workers could die from
cancer due to exposure to avoidable
carcinogens, like asbestos, and
unhealthy practices in factories,
fields and building sites.
To protect employees, WHO urges governments and industry to
ensure workplaces are equipped with adequate health and safety
standards and free from dangerous pollutants.
Each year, occupational carcinogens cause at least 152 000
cancer deaths, including lung, larynx and skin, leukaemia and
nasopharyngeal.
“We promote awareness that cancer can be pre-
vented through improving working environments,”
says Dr Ivan Ivanov, a scientist with WHO’s
Department of Public Health and Environment.
Unlike people who contract cancer by knowingly exposing them-
selves to carcinogens like tobacco, many workers have little say in
workplace health and safety measures and fall prey to poor health
protection standards, Ivanov says.
Most workplace cancer deaths occur in the developed world, but
numbers are growing in developing nations where safety standards
are often poor.
WHO provides policy recommendations to help numerous coun-
tries stop using carcinogens in the workplace.
Asbestos is one of the main occupational carcinogens and expo-
sure kills over 90 000 workers through lung cancer and mesothe-
lioma annually. Exposure occurs through inhaling contaminated air
both in workplaces and living environments.
Thousands more die from leukemia caused by exposure to ben-
zene, an organic solvent widely used by workers, including in
chemical and diamond industries.
WHO works closely with the International Labour Organization
(ILO) to reduce asbestos exposure and prevent other occupational
cancers. In 2006, WHO warned countries to stop using asbestos
or face a cancer epidemic. It also provided a series of recommen-
dations on eliminating asbestos-related diseases.
WHO also arms health ministries with up-to-date information to
frame health arguments and legislation to rid workplaces of car-
cinogens. Kenya used this information to help to replace all school
roofs containing asbestos with non-asbestos material.
www.who.int/occupational_healthwww.who.int/occupational_health
www.who.int/occupational_health/publications/asbestosrelateddiseasewww.who.int/occupational_health/publications/asbestosrelateddisease
WhO advises On asBestOs
dangers in india, asia
labourers using such products. Many Indian school roofs are made
with asbestos, putting students and teachers at risk.
WHO holds workshops across Asia on the dangers of asbestos,
bringing together government officials, industry, other UN agencies
and nongovernmental organizations.
While calling for an end to the use of asbestos, WHO suggests
alternative building materials that industry can use instead of this
cancer-causing product.
Across India, asbestos exposure puts millions of people, from concrete
makers to students, at risk of developing cancer.
WHO is working with officials in India, and with many developing
Asian nations, to stamp out asbestos use by promoting awareness and
legislation on its cancer-causing risks.
“If countries follow our advice, there will be reductions in cancer,”
says Dr Habibullah Saiyed, WHO’s South-East Asian regional officer for
occupational health. “It will take several decades to see the results
because cancer takes a long time to emerge, but we must start now.”
Asbestos causes an estimated 8000 cancer deaths annually in India
and that number could increase if asbestos use continues.
People most at risk of dying from lung cancer and mesothelioma
are workers making asbestos-filled concrete and pipes, along with
WHO is a key player in raising awareness to prevent cancer caused
by exposure to sunlight and other non-ionizing, low-frequency forms
of radiation, such as sunbeds.
In 2006, WHO released its Global Burden of Disease of Solar Ultra-
violet Radiation, estimating that up to 60 000 people die every year
due to over exposure to ultraviolet
radiation. Of those, 48 000 are
caused by malignant melanomas
and 12 000 by skin carcinomas.
“Ultraviolet radiation can have
significant negative health conse-
quences such as skin cancer, as
well as a positive effect in terms of
providing our body with vitamin D,”
says Dr Emilie van Deventer, a
scientist specializing in non-ioniz-
ing radiation within WHO’s Radia-
tion and Environmental Health
Programme.
“For this reason we work to develop
population-based approaches to
help people live with the sun.”
WHO’s Sun Protection and
Schools Module, How to Make a
Difference, assists Ministries of
Health and Education to develop
www.who.int/uv/healthwww.who.int/uv/health
Ionizing radiation is a well established carcin-
ogen for certain cancers, like lung, breast and
thyroid cancer and most types of leukaemia.
“We look at all environments where radia-
tion may affect human health, including natural
radiation sources, accidental exposures, and
radiation use in occupational or medical settings,” says Dr Zhanat
Carr, a scientist with WHO’s Radiation and Environmental Health
Programme.
One of the world’s largest natural radiation sources is radon, a
gas produced from the uranium decay chain in rocks and soils. It
accumulates in the basement of homes built in areas where radon
occurs naturally. It is the second most important risk factor for
lung cancer after tobacco, causing tens of thousands of deaths
annually.
WHO launched its International Radon Project to estimate radon-
associated disease burdens, provide mitigation and surveillance
guidance and help Member States form evidence-based radon
policies.
WHO also deals with the results of nuclear emergencies like the
1986 Chernobyl nuclear reactor explosion that resulted in a mas-
sive radioactive fallout that affected mainly Belarus, Ukraine, and
the Russian Federation.
www.who.int/ionizing_radiationwww.who.int/ionizing_radiation
www.who.int/ionizing_radiation/env/radonwww.who.int/ionizing_radiation/env/radon
Who reduCes ionizing
radiaTion-relaTed CanCer
WHO’s efforts to reduce harmful exposure to ionizing radiation, from radon to
nuclear emergencies, are preventing cancer.
Since 1986, WHO has been involved in programmes at Chernobyl
providing assistance and assessing the health impacts of the explosion.
The accident led to a large increase in thyroid cancer among those
who were children at that time, most of whom were able to be treated
successfully. Thousands of clean-up workers are also under medical
and epidemiological surveillance in Belarus, the Russian Federation
and Ukraine.
In 2006, WHO issued a report with findings of 20 years of health
research into the Chernobyl explosion, which provides a basis for
national policy recommendations.
WHO works with its International Agency for Research on Cancer
(IARC) to gather evidence on Chernobyl and develop strong radiation
safety policies.
www.who.int/ionizing_radiation/chernobylwww.who.int/ionizing_radiation/chernobyl
Who CanCer fighters
Dr Zhanat Carr, Scientist, Radiation and Environmental Health
12