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OCCUPATIONAL CANCER

OCCUPATIONAL CANCER

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OCCUPATIONAL CANCER

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  1. OCCUPATIONAL CANCER Funded by the Netherlands embassy , Ankara, Turkey

  2. Learning Objectives • Knowing about common hazards for occupational cancer in metal sector • Be able to identify the cancer risks for metal sector workers

  3. . . Introduction One of every two or three individuals in the industrialized world will develop some type of cancer during their lifetimes Approximately 3-10% of all human cancers are thought to be caused by occupational exposure to carcinogens It is estimated that approximately 20,000 cancer deaths and 40,000 new cases of cancer each year in the U.S. are attributable to occupation

  4. Risk of developing a particular cancer Personal characteristics Family History Diet and Personnel habits Having certain medical conditions Environmental exposure to carcinogens Exposure to carcinogens at work place

  5. Induction period 3-5 years for radiation or toxin induced Leukemia 40 or more asbestos-induced Mesothelioma For most tumors about 12-25 years

  6. The most common cancers associated with occupational exposure: • leukemia • throat • lymphoma • soft-tissue sarcomas • liver lung and pleura bladder skin laryngeal nasal cavity

  7. Most widespread carcinogens at work: • Solar radiation • Passive smoking • Crystalline silica • Diesel engine exhausts • Radon • Wood dust • Lead and its inorganic compounds • Benzene • Asbestos • Formaldehyde • Chromium VI

  8. Cancer Registry by Industry • Nasopharyngeal: carpenters and other blue collar special trade construction • Colorectal: machinery manufacturing, printing • Liver: general construction and rubber and plastics • Gallbladder: electrical equipment • Lung: primary metals, shipbuilding, construction, and stone, clay, and glass • Mesothelioma: shipbuilding and asbestos manufacturing • Source : New Jersey cancer registration - USA

  9. Cancer Registry by Industry • Breast: (females) chemical and pharmaceutical • Bladder: (males) apparel and textile industries. • Non-Hodgkin's lymphoma: • (females) printing • (male) bakers and motor vehicle manufacturing • Lymphocytic leukemia: chemical and construction • Source : New Jersey cancer registration - USA

  10. silica asbestos diesel engine exhaust radon progeny arsenic chromium, beryllium, nickel, and cadmium acrylonitrile Lung cancer (Steenland, 1996)

  11. Cutting fluid exposure (Eisen, 1992) • 85% increase of laryngeal cancer (also stomach)

  12. IARC International Agency of Research on Cancers

  13. IARC EvaluationsDimensions and Groups Types of evidence Human Animal Other - mutagenicity - genotoxicity - metabolism - etc. Group 1 Carcinogenic to humans 2A Probably carcinogenic to humans 2B Possibly carcinogenic to humans 3 Not classifiable 4 Not carcinogenic to humans

  14. Numbers of occupational carcinogens and high risk occupations and industries designated by the IARC Monograph Programme, 1971-2003 Mixtures Occupations Groups & Agents & Industries 1 (definite) 28 12 2A (probable) 27 3 2B (possible) 113 4 Siemiatycki et al, Environ Hlth Persp, 2004, http://www.ehponline.org

  15. Lung cancer (Exposures) Tobacco smoking is responsible for nearly 90% of all lung cancers. Second-hand smoke Byproducts of fossil fuel Air pollution Insufficient consumption of fruits and vegetables High doses of ionizing radiation Asbestos Radon chloromethyl ethers Polycyclic aromatic hydrocarbons Inorganic arsenic Chromium Nickel Mustard Gas General workplaces

  16. Mesothelioma (exposure) Asbestosis (trivial contact) Crocidolite: the most potent carcinogen

  17. Mesothelioma (prevention) OSHA PEL (1970) :5 Fiber/cm3 (1986):2 fiber/cm3 now: 0.1 fiber/cm3 Asbestos ban : since 1989 by EPA

  18. Asbestos Ban (1989)

  19. Bladder cancer (exposure) The most important risk factor is cigarette smoking . Heavy coffee consumption (Possible risk factors ) Bladder infection with schistosoma Cyclophosphamide Long-term use of pain killers containing phenacetin, Urinary tract infections or low urine flow Genetic factors Benzidine 2-naphthylamine Occupations in the dye, leather or rubber industry Chlornaphazine 4 chlorotoluidine Phenacetine General workplace

  20. Bladder cancer (prevention) Avoidance of exposure Medical monitoring : Urinary cytology (75% Sen. 99.9 Spes.) Immunocytology

  21. Liver cancer (hepatic angiosarcoma) (exposure) Vinyl chloride Arsenic Copper, Lead, Zinc Thorotrast (thorium dioxide) 1930-1955

  22. Liver cancer (hepatic angiosarcoma) (prevention) Avoidance of exposure Medical monitoring (history, Ph/E, CBC, LFT, Ultrasonography)