P-542 Intervening to Reduce the Future Burden of Lung Cancer and Silicosis From Occupational Silica Exposure

Introduction Silicosis has recently re-emerged in several countries due to increased exposure to respirable crystalline silica (RCS) in mines, tunnelling, and kitchen benchtop fitting. Methods We used the future excess fraction (FEF) method to estimate the future number of lung cancer cases arising from occupational RCS exposure. Using census data, national predictions of future cancer occurrence, and information on the prevalence of RCS exposure from an OccIDEAS survey, we predicted the future number of lung cancers from occupational exposure to RCS. We then extrapolated the number of lung cancers to future silicosis cases using ratios derived from past cohort studies. By changing assumptions within this model we could then estimate the relative effect of various interventions on the future burden of disease. Results and discussion We estimated that approximately 584,050 Australian workers are currently exposed to RCS in the workplace, and that around 10,390 cases of lung cancer and 83,090 cases of silicosis will arise among those workers as a result of their exposure. Higher order interventions such as wet-cutting and banning engineered stone are likely to have the most impact on future burden of disease; however, modelling demonstrated that significant impact could still be achieved with the use of lower order controls. Conclusion These findings have clear implications for policy action. Our study received considerable press coverage and contributed to the national government taking action to reduce occupational RCS exposure. The FEF method is a useful way to demonstrate the effect of different policy options.