Global Burden, Projection, and Inequalities Analysis of Cancer Attributable to Occupational Carcinogen Exposure in Individuals Aged Over 40 Years.

Background: In this study, we investigated the global burden, projection, and inequalities of cancer attributable to occupational carcinogen exposure in individuals aged over 40 years.

Methods: Using the Global Burden of Disease 2021 dataset, we examined age-standardized disability-adjusted life years (ASR-DALYs) and deaths associated with cancer attributable to occupational carcinogen exposure. Statistical analyses included: the estimated Annual Percentage Change to assess trends (1990-2021); Bayesian age-period-cohort modeling for projections to 2030 and 2050; decomposition analysis to quantify contributions of aging, population growth, and epidemiological changes; and slope and concentration indices (SII, CI) to evaluate health inequalities by sociodemographic index (SDI).

Results: In 2021, the global ASR-DALYs attributable to occupational carcinogen exposure were 239.3 per 100,000 (95% uncertainty intervals [UI]: 180.76-300.91), with significant declines found since 1990. The ASR-deaths in the same year were 11.45 per 100,000 (95% UI: 8.57-14.29). By 2050, ASR-DALYs and ASR-deaths are projected to decline to 177.24 and 8.50 per 100,000, respectively. Men exhibited higher DALYs and mortality (3.92 million DALYs, 0.18 million deaths) compared with women. From 1990 to 2021, high SDI regions exhibited the most substantial decline, whereas low-middle SDI regions experienced the highest increase. The most prominent occupational carcinogens were asbestos (ASR-DALYs: 142.36 per 100,000), silica (50.36 per 100,000), and diesel engine exhaust (20.56 per 100,000). Among the seven types of occupational cancers observe, tracheal, bronchial, and lung cancers exhibited the highest ASR-DALY and ASR-deaths. Population growth is the primary contributor to both DALYs and deaths globally, followed by epidemiological changes.

Conclusion: This study highlights the declining global burden of cancer due to occupational exposure to carcinogens; however, significant disparities persist. Addressing occupational cancer risk in low-SDI regions and under-researched populations is crucial for reducing this health burden.