Occupational lung cancer surveillance in South Korea, 2006-2009

Pesticide exposure and lung cancer risk: A case-control study in Nakhon Sawan, Thailand

Background

Pesticide exposure might increase risk of lung cancer. The purpose of this study was to investigate the association between the historical use of pesticides and lung cancer using a case-control design.

Methods

This case-control study compared a lifetime pesticide exposure of 233 lung cancer cases, and 447 healthy neighbours matched for gender, and age (±5 years). Data on demographic, pesticide exposure and other related factors were collected using a face-to-face interview questionnaire. Associations between lung cancer and types of pesticides as well as individual pesticides were analysed using logistic regression adjusted for gender, age, cigarette smoking, occupation, cooking fumes exposure, and exposure to air pollution.

Results

It was found that lung cancer was positively associated with the lifetime use of herbicides and insecticides. Compared to people in the non-exposed groups, those in Q3-Q4 days of using herbicides and insecticides had an elevated risk of lung cancer, with odds ratio (OR) between 2.20 (95% confidence interval (CI) 1.24-3.89), and 3.99 (95% CI 1.62-7.11) (p < 0.001). For individual pesticides, those presenting a significant association with lung cancer were dieldrin (OR = 2.56; 95% CI 1.36-4.81), chlorpyrifos (OR = 3.29; 95 % CI 1.93-5.61), and carbofuran (OR = 2.10; 95% CI 1.28-3.42). It was also found, for the first time, carbofuran, glyphosate, and paraquat to be significantly associated with lung cancer.

Conclusions

The study confirmed dieldrin, and chlorpyrifos as risk factors and suggested carbofuran, glyphosate, and paraquat as potential risk factors for the disease. The paper stands as a noteworthy contribution to literature, particularly because the majority of publications on the topic originate from developed Western countries. However, further studies are imperative to validate the results and pinpoint additional individual pesticides that may be associated with lung cancer.

Occupational and environmental asbestos exposure and the risk of lung cancer in Korea: A case-control study in South Chungcheong Province of Korea

Despite the use of large amounts of asbestos in the 1990s, few studies have been conducted in Korea on occupational and environmental asbestos exposure and lung cancer risk. The main aim of this study was to estimate the risk of lung cancer development caused by occupational and environmental asbestos exposures in residents of South Chungcheong Province, where about half of the asbestos mines in Korea operated. We conducted a case-control study, for which the information on asbestos exposure history and demographic characteristics was provided by the Environmental Health Center for asbestos of Soonchunhyang University Cheonan Hospital. After adjusting for all covariates, the odds ratios for lung cancer tended to increase with higher exposure probability for both occupational as well as environmental asbestos. The relative risk of occupational asbestos exposure was higher than that of environmental exposure; the interaction of co-exposure was not statistically significant. The estimated means of the latency period were significantly shorter in participants who were engaged in the production of asbestos-containing products and in those who lived near asbestos industries as compared to other groups.

Occupational cancer claims in Korea from 2010 to 2016

Background

Research on carcinogens causing occupational cancer has been updated. Further, social interest in occupational cancer has increased. In addition, the standard for recognizing cancer as a work-related disease has also been revised. The present study aims to describe the distribution of occupational cancer claims or its approval rate and their association with work-related variables.

Methods

We analyzed 1299 claim cases for occupational cancer from 2010 to 2016 provided by the Korea Workers’ Compensation and Welfare Service (KCOMWEL). The status of approval rate was shown by year, sex, industry, occupation, age of diagnosis, duration from employment to diagnosis, and cancer site.

Results

The approval rate was 39.0% from 2010 to 2016 and tended to increase annually since 2011. Both the number of claims and the approval rate were higher in men. Mining and quarrying showed the highest approval rate (78.4%). The approval rates by age of diagnosis and duration from employment to diagnosis increased as the time periods increased. Respiratory organ had the highest number of claims and the highest approval rate by cancer site.

Conclusions

The approval rate of occupational cancer has shown an increasing trend since 2011. The increase of occupational carcinogens and cancer sites and the improvement of social awareness about occupational cancer could have resulted in this trend. The present study provides unique, and the latest and most accurate findings on occupational cancer data of recent 7 years that could be helpful to researchers or policy makers on occupational cancer.

Lung Cancer Risk and Residential Exposure to Air Pollution: A Korean Population-Based Case-Control Study

PURPOSE

To investigate the association between long-term exposure to ambient air pollution and lung cancer incidence in Koreans.

MATERIALS AND METHODS

This was a population-based case-control study covering 908 lung cancer patients and 908 controls selected from a random sample of people within each Korean province and matched according to age, sex, and smoking status. We developed land-use regression models to estimate annual residential exposure to particulate matter (PM₁₀) and nitrogen dioxide (NO₂) over a 20-year exposure period. Logistic regression was used to estimate odds ratios (ORs) and their corresponding 95% confidence intervals (CI).

RESULTS

Increases in lung cancer incidence (expressed as adjusted OR) were 1.09 (95% CI: 0.96-1.23) with a ten-unit increase in PM₁₀ (μg/m³) and 1.10 (95% CI: 1.00-1.22) with a ten-unit increase in NO₂ (ppb). Tendencies for stronger associations between air pollution and lung cancer incidence were noted among never smokers, among those with low fruit consumption, and among those with a higher education level. Air pollution was more strongly associated with squamous cell and small cell carcinomas than with adenocarcinoma of the lung.

CONCLUSION

This study provides evidence that PM10 and NO₂ contribute to lung cancer incidence in Korea.

Reducing the underreporting of lung cancer attributable to occupation: outcomes from a hospital-based systematic search in Northern Italy

PURPOSE

Occupational exposure to lung carcinogens is and was common in workplaces. 5-25 % of lung cancers (LCs) could be causally attributable to occupation; however, LC underreporting and undercompensation are widespread, with remarkable tolls paid by individuals and society. This work aims to: describe an ongoing hospital-based systematic search (SS) of occupational LC; improve aetiological diagnosis; increase number and quality of LC notifications.

METHODS

Through a short form, physicians at a public hospital referred incident LC to the Occupational Health Unit (OHU). Only patients selected through the form were interviewed; a personal, occupational and clinical history was collected; reports were sent to the ward and Local Health Authority, with aetiological diagnosis criteria and probability of causation.

RESULTS

From 1998 to 2013, 3274 cases of LC were notified to the OHU; prior to the system, just couple of dozens were assessed. A total of 1522 patients were fully interviewed; in 395 cases, causation was attributed to occupation (26 % of interviewed patients); all were notified to authorities, as compared to the handful reported before the system was adopted. Main aetiological agents were silica, asbestos, polycyclic aromatic hydrocarbons, truck driving, painting, multiple exposures. Compensation rate was remarkable (39 %).

CONCLUSIONS

Through SS, many occupational LCs were found that otherwise would have been lost. Aetiological diagnosis proved to be rich of scientific advantages and practical implications, with attention to equity and social aspects. SS was easy, accountable and fostered multidisciplinary collaboration among medical specialties, significantly reducing underreporting and undercompensation of occupational LC.

Necessity for a national carcinogen list in Korea, based on international harmonization

Cancer has been the leading cause of death in Korea for the last 30 years. Cancer patients' 5-year survival rate between 2005 and 2009 was 62.0%, representing a highly advanced standard of care, as much as developed countries in the EU and the US. The Korean government formulated its first 10-year plan for cancer control in 1996 and has been carrying out a second 10-year plan for cancer control since 2006. But despite the Korean government's efforts, the cancer burden in Korea continues to increase. Many separate laws have gone into effect concerning the management of carcinogen exposure. However, there are no integrated regulatory laws or management systems against carcinogen exposure in Korea. Dead zones remain where carcinogen exposure cannot be controlled properly in Korea. In this paper, we suggest the need to establish a national carcinogen list based on international harmonization as a prerequisite for a paradigm shift in cancer control policy from treatment to primary prevention.

Occupational respiratory cancer in Korea

Malignant mesothelioma and lung cancer are representative examples of occupational cancer. Lung cancer is the leading cause of cancer death, and the incidence of malignant mesothelioma is expected to increase sharply in the near future. Although information about lung carcinogen exposure is limited, it is estimated that the number of workers exposed to carcinogens has declined. The first official case of occupational cancer was malignant mesothelioma caused by asbestos exposure in the asbestos textile industry in 1992. Since then, compensation for occupational respiratory cancer has increased. The majority of compensated lung cancer was due to underlying pneumoconiosis. Other main causative agents of occupational lung cancer included asbestos, hexavalent chromium, and crystalline silica. Related jobs included welders, foundry workers, platers, plumbers, and vehicle maintenance workers. Compensated malignant mesotheliomas were associated with asbestos exposure. Epidemiologic studies conducted in Korea have indicated an elevated risk of lung cancer in pneumoconiosis patients, foundry workers, and asbestos textile workers. Occupational respiratory cancer has increased during the last 10 to 20 yr though carcinogen-exposed population has declined in the same period. More efforts to advance the systems for the investigation, prevention and management of occupational respiratory cancer are needed.