Relationship between work, health hard to nail down

How cancer cases are reported in Washington is up for review, with a hearing set later this month.


One reason that safety experts have faced major obstacles in making their case for stricter rules surrounding drug handling practices, is that there is no easy way to cross reference occupational histories and health outcomes.

In Washington, the state's cancer registry collects data from health care providers when someone is newly diagnosed with cancer. In principle, that data could include the person's "usual occupation" -- if that info is in the person's medical record.

In practice, that piece of data is frequently missing, said Kathryn Golub, program director for the Washington State Cancer registry. The registry also collects information from death records, which have similar limitations, she said.

The U.S. Cancer Statistics website, which combines data from every state, similarly does not break out statistics by occupation, although it does provide statistics related to type of cancer, geography, race, gender, ethnicity and age.

"People spend about half their waking hours on the job, and so there's important risk factor info available from industry and occupation information," said Dr. Geoff Calvert, supervisor of medical epidemiology for the National Institute for Occupational Safety and Health, a division of the CDC. Calvert's group at NIOSH has been pushing to get states to obtain better, coded information about occupation and job histories and to supply that to the national database.

Washington's cancer registry plans to provide additional training to physicians about the need to capture occupation and industry data, Golub said.

Washington's current law requiring reporting of cancer cases is under review, and is open for public comment until July 28th. The Department of Health will hold a hearing on the proposed changes, which primarily involve clarifying existing rules.

For information or to comment on the proposed changes to the current WAC you can go to the Department of Health Rules website at

The rule hearing is scheduled for July 28 at 8:30 a.m. at the Department of Health, Town Center Two, 111 Israel Road SE, Tumwater, WA 98501.

In an effort to help researchers identify the incidence of exposure-related illnesses, InvestigateWest is conducting a brief survey aimed at healthcare workers. This information will be made available to occupational health researchers interested in following up with their own studies, and to identify potential future areas for coverage of this important safety issue.

To participate in our survey, go to


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