Introduction Interventions to reduce occupationally related cancers should be evidence based. We have developed a method for forecasting the future burden of occupational cancer given past and projected exposure trends and under targeted reductions in workplace exposure levels.

Methods The method builds on an approach using attributable fractions (AFs) developed to estimate the current burden of occupational cancer. We project risk exposure periods (REPs), accounting for cancer latencies of up to 50 years, forward in time, to estimate AFs for a series of forecast target years given past and projected exposure trends and under targeted reduction scenarios. Adjustment factors for changes in exposed numbers and levels are applied in estimation intervals within the REPs.

Results The methods are illustrated using a range of scenarios for reducing lung cancer due to occupational exposure to respirable crystalline silica (RCS). AFs for lung cancer due to RCS could potentially be reduced from 2.07% in 2010 to nearly zero by 2060, depending on the timing and success of interventions.

Conclusion The importance of focusing on achieving compliance with current exposure standards in small industries is highlighted and can be more effective than setting standards at a lower level. The method can be used to highlight high-risk carcinogens, industries and occupations and is designed to allow comparative estimates to be made even where exposure data are limited. It is adaptable for other countries and other exposure situations in the general environment and can be extended to include socio-economic impact assessment.