Cancer, Reproductive, Cardiovascular, and Other Chronic Disease Prevention Program
The mission of the Cancer, Reproductive, Cardiovascular and Other Chronic Disease Prevention Program (CRC) is to provide national and international leadership for the prevention of work-related diseases using a scientific approach to gather and synthesize information, create knowledge, provide recommendations, and deliver products and services to those who can effect prevention. CRC includes projects addressing a wide variety of health endpoints. As the name implies, the concentration of projects within this program includes work-related research related to many types of cancer, reproductive health, and cardiovascular disease. Additionally, CRC is the NIOSH program that includes projects related to occupational neurologic and renal diseases as well as other conditions or illnesses not identified elsewhere in the program portfolio.
Based on well-documented associations between occupational exposures and cancer, it is estimated that approximately 20,000 cancer deaths and 40,000 new cases of cancer each year in the United States are attributable to occupation; additionally, it is estimated that less than 2% of chemicals in commerce have been tested for carcinogenicity. To continue to investigate and prevent the occupational cancers of the future requires the development of new methods to address etiologic and intervention questions; these new methods may involve advances in molecular biology, analytical chemistry, and genetics.
Disorders of reproduction include birth defects, developmental disorders, spontaneous abortion, low birth weight, preterm birth, and various other disorders affecting offspring; they also include reduced fertility, impotence, and menstrual disorders. Infertility is currently estimated to affect more than 2 million U.S. couples (one in 12 couples find themselves unable to conceive after 1 year of unprotected intercourse). Although numerous occupational exposures have been demonstrated to impair fertility (e.g., lead, some pesticides, and solvents), the overall contribution of occupational exposures to male and female infertility is unknown.
Cardiovascular Disease among Workers
Research about occupational risks for cardiovascular disease is an emerging area. A few specific toxins encountered occupationally are known to affect the heart, most prominently carbon disulfide, nitroglycerin, and carbon monoxide. There is substantial evidence that environmental tobacco smoke, air pollution, extreme heat, and extreme cold are risk factors for cardiovascular disease, and it is presumed that they are risk factors when they are encountered in the occupational setting. In addition, while the linkages are not yet understood, numerous studies show a relationship between heart disease and depression and exposure to stress at work. Other work-related exposures potentially related to cardiovascular disease include occupational noise exposure, shift work, and physical activity at work.
Occupational Neurologic and Renal Diseases
A number of occupational hazards have been associated with different types of occupational neurologic and renal diseases. In some instances, excessive exposure to agents used in the workplace has been clearly associated with neurologic or renal health effects – in those instances the need for research may involve intervention effectiveness or improved characterization of health effects related to lower levels (or different types) of exposure. In other areas, the research needs involve etiologic work – research to improve understanding of potential hazards and associated health effects.