Cocco P
Istituto di Medicina del Lavoro, Università di Cagliari.
Med Lav. 2000 Jan-Feb;91(1):14-23.
In the last twenty years scientific research in the field of occupational cancer has achieved some outstanding results. The number of substances and work processes classified as carcinogens for man has doubled. New cancer sites have been associated with exposure to known occupational carcinogens. New occupational risk factors for cancer sites already known as targets for occupational exposures have been identified. The agents responsible for the excess cancer risk in some industrial settings have also been identified, as well as the mechanisms by which numerous occupational risk factors play a role in the various steps of the multifactorial carcinogenic process. Experimental studies have provided strong support for this progress but substantial contributions have been made as a result of the increase in the number of studies of occupational cancer epidemiology, the establishment and use of large data-bases, the increasing tendency to planning of multicentric epidemiological studies, and the constant improvement of retrospective exposure assessment methods with the aid of more sophisticated job-exposure matrices and the use of biomarkers, some deriving from the old biological monitoring programs, others only recently introduced. However, in spite of the attention that recent Italian legislation for the prevention of occupational diseases has devoted to the problem of occupational cancer, a gap between scientific research in the field of occupational cancer and the practice of occupational health persists in Italy. Future studies can help to close this gap by integrating multidisciplinary contributions from clinicians, toxicologists, epidemiologists, and industrial hygienists right from the planning stage.
在过去二十年中，职业性癌症领域的科研工作取得了一些显著成果。被归类为对人类致癌的物质和工作流程数量增加了一倍。新的癌症部位已与接触已知职业致癌物相关联。已确定了针对已知为职业暴露目标的癌症部位的新职业风险因素。还确定了某些工业环境中导致癌症风险增加的因素，以及众多职业风险因素在多因素致癌过程各个阶段发挥作用的机制。实验研究为这一进展提供了有力支持，但职业性癌症流行病学研究数量的增加、大型数据库的建立和使用、多中心流行病学研究规划趋势的增强，以及借助更精密的工作暴露矩阵和生物标志物（其中一些源自旧的生物监测项目，另一些则是最近才引入的）对回顾性暴露评估方法的不断改进，也做出了重大贡献。然而，尽管意大利近期预防职业病的立法对职业性癌症问题给予了关注，但在意大利，职业性癌症领域的科研与职业健康实践之间仍存在差距。未来的研究可以通过在规划阶段整合临床医生、毒理学家、流行病学家和工业卫生学家多学科的贡献来帮助缩小这一差距。
