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LETTER TO EDITOR |
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| Year : 2022 | Volume
: 26
| Issue : 4 | Page : 289-290 |
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Predisposition of medical professionals to cancer: Are we ignoring a demon?
Asmita Chakrabarti1, Sumit R Chowdhury2, Avishek Roy2
1 Department of Neurosurgery, Park Clinic, Kolkata, West Bengal, India
2 Department of Anesthesiology Pain Medicine and Critical Care, All India Institute of Medical Sciences, New Delhi, India
| Date of Submission | 13-Mar-2022 |
| Date of Decision | 02-Jun-2022 |
| Date of Acceptance | 13-Aug-2022 |
| Date of Web Publication | 24-Dec-2022 |
Correspondence Address:
Dr. Sumit R Chowdhury
Room No. 5011, Fifth Floor Office, Department of Anesthesiology, Pain Medicine and Critical Care, All India Institute of Medical Sciences, Ansari Nagar East, New Delhi - 110 029
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/ijoem.ijoem_70_22
How to cite this article:
Chakrabarti A, Chowdhury SR, Roy A. Predisposition of medical professionals to cancer: Are we ignoring a demon?. Indian J Occup Environ Med 2022;26:289-90 |
How to cite this URL:
Chakrabarti A, Chowdhury SR, Roy A. Predisposition of medical professionals to cancer: Are we ignoring a demon?. Indian J Occup Environ Med [serial online] 2022 [cited 2023 Apr 1];26:289-90. Available from: https://www.ijoem.com/text.asp?2022/26/4/289/364945 |
We have gone through, with great interest, the editorial by Sukumar GM et al.[1] where the authors have aptly described non-communicable diseases (NCDs) and mental health issues as the “elephant in the room” and curated the way ahead to tackle the upcoming challenges in the occupational health practice in India. However, we want to look at this from the viewpoint of a healthcare provider. As the global incidence of cancer, one of the deadliest NCDs, is rising, medical professionals are not without the risk of getting the disease. Unfortunately, till now, there has not been enough studies on the incidence and the risk factors of cancer among healthcare workers (HCWs). With the sparse data available to us, it is difficult to comprehend the propensity of the risk factors that are compelling a significant number of our dedicated HCWs to fight the disease every other day, many succumbing to it. Hence, we made a sincere effort to explore the occupational risk factors and ways to improve them.
| Which occupational factors have been implicated? | |  |
Insomnia has always been prevalent among HCWs and the COVID-19 outbreak has further worsened the scenario. Sleep deprivation, fatigue, and excessive daytime sleepiness are common features of shift work disorder, which often warrant attention.[2]
Altered circadian rhythm affects the melatonin pathway and often gets manifested in the form of low thyroid stimulating hormone (TSH) levels in the morning, elevating the risk of thyroid neoplasms. In one study, female physicians were found to have an overall higher prevalence of breast cancer as compared to the general population. The same study also attributed to frequent thyroid and prostatic cancers among male physicians with stressful work conditions.[3] Every day in the line of work, the HCWs are exposed to an array of occupational hazards, for example, ethylene oxide (sterile workers), chemotherapeutic agents (oncology nurses, pharmacists), formaldehyde (clinical technicians in the laboratory), pathogens like hepatitis B and C viruses, etc., all of which are known to be potential human carcinogens. An overall lack of awareness about radiation exposure has been found to be consistent amongst the doctors.[4] Talking of exposures, another important causal association can be traced back to the lack of exposure to sunlight due to long working hours. Doctors are often found to have low levels of vitamin D, especially those who are working in the hospitals, adding up to the pathogeneses of many cancers.[5],[6]
The perks of being a healthcare giver come with the perils of occupational hazards. A constant fear of such work place hazards, tedious work environment, limited health resources cause physical as well as mental stress, exhaustion and subsequent burnout to the HCWs. Looking for an escape to the aforesaid, many resort to alcohol, drugs, smoking, all of which have been known to be potent carcinogens. In a study strikingly, the incidence of smoking has been found to be even more than the general population.[7]
| What can be modified? | | |
As preordained as it may sound, there are still many ways to get the better of the situation. Prevention is better and wiser than cure. Standard precautionary habits like wearing appropriate protective apparel should be followed with strict obedience, even if it is for a “brief” exposure. Implementation of dosimeter in high radiation prone settings and repeating audits periodically can help monitor the radiation exposure. Thus, it is important to train the HCWs about appropriate protective measures to increase awareness about occupational hazards.[8]
| Conclusion | | |
A positive work environment should be established by executing multi-level amendments. The institutions and hospitals should make efforts to modify the organizational construct and work processes to build a sustainable well-being culture.[9] Attempts should be made to achieve recreational set up in the work place to elevate the efficiency to its maximum. The caregivers should take care of themselves. Constancy to a healthy routine, avoiding detrimental practices, maintaining a family-work balance, and an overall positive outlook on life can help us avoid a nettlesome adversary after all. Finally, a thorough study to find out the incidence and risk factors of different cancers among the healthcare professionals, particularly in countries where occupational health is still neglected, is the need of the hour. We hope that further research can help us to dig out the possible causes of cancer among healthcare professionals, which will aid in implementing necessary policy modifications.
Acknowledgement
We cordially thank Mr. Rangan Bhattacharyya for his valuable inputs in preparing this manuscript.
Financial support and sponsorship
Nil.
Conflicts of interest
There are no conflicts of interest.
| References | | |
| 1. | Sukumar GM, Joseph B. Non-communicable diseases and mental health disorders in Indian workplaces: 'Elephant in the room' or 'future of occupational health practice'. Indian J Occup Environ Med 2021;25:189-91.  [Full text] |
| 2. | Mathew JJ, Joseph M, Madonna Britto BJ. Shift work disorder and its related factors among health-care workers in a Tertiary Care Hospital in Bangalore, India. Pak J Med Sci 2018;34:1076-81. |
| 3. | Yang HY, Chen CR, Lee SY, Tsai WC, Hsu YH. The cancer risk among physicians in Taiwan, a population-based propensity score matched cohort study. Iran J Public Health 2021;50:297-305. |
| 4. | Soye JA, Paterson A. A survey of awareness of radiation dose among health professionals in Northern Ireland. Br J Radiol 2008;81:725-9. |
| 5. | Munter G, Levi-Vineberg T, Sylvetsky N. Vitamin D deficiency among physicians: A comparison between hospitalists and community-based physicians. Osteoporos Int 2015;26:1673-6. |
| 6. | Holick MF. Sunlight and vitamin D for bone health and prevention ofautoimmune diseases, cancers, and cardiovascular disease. Am J Clin Nutr 2004;80:1678S-88S. |
| 7. | Ficarra MG, Gualano MR, Capizzi S, Siliquini R, Liguori G, Manzoli L, et al. Tobacco use prevalence, knowledge and attitudes among Italian hospital healthcare professionals. Eur J Public Health 2011;21:29-34. |
| 8. | Olorunfemi O, Osunde NR, Ilaboya IE, Oko-Ose JN, Ehidiamen-Edobor OR, Akpor OA. Knowledge of occupational hazards and their perceived effects among operating theatre workers. Indian J Occup Environ Med 2022;26:29-32. [Full text] |
| 9. | Jain AV. Secrets toward building a sustainable health and well-being culture. Indian J Occup Environ Med 2022;26:1-2. [Full text] |
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