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Bone Cancer A sentinel health event (occupational) associated with radium exposure by radium chemists, processors, and dial painters; [Mullan] Documented causes of radiation-induced bone cancer in humans include 226,228-radium, 224-radium, plutonium, Thorotrast (thorium oxide), and radiotherapy. "Radiation-induced bone cancer appears, it seems, only at very high doses, and it is rarely reported at doses under 5 Gy." [Schottenfeld, p. 946-52] There was strong evidence of work-related bone cancer in radium dial painters and a "meaningful association" in Mayak workers who had very high exposure to plutonium. [Boice, p. 261]
Brain Cancer Ionizing radiation, at high doses well above background levels, is the only established environmental cause of brain cancer. Some epidemiological studies have found an increased risk of brain cancer associated with petrochemical workers, rubber and tire workers, electrical workers, health professionals, farmers, and workers with exposures to vinyl chloride and polychlorinated biphenyls. [Adami, p. 494-7] Brain cancer after radiation treatment is "occasionally associated with robust risk estimates." It is seen mainly after high-dose irradiation in childhood, e.g., an estimated dose of 1.5 Gy for treatment of ringworm of the scalp. Brain cancer was not associated with radiation in studies of Japanese A-bomb survivors, radium dial painters, radiologists, underground miners, nuclear workers, and uranium processors. [Boice, p. 260-263] There is suggestive evidence that non-arsenical insecticides and petroleum refining are occupational carcinogens. There is no strong evidence that occupational exposure to ionizing radiation is associated with brain cancer. [Siemiatycki, p. 334] Colorectal Cancer Studies showing an association with asbestos exposure are inconsistent. Increased colorectal cancer has been reported in workers exposed to mineral oils in the operation of printing, typesetting, and textile processing machines. There was an association between rectal cancer and machinists exposed to mineral-based metalworking fluids. [Ward, p. 173-4] Colon cancer is increased in white-collar workers who have sedentary jobs. Some studies have shown a small excess risk for workers exposed to asbestos. [Adami, p. 202] Colon cancer was not associated with ionizing radiation exposure in studies of radiologists, underground miners, nuclear workers, or uranium processors. There was a "meaningful association" in Japanese A-bomb survivors. [Boice, p. 261] Esophagus Cancer Information relating to occupational causes of esophageal cancer is limited. It is not known what proportion of esophageal cancer today is linked to workplace exposures. Some studies suggest associations with occupational exposures to perchloroethylene, mustard gas, silica dust, metal dust, asbestos, combustion products, sulfuric acid, carbon black, and ionizing radiation. [Ward, p. 195] Many of these studies have inadequate adjustment for the main confounders, smoking and alcohol use. Based on heavier exposure levels that existed in the past, two groups that showed higher risks for cancer of the esophagus were workers who vulcanized rubber and those who assembled automobiles. [Adami, p. 152-3] There is suggestive evidence that occupational exposure to soots and tetrachloroethylene cause esophageal cancer. [Siemiatycki, p. 334] Studies of radiologists, underground miners, and nuclear workers have found negative associations. "Meaningful associations" were found for Japanese A-bomb survivors and patients with spondylitis treated with medical radiation. [Boice, p. 261] Liver Cancer There were negative associations that ionizing radiation caused liver cancer in studies of radium dial painters, radiologists, underground miners, nuclear workers, uranium processors, and Mayak workers. There was strong evidence that Thorotrast (Th-232) caused liver cancer when used as a radiographic contrast agent between 1928 and 1955. [Boice, p. 261, 271] Hepatocellular carcinomas (HCC) comprise about 75% to 90% of liver cancers. "Eighty to 95% of HCCs are associated with chronic infection of hepatocytes with either of two viruses, hepatitis B virus (HBV) or hepatitis C virus (HCV)." Increased risk of angiosarcoma of the liver (ASL) was found in workers exposed to vinyl chloride while cleaning reactor vessels for the production of polyvinyl chloride. There is suggestive evidence that German vineyard workers exposed to arsenic in the 1930s and 1940s had increased incidence of angiosarcoma of the liver. [Schottenfeld, p. 763, 773]
Kidney Cancer "Kidney cancer, in contrast to bladder cancer, is generally not considered an occupation-related cancer . . ." [Adami, p. 478] The relationship between occupational exposures and kidney cancer is poorly understood. Increased risks have been reported in the following industries: coke production, iron and steel production, chimney sweeping, nickel smelting, lead smelting, dry cleaning, oil refining, textile production, electric power, farming, printing. Also in the following jobs: tailors, firefighters, painters, gasoline station attendants, truck drivers, and workers exposed to asbestos. [Ward, p. 294] Laryngeal Cancer Cancer of the larynx in western countries is for the most part attributable to smoking tobacco and drinking alcohol. Possible occupational risks include exposure to nickel, asbestos, and ionizing radiation. [Adami, p. 271] Studies of cohorts from past decades have found strong associations between laryngeal cancer and occupational exposures to mustard gas manufacturing, nickel refining, and metalworking with mineral-based oils. [Ward, p. 296] Risk factors for laryngeal cancer include smoking, drinking alcohol, and asbestos exposure. Possible risk factors are leather workers, textile workers, and exposure to gasoline, diesel oil, and mineral oil. [LaDou, p. 312] There is strong evidence that the following are occupational carcinogens: isopropanol manufacture, strong acid process; inorganic acid mists containing sulfuric acid; and mustard gas. There is suggestive evidence that exposure to asbestos and the rubber industry are associated with an increased risk of work-related laryngeal cancer. [Siemiatycki, p. 334] "The committee concluded that the evidence is sufficient to infer a causal relationship between asbestos exposure and laryngeal cancer." [National Academy of Sciences. Asbestos: Selected Cancers. 2006]
Leukemia Leukemias represent 3% of all malignant neoplasms. Ionizing radiation, benzene, and cytotoxic drugs are known causes of acute leukemia. In atomic bomb survivors, the incidence of acute leukemias peaked at 2 to 5 years and declined after 10 years. After chemotherapy, the incidence peaks at 5 to 8 years. Acute lymphocytic leukemia (ALL) is limited mainly to the first 2 decades of life. It is associated with several congenital disorders characterized by chromosomal abnormalities. Since a majority of patients with these congenital syndromes do not develop ALL, an environmental cause is suspected. (Rosenstock, p. 746-7) There is strong evidence for associations between the following and occupational leukemia: boot and shoe manufacture and repair, benzene, ionizing radiation, and ethylene oxide. [Siemiatycki, p. 334] In studies of ionizing radiation and leukemia, strong associations were found for Japanese A-bomb survivors, radiation treatments for spondylitis, and use of Thorotrast as a contrast agent. Meaningful associations were found for radiologists working in past decades and Mayak workers. Negative associations were found for radium dial painters, underground miners, uranium processors, and Chernobyl cleanup workers. For nuclear workers the association is "suggested but unconfirmed or questionable association." Ionizing radiation increases risks for acute lymphocytic and acute myeloid leukemias and chronic myeloid leukemia, but not for chronic lymphocytic leukemia. [Boice, p. 261, 268]
Lung cancer Processes strongly associated with occupational lung cancer: aluminum production, coke production, coal gasification, underground hematite mining (radon), iron and steel founding, nickel refining (nickel oxides and sulfides), painters, and passive smoking. Agents (IARC Group 1) strongly associated with occupational lung cancer: arsenic compounds, hexavalent chromium compounds, asbestos, beryllium, cadmium compounds, ionizing radiation, crystalline silica, soots, and talc containing asbestiform fibers. Bis(chloromethyl)ether and chloromethyl methyl ether (technical grade) were strongly associated with lung (oat cell) cancer. [Siemiatycki, p. 334] Ionizing radiation was strongly associated with lung cancer in studies of Japanese A-bomb survivors, patients treated with radiation for Hodgkin's disease, underground miners, and Mayak workers with heavy exposure to plutonium. Negative associations were found in studies of radiologists, nuclear workers, uranium workers, and populations exposed to background radiation. [Boice, p. 261]
Melanoma
Mesothelioma, peritoneal A sentinel health event (occupational) associated with asbestos exposure; [Mullan]
Mesothelioma, pleural A sentinel health event (occupational) associated with asbestos exposure; [Mullan] Seventy percent of patients with pleural mesothelioma reported in Denmark around 1980 were excess cases due to occupational asbestos exposure assuming a baseline incidence rate for women in rural areas. [Skov T, Mikkelsen S, Svane O, Lynge E. Reporting of occupational cancer in Denmark. Scand J Work Environ Health 1990;16:401-5]
Nasal Sinus Cancer Agents associated with sino-nasal cancer include cigarette smoking, wood and leather dust, nickel refining, chromates, mustard gas manufacturing, isopropanol manufacturing (sulfuric acid mists), and possibly formaldehyde and welding. [LaDou, p. 312] Softwood dust is associated with squamous cell carcinoma, and hardwood dust is associated with adenocarcinoma of the nasal cavity. An increased risk exists for sawmill workers, furniture workers, wood products workers, and carpenters. No increased risk exists for workers in forestry, logging, or paper and pulp. [Dement J. Wood Dust. In: Bingham E, Cohrssen B, Powell C, eds. Patty's Toxicology, 5th ed. New York: John Wiley & Sons; 2001:619-49] Seventy percent of patients with sinonasal adenocarcinoma reported in Denmark between 1965 and 1974 had worked for many years in wood-working jobs. [Skov T, Mikkelsen S, Svane O, Lynge E. Reporting of occupational cancer in Denmark. Scand J Work Environ Health 1990;16:401-5] Sino-nasal cancer is associated with occupational exposure to nickel (refining), wood dusts (furniture making), boot and shoe dusts (manufacturing), hexavalent chromium (pigment manufacturing), and radium (dial painting). [Ward, p. 366] Strong evidence: Boot and shoe manufacture and repair; furniture and cabinet making; isopropanol manufacture, strong acid process (sulfuric acid); nickel refining (nickel oxides and sulfides); wood dust. Suggestive evidence: chromium compounds, hexavalent; formaldehyde, mineral oils, untreated and mildly treated. [Siemiatycki, p. 334]
Nasopharynx cancer There is suggestive evidence that mustard gas and formaldehyde can cause occupational nasopharyngeal cancer. [Siemiatycki, p. 334] Formaldehyde is a Group 1 carcinogen with sufficient evidence that it caused nasopharyngeal cancer in humans. [IARC Vol.: 88 (2006)]
Pancreatic Cancer For pancreatic cancer, occupation is not a major causal factor and probably accounts for less than 5% of all cases. There is a weak association with chlorinated hydrocarbons in epidemiological studies. [Lowenfels AB, Maisonneuve P. Epidemiologic and etiologic factors of pancreatic cancer. Hematol Oncol Clin North Am 2002;16:1-16.] Increased risk of pancreatic cancer was associated with working as a dry cleaner. There is inconclusive evidence that workers exposed to cadmium, asbestos, and ionizing radiation have increased risk. [Ward, p. 374-5] There is suggestive evidence that acrylamide can cause pancreatic cancer. [Siemiatycki, p. 334] Skin Cancer The major risk for outdoor workers is exposure to ultraviolet light. Other agents carcinogenic to the skin include: PAHs (coal tar, shale oil, or mineral oils); arsenic (pesticide manufacturing; sheep dip; copper, lead or zinc smelting); and ionizing radiation (radiologists); [LaDou, p. 260-3] Arsenic exposure is associated with an increased risk of basal cell cancer after a long latency. Sun exposure increases risk for basal cell cancer, squamous cell cancer, and melanoma. [Adami, p. 290-1] Chronic arsenic poisoning causes keratoses of palms and soles, patchy hyperpigmentation, and skin cancer (squamous and basal cell). [LaDou, p. 261, 434, 302] The evidence is strong for associations between the following agents or processes and occupational skin cancer: arsenic and compounds; coal tars and pitches; coal gasification; coke production; dibenz[a,h]anthracene; mineral oils, untreated and mildly treated; shale oils or shale-derived lubricants; solar radiation; and soots. [Siemiatycki, p. 334] Studies of ionizing radiation and skin cancer have found "meaningful associations" for Japanese A-bomb survivors, tinea capitis patients treated with radiation, and radiologists working in earlier decades. [Boice, p. 260]
Stomach Cancer In the list of industrial processes associated with human cancer, only work in the rubber industry is a possible cause of stomach cancer. [LaDou, p. 238-9] Populations exposed to high-dose radiation from the atomic bomb and from radiotherapy for ankylosing spondylitis had increased risk for stomach cancer. "Because the large literature on occupational exposures and gastric cancer risk is not strikingly consistent, the data need cautious interpretation." For the following chemicals, the evidence is weak for a causal relationship: asbestos, silica, wood dust, chlorophenols. Many studies show a positive association between gastric cancer and occupational exposure to mineral/metal dusts, nitrosamines, and some metalworking fluids. [Adami, p. 180-1] Substantial evidence exists for a causal association between heavy exposure to asbestos and stomach cancer. Strong evidence exists for coal miners, and some evidence exists for ethylene oxide production, painters, and exposure to sulfates and sulfites in the pulp and paper industry. [Ward, p. 462-3] There was suggestive evidence of increased occupational stomach cancer in painters and workers in the rubber industry. [Siemiatycki, p. 334] Negative associations were found in studies of ionizing radiation and stomach cancer in radiologists, underground miners, nuclear workers, and uranium processors. There was a suggested but unconfirmed or questionable association between Mayak workers heavily exposed to plutonium and stomach cancer. [Boice, p. 261] Thyroid Cancer Thyroid cancer was strongly associated with exposure to ionizing radiation in Japanese A-bomb survivors, patients treated with radiation to the head and neck (tinea capitis, thymus, and hemangiomas); and children exposed to Chernobyl fallout. Negative associations have been found in studies of nuclear workers, uranium processors, Chernobyl cleanup workers, and populations exposed to background radiation. [Boice, p. 261]
Revised: June 28, 2009 |
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