Conso Françoise
Département universitaire de médecine du travail, Faculté Cochin-Port-Royal, université Paris V, 75014 Paris.
Rev Prat. 2004 Oct 15;54(15):1665-70.
There is an important gap between the number of bladder cancer cases--over a 1000 per year--that are imputable, by epidemiologists'estimations, to occupational factors and the small number--fewer than 20--compensated as occupational diseases. This can be explained by the latency of the disease and by the fact that the chemicals mainly responsible for bladder cancer--aromatic amines compounds and, to a lesser extent, polycyclic aromatic hydrocarbons--are very complex and disseminated in a large variety of industrial settings. Besides the sectors historically known as involving this occupational risk--the dye and the rubber industries--new branches have been identified as hazardous: some sectors of plastic materials or aluminium industries, of laboratory research, the industrial gas production from coke ovens, foundries... The European policy for the prevention of occupational cancers has applied for over 10 years to carcinogenic aromatic amines. Screening for the early detection of vesical lesions is legally prescribed in France for workers that are or have been exposed to chemicals or processes potentially carcinogenic for the bladder.
据流行病学家估计,每年可归因于职业因素的膀胱癌病例数量超过1000例,但被认定为职业病并得到补偿的病例却很少,不到20例,这两者之间存在巨大差距。这可以用疾病的潜伏期以及膀胱癌的主要致病化学物质——芳香胺化合物,以及程度稍轻的多环芳烃——非常复杂且散布于各种工业环境中来解释。除了历来被认为存在这种职业风险的行业——染料和橡胶行业——之外,新的危险分支行业也已被确定:一些塑料材料或铝行业、实验室研究、焦炉工业气体生产、铸造厂……欧洲预防职业性癌症的政策针对致癌芳香胺已经实施了十多年。在法国,法律规定要对现在或曾经接触过可能导致膀胱癌的化学物质或工艺的工人进行筛查,以便早期发现膀胱病变。