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[致癌工业物质——当前信息综述]

[Carcinogenic industrial substances--a review of the present information].

作者信息

Triebig G

出版信息

Zentralbl Bakteriol Mikrobiol Hyg B Umwelthyg Krankenhaushyg Arbeitshyg Prav Med. 1987 Apr;183(5-6):488-504.

PMID:3109152
Abstract

The potential carcinogenic risks of chemical substances at the workplace show increasing importance in occupational and environmental medicine, but the problems are also discussed controversially. Based on national and international literature estimations according the portions of occupational cancer are given. In accordance with former estimations from our institute, it is concluded, that 1-2% of all cancer deaths are caused by work and profession. A review of data from newer literature shows, that the numbers of chemicals with carcinogenic potency vary considerably. This is mainly due to the largely unknown mechanism of carcinogenesis, aspects of syncarcinogenesis and cocarcinogenesis as well as the different evaluation of mutagenicity-, short-term- and animal-tests on the one hand and of epidemiologic as well as casuistic studies on the other hands regarding carcinogenicity of chemicals for humans. In this context, the importance of epidemiologic studies for detecting unknown cancerogenic risks for humans is emphasized. In the field of occupational medicine it is relevant to differ between compensation and prevention. According to this aspects, for compensation of a malignant tumor as an occupational disease, more strict criterias must be fulfilled to objectify the carcinogenicity of a substance for humans than for preventive measures. On the basis of the monographs as well as reviews of the International Agency for Research on Cancer (IARC) the single substances, mixture of substances and industrial processes with proven or probably carcinogenicity for humans are given. In comparison to the monograph of Hueper from 1963 it is concluded, that until now no critical increase of carcinogenic substances at the workplace has occurred. For preventive efforts at the workplace, the medical examinations are important. These are based on various regulations by law or by German Employers Liability Insurance. In conclusion, recommendations and demands are given regarding prevention, evaluation and compensation of malignant diseases as well as detection of unknown carcinogenic risks for humans at the workplace.

摘要

工作场所化学物质的潜在致癌风险在职业与环境医学中愈发重要,但对此问题的讨论也存在争议。基于国内外文献给出了职业性癌症比例的估计。根据我们研究所之前的估计,得出结论:所有癌症死亡病例中有1 - 2%是由工作和职业导致的。对最新文献数据的回顾表明,具有致癌潜力的化学物质数量差异很大。这主要是由于致癌机制在很大程度上尚不明确、协同致癌和促癌方面的问题,以及一方面对化学物质致突变性、短期试验和动物试验的评估,与另一方面对化学物质对人类致癌性的流行病学及个别病例研究的评估存在差异。在此背景下,强调了流行病学研究对于发现人类未知致癌风险的重要性。在职业医学领域,区分补偿和预防很重要。根据这方面情况,对于将恶性肿瘤作为职业病进行补偿而言,要确定一种物质对人类的致癌性,必须满足比预防措施更严格的标准。依据国际癌症研究机构(IARC)的专著及综述,列出了已证实或可能对人类具有致癌性的单一物质、物质混合物及工业过程。与1963年休珀的专著相比,得出结论:到目前为止,工作场所致癌物质并未出现显著增加。对于工作场所的预防工作而言,医学检查很重要。这些检查基于各种法律规定或德国雇主责任保险。最后,针对恶性疾病的预防、评估和补偿以及发现工作场所人类未知致癌风险给出了建议和要求。

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