Construir a visibilidade dos cânceres ocupacionais. Uma pesquisa permanente em Seine-Saint-Denis

Abstract

Since 2003, the prevention of occupational cancers has been considered as a sanitary priority that supposes a production of knowledge mobilizable by strategies to protect salaried workers against occupational exposure to carcinogenic causes. The first part of this article questions the interpretation of the inequalities related to cancer and highlights the limits of the dominant model of interpretation of cancer causality, based on the exclusive role of behavioral factors. Relying on the characteristics of cancer, a disease that falls within a long and complex process, the author demonstrates the triple socially constructed invisibility of work-related cancer: toxic ignorance, physical invisibility, and social invisibility. The second part presents a research for the action taken since 2001 with cancer patients in three hospitals in Seine-Saint-Denis, in order to reconstruct their careers, identify carcinogens in these careers and monitor procedures for recognition as occupational diseases. After a brief history of the constitution of the interdisciplinary and interinstitutional network in which this research is carried out, the author presents the method and the results. Significant occupational polysaccharide exposure to the carcinogens of the 684 patients followed up in the study is evidenced. Another history of occupational cancers emerges, followed by changes in work and economic production, calling into question the reference model for the recognition of workers or ex-workers with cancer as occupational diseases. In conclusion, the author proposes that the reconstruction of occupational pathways and exposure histories become a necessary dimension of the departmental registries of cancer, making it possible to determine, at the local level, the priorities and strategies to be implemented to protect workers against cancer. occupational exposure to carcinogens.

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