Methodological approach for assessing risks and reducing workers’ worry for rare occupational cancer—managing a case of liver angiosarcoma

Background Rare occupational cancer affects both the patient and their workplace. A case of occupational liver angiosarcoma was diagnosed within the Swedish polyvinyl chloride industry nearly 30 years after the last known case. This necessitated an intervention aiming to investigate the exposure, assess risks, and reduce the workers' worry for this rare occupational cancer within the industry. Materials and methods An intervention was designed consisting of five parts: investigation of the case, retrospective exposure assessment to identify current workers at risk, risk communication to the employer and employees, evaluation of the intervention, and transferring knowledge beyond the specific organization. The retrospective exposure and risk assessments were performed using available exposure data from the industry, interviews with workers, and reported dose-effect relationships. Results The index case diagnosed with occupational liver angiosarcoma, exposed since 1951, had an assessed vinyl chloride exposure of 6400 ppm-years resulting in a lifetime risk of 20%. For workers employed after 1974, the lifetime risk of angiosarcoma was considered low (≤0.03%). For six workers exposed before 1974, individual risk assessments were performed resulting in lifetime risks of 0.03%-1%. The intervention resulted in reduced worry among the workers within the industry. Conclusions This methodological approach was successful in reducing workers' worry about a rare occupational cancer and could also be successfully applied to other rare occupational cancers. Results showed a negligible risk of angiosarcoma due to vinyl chloride exposure among Swedish workers employed after 1974. Even current workers employed before 1974 had a limited risk.