Pairon J-C, Andujar P, Matrat M, Ameille J
INSERM Unité 841, Créteil, France.
Rev Mal Respir. 2008 Oct;25(8 Pt 2):3S18-31.
Lung cancer and pleural mesothelioma are the most common occupational cancers. Recent epidemiological studies have estimated that the fraction attributable to occupational factors varies from 13 to 29% for lung cancer in men and is about 85% for pleural mesothelioma in men. Previous occupational exposure to asbestos is the most common occupational exposure in these cancers. Mesothelioma immediately leads the clinician to look for past asbestos exposure. In contrast, the search for an occupational exposure that should be routine in all cases of lung cancer, is generally more difficult because of the number of occupational aetiological factors and the absence of criteria that allow distinction of an occupational cancer from a tobacco related one. Therefore attention should be paid to the identification of occupational exposure in order to set up primary prevention programmes to prevent exposure still present in the working environment and, on the other hand, to identify the subjects entitled to the acknowledgement of occupational disease and/or to obtain the compensation available to asbestos victims.
肺癌和胸膜间皮瘤是最常见的职业性癌症。最近的流行病学研究估计,职业因素导致的肺癌比例在男性中为13%至29%,而男性胸膜间皮瘤的这一比例约为85%。既往职业性接触石棉是这些癌症中最常见的职业暴露。间皮瘤会立即促使临床医生去寻找过去的石棉接触史。相比之下,在所有肺癌病例中寻找应常规排查的职业暴露通常更为困难,这是因为职业病因因素众多,且缺乏区分职业性癌症与烟草相关癌症的标准。因此,应重视职业暴露的识别,以便制定一级预防计划,防止工作环境中仍存在的暴露,另一方面,识别有权被认定为职业病的对象和/或获得石棉受害者可享有的赔偿。