The word cancer was once uttered in hushed voices, if at all. The media considered the subject depressing and avoided it until the advent of trauma television. Few now use euphemisms such as “the big C”. We talk openly about cancer and its causes. No longer is it considered a random, unspeakable act of God or nature. But where fear has disappeared, blame takes its place. An emphasis on prevention that urges lifestyle changes means those who already live with cancer are tormented by thoughts it might be self-inflicted.

Smoking is said to affect many more organs than the lungs, but to cigarettes we must now add hormone replacement treatment, bacon sandwiches, roast beef dinners, any level of alcohol, burnt toast, delayed childbearing, being overweight or too sedentary, lying in the sun, bottle feeding or — in those too old to get the new cervical cancer vaccine — having sex.

Individual responsibility is generally a good thing, but blame in this case is disproportionate. One in five cases of lung cancer in women and one in 10 among men affect people who have never smoked. Secondary inhalation is a proven cause — women were more likely to work as barmaids when smoking was allowed in pubs. But this is by no means the only example of occupational cancer.

The European Journal of Oncology this month publishes Scottish research that suggests carcinogens at work kill many more people than the government claims. Professor Andrew Watterson, at Stirling University, says between 10% and 12% of fatal cancers in Scotland relate to occupation. That would mean 1,800 deaths a year — many more than those killed by road accidents, murder and suicide. All these trends are subject to high-profile government campaigns. We should be just as concerned that people die earning a living. Often, they are ignorant about the cause of their illness, as are their doctors. They lacked the information to make a safe career choice.

We tend to associate industrial cancers with the era of rust bucket industries . . . when concern about safety was seldom uppermost in the master’s mind. Victorian chimney sweeps contracted an unusual form of testicular cancer from exposure to soot, while match girls got bone cancer in the jaw from the use of phosphorous.

Today, we might not be surprised to learn that coal miners are more likely to get lung cancer, but many people are at risk above ground. Firefighters are more likely to get tumours in the brain, bladder, kidneys and colon, and are susceptible to non-Hodgkin’s lymphoma and leukaemia. Hairdressers are exposed to chemicals in dyes, cleaners are at risk from solvents and house painters are vulnerable, along with anybody working with the material popular in home make-over shows: MDF. Medium-density fibreboard, to use its correct name, combines wood dust with formaldehyde. Both are classified as group one carcinogens by the International Agency for Research on Cancer.

It seems extraordinary that materials with this classification — which means a link to cancer is proven — are used routinely. Watterson wants Britain to follow Canada, and some American states, where there is a policy of phasing out such toxins. We are cavalier in comparison, with no plans to follow. Yet in Scotland alone 539,172 people are exposed to carcinogens, according to Watterson’s calculations.

We assume that Fordist manufacturing of the past was more likely to make workers ill, but the 21st-century economy brings its own risks. We have many more small and medium firms, which are less likely to have good safety systems than multinationals. Changing jobs more often can mean exposure to a wider range of carcinogens — often for longer among the increasing number who work past retirement age. A desire to cut labour costs can lead to short cuts using chemicals — councils once used armies of gardeners to weed municipal flowerbeds, but now use fewer, unskilled people to zap the problem with pesticides.

We need a register of occupational cancer to illustrate who has been exposed to what, where and when. This is particularly important as it seems that a chemical is only classified as dangerous after it has done its worst. Hundreds, perhaps thousands of people might have died. New substances are introduced each year, but according to Hazards journal, which monitors safety at work, only 1% of chemicals used in industry are systematically tested.

Although health and safety is reserved to Westminster, Watterson suggests the Scottish parliament could still make a difference by working with companies to cut the use of toxins. Holyrood reacted to his findings with a disappointing civil servant response. It cited advice from the Health and Safety Executive that incidences of such cancers are 4% and there is no evidence of them rising.

The executive’s figure is based on a report in 1981 by Sir Richard Doll, the eminent epidemiologist who first made the link between tobacco and lung cancer. Unfortunately, Doll’s legacy was tainted two years ago when it was revealed that he was being paid by the chemical industry at the time he wrote it. Doll was also found to have worked as a consultant for Monsanto, which made Agent Orange, the chemical dropped by the US in Vietnam. He then insisted it did not cause cancer.

The executive has taken a laissez-faire approach to this issue, despite the advice of academics such as Watterson and campaigning organisations like Hazards journal. The Scottish government would do well to take an independent, more moral, position.

joan.mcalpine@sunday-times.co.uk

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