Im Sanghyuk, Youn Kan-Woo, Shin Donghee, Lee Myeoung-Jun, Choi Sang-Jun
Wonjin Institute for Occupational & Environmental Health, Green Hospital, Seoul, South Korea.
Catholic University of Daegu, Gyeongsan-si, South Korea.
Ann Occup Environ Med. 2015 Dec 30;27:34. doi: 10.1186/s40557-015-0080-1. eCollection 2015.
Carcinogenicity of asbestos has been well established for decades and it has similar approval standards in most advanced countries based on a number of studies and international meetings. However, Korea has been lagging behind such international standards. In this study, we proposed the approval standards of an occupational cancer due to asbestos through intensive review on the Helsinki Criteria, post-Helsinki studies, job exposure matrix (JEM) based on the analysis of domestic reports and recognized occupational lung cancer cases in Korea. The main contents of proposed approval standards are as follows; ① In recognizing an asbestos-induced lung cancer, diagnosis of asbestosis should be based on CT. In addition, initial findings of asbestosis on CT should be considered. ② High Exposure industries and occupations to asbestos should be also taken into account in Korea ③ An expert's determination is warranted in case of a worker who has been concurrently exposed to other carcinogens, even if the asbestos exposure duration is less than 10 years. ④ Determination of a larynx cancer due to asbestos exposure has the same approval standards with an asbestos-induced lung cancer. However, for an ovarian cancer, an expert's judgment is necessary even if asbestosis, pleural plaque or pleural thickening and high concentration asbestos exposure are confirmed. ⑤ Cigarette smoking status or the extent should not affect determination of an occupational cancer caused by asbestos as smoking and asbestos have a synergistic effect in causing a lung cancer and they are involved in carcinogenesis in a complicated manner.
几十年来，石棉的致癌性已得到充分证实，基于多项研究和国际会议，大多数发达国家都有类似的批准标准。然而，韩国在这方面一直落后于国际标准。在本研究中，我们通过对赫尔辛基标准、赫尔辛基之后的研究、基于对韩国国内报告和已确认的职业性肺癌病例分析的工作暴露矩阵（JEM）进行深入审查，提出了因石棉导致的职业性癌症的批准标准。提议的批准标准主要内容如下：①在认定石棉诱发的肺癌时，石棉肺的诊断应基于CT。此外，应考虑CT上石棉肺的初始表现。②韩国还应考虑石棉的高暴露行业和职业。③对于同时接触其他致癌物的工人，即使石棉暴露时间少于10年，也需要专家进行判定。④因接触石棉导致的喉癌的判定标准与石棉诱发的肺癌相同。然而，对于卵巢癌，即使确认有石棉肺、胸膜斑或胸膜增厚以及高浓度石棉暴露，也需要专家进行判断。⑤吸烟状况或程度不应影响由石棉引起的职业性癌症的判定，因为吸烟和石棉在导致肺癌方面具有协同作用，并且它们以复杂的方式参与致癌过程。
