Are some breast cancers caused by work? In France, where a health agency is working on the issue, only a few women have succeeded in having the occupational origin of their illness recognized—a blind spot in public policy, experts believe.
While the annual Pink October campaign, dedicated to screening, has begun, the public authorities "are not paying enough attention to the consequences of work for women," said Jean-Luc Rué, health and safety manager at CFDT Grand Est, a union that is very active on the subject.
Breast cancer, the most deadly cancer among women in France, with 12,000 deaths per year, is a disease whose risk factors have not yet been fully explored: night work was deemed "probably carcinogenic" in 2007 by the International Agency for Research on Cancer, a WHO agency which also classified X-rays and gamma rays as "proven carcinogens".
Working nights more than two nights a week for more than 10 years triples the risk, the National Institute of Health and Medical Research said in 2018.
Exposure to certain chemicals could also have an impact.
However, the "consequences of work that can lead to increased risk" are "very rarely" mentioned in public policies, whereas "by eliminating these elements, we could reduce the number of pathologies," Mr. Rué recently lamented before the Association of Social Information Journalists (Ajis).
Health prevention campaigns advocate "stopping smoking, stopping drinking, moving more, eating better," which would help prevent 40% cancers, but "ignore any other risk factor whose genesis would be collective," argued sociologist Anne Marchand in "Dying from work today, an avoidable scourge" (L'Atelier editions).
For the medical profession, identifying and preventing occupational risks is no longer a priority, the researcher noted while supporting some 200 employees and retirees suffering from bronchopulmonary cancers in their recognition process.
– Lack of studies –
"Few doctors ask people about their professional activity. Some will ask, 'What do you do for a living?' and leave it at that," she told AFP. "But they won't ask, 'What did you work in?' Yet cancers occur 20, 30, or 40 years after exposure."
An illness is said to be "occupational" when it is the consequence of a worker's usual exposure to a physical, chemical or biological risk and if it appears in one of the tables of the general or agricultural Social Security scheme, resulting from negotiations between unions and employers.
When there is no chart, as in the case of breast cancer, doctors study the case and decide on the link between work and the pathology, in a regional committee for the recognition of occupational diseases (CRRMP). The woman must then prove a "direct and essential link" between her cancer and her work.
So far, very few women have received this recognition, which entitles them to compensation. The first, in 2023, was a nurse from Moselle who was exposed to radiation and worked nights at the hospital for 28 years.
"The difficulty is that there is a lack of studies on the impact of work on women, even though one in two workers is a woman," pointed out Mr. Rué, a member of the commission setting the criteria for recognizing occupational diseases (CS4).
The studies "are mostly conducted on a male population, without hormonal variations, whereas body fat and hormones vary the reaction to exposures and toxins," explained Ms. Marchand.
To break the deadlock, the French National Agency for Food, Environmental and Occupational Health and Safety (ANSES), whose expertise is used to inform negotiations between social partners, is analyzing the occupations and exposures that could lead to an increased risk of breast cancer.
"We are working on several factors: night work, certain chemicals, which remain to be determined, and ionizing radiation," explained Henri Bastos, scientific director of health and work at ANSES.
Conclusions expected at the earliest by the end of 2026.
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