"There are not many books about occupational cancers for the general reader. And yet they are part of the wider debate about health at work. Laura Boujasson's book tells of her experience as a surveyor with the Giscop workrelated cancers research body. Since 2002, Giscop has reconstructed the work histories of over 900 lung cancer patients in the Seine- Saint-Denis département (Paris region) where there is a significant excess incidence of cancer mortality.
A word about the area's history might not go amiss: the first batch of factories (chemical, textile, metalworking) was set up there in the 1860s to open up central Paris and give it "breathing space". The area's economic growth continued until after the Second World War. In the 1960s, the French government's drive to decentralize industrial employment through business relocation grants brought significant job losses. In 1968, administrative reforms turned the area into a département; the ruling Gaullist party's aim with local elections coming up was to ringfence inside it the French Communist Party – a big influence since the 1930s and still the main opposition at the time. The economic crises of the 1970s and ‘80s accelerated the loss of all the département's major industries. But while it is now abuzz with new service and R&D businesses, the scars of the past remain: high unemployment, poor housing, lower educational levels than neighbouring départements, etc.
But where do the patients' personal accounts and work histories collected in faceto- face interviews by the Giscop investigators take us? A collective and multidisciplinary expertise is brought to bear on the information gleaned which stacks up patients' experiences (work as it is) with those of experts from different disciplines (toxicologists, doctors, safety engineers, health and safety committee reps). The result is an inventory of work activities than can be exposed to carcinogens or carcinogenic processes.
The author presents a concise but highly detailed selection of cancer sufferers' work histories – ordinary people for whom the importance of work (structuring of social relations, material issues, forging an identity, etc.) plays into their self-definition. She describes what the outcomes of the scientific process these recently diagnosed workers agreed to take part in meant to them. The survey brought home to them how their past working conditions had impacted their present state of health, when they had previously seen their illness as most often the result of poor lifestyle choices (especially smoking) and therefore blamed themselves for their failing health, says the interviewer. She waxes even more indignant when talking of the added social injustice of the obstacle course that follows the classification of their cancer as work-related, namely the demand for recognition as an occupational disease and the possibility of getting compensation.
Off the back of this, Laura Boujasson voices her feelings about social and health inequalities, the havoc wrought by casual hire-and-fire and how hard it is for our social protection system to recognise cancer as work-related. What surprises her most may be, as she herself says, "realising how very common cancer risks are in the workplace". Most of them are reported in the scientific literature but, as often in health at work matters, the advancement of knowledge is no guarantee that effective prevention policies will necessarily follow!
The analysis moves up a level in the second part of the book where Laura Boujasson looks at industry and employers' denial of carcinogenic properties so as to avoid restrictive regulations. The effectiveness of this was seen with asbestos, even if that denial was eventually rebuffed after many years of struggle and legal battle by victims' groups which help those affected break out of their isolation.
The book closes with Laura Boujasson's assertion that both more science and more politics must be brought to bear on occupational cancers, but even more so, assessment of workplace risks and solutions to reduce them. The introduction of mandatory postoccupational medical monitoring of certain categories of workers and a strengthening of occupational health services could also help. — Marianne De Troyer"

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