An Overview of Occupational Cancers

Cancer can develop anywhere in the body. The disease begins with uncontrolled proliferation of cells, leaving no room for normal cells. This makes it difficult for the body to function as it should.

Cancer is a disease that can be treated very well in many people. In fact, not at all anymore. More patients than ever continue to live after cancer treatment.

As a result of the rapid development of cancer science and technology, with the emergence of new carcinogens, there are publications every day stating that some substances are or are not carcinogenic. The main reason for the difficulty in this regard is that the disease occurs years after exposure to the suspected carcinogenic agent.

Due to this feature of cancers, people who are monitored disappear over the years and the evaluation of the results creates difficulties. This is especially the case for occupational cancers. If a person working with a factor thought to be carcinogenic leaves their job for any reason, it makes it difficult to follow up the incident and makes the results meaningless.

Cancers are a group of diseases with very different causes. Although the etiology of cancer has not been definitively revealed, it is known that the majority of cancers in humans (about 80%) occur as a result of environmental effects and lifestyle characteristics.

Among these factors, the biggest share is smoking and faulty practices regarding nutrition. Occupational factors also play a role among the causes of cancer. has. Approximately 4-5% of cancers in humans occur due to factors encountered during work. While the share of occupational factors, which is around 4-5% on average, increases to around 10-15% in some types of cancer (for example, lung cancer), it is much lower at around 1-2% in digestive system cancers. ;k shares.

Cancers that occur as a result of occupational exposure occur younger than cancers that occur due to other reasons. It occurs with age. This is due to the constant and high levels of exposure in the working environment. It is thought to be. Since the formation and development of cancer covers a very long period of time, there are difficulties in establishing an objectivity link between occupational risk and cancer. If the patient has any reason (illness, death, job change, etc.) Diagnosing the disease years after leaving the workplace is a cause and effect. It prevents the relationship from being revealed.

As a result, the occupational aspect of the disease; It is seen that the incidence and prevalence are shown to be small.

For this reason, the International Agency for Research on Cancer (IARC) recommends that "clinicians who follow up cancer patients should be aware of the risk of cancer in areas affected by occupational carcinogens, such as nose, lung, pleura, skin, bladder and hematopoietic system, especially those who work with their hands." The occupational anamnesis of the patients is taken in great detail. recommends.

Diagnosis and treatment of occupational cancers vary depending on the type of cancer. However, a good evaluation of the work history in terms of diagnosis is important in terms of elucidating the occupational cause of cancer. Occupational etiology should be remembered, especially in cases of lung cancer, mesothelioma, bladder cancer and leukemia, and the work history of the patients should be taken into account. It should be learned in detail.

Historical Development of Occupational Cancers

The role of occupational factors in the occurrence of cancer was first pointed out by Dr. Percival Pott, one of the doctors of St. Bartholomew's Hospital in London, in 1775. Dr. Pott claimed that the cause of this cancer, which was thought to be venereal until then, was the soot and tar accumulated in the chimney. He was later called "Sir" by the queen for his work. Awarded with the title of Dr. Pott drew attention to the frequent occurrence of scrotum cancer at older ages among children working in chimney sweeping in England. As a result of this invention, young people The law preventing workers from working in chimneys was enacted (1840). It is very important that such a determination was made in a period when microbes did not yet exist and knowledge about the causes of diseases was very limited.

This observation about the cause of cancer, beyond being the first detection of occupational cancer, is considered in most sources as the beginning of cancer epidemiology.

In 1932, about 150 years after this information was revealed by Percival Pott, the chemical agent that causes this cancer (tar; 1-2 dibenz anthracene) was identified as the first chemical carcinogen. "Bladder cancers" are among the most common occupational cancers. It is among the first to be identified. The paint industry started to develop in the mid-19th century. A long time after Percival Pott's observation, in 1895, Rehn pointed out that bladder cancer was common among workers in the paint industry.

At first, it was thought that this cancer occurred due to aniline, which is frequently used in dyeing works, and therefore the bladder cancers seen in dye workers were called "aniline cancer". has been named. However, as a result of the studies carried out by Case and his friends in the 1950s and the following years, it was revealed that the substance that causes bladder cancer was naphthyl amine, not aniline.

In recent years, an increase in asbestos-related respiratory cancers has been observed. While asbestos causes asbestosis (interstitial fibrosis, recognized by diffuse fibrosis in the lungs and pleural thickening), it also causes metaplasic changes.

Smoking increases the risk even further. Thus, there is a synergism between cigarette consumption and asbestos in terms of lung cancer.

Situation in Turkey and the World

Every year, more than 8 million people in the world get cancer and more than 7 million people die due to cancer. Various studies report that the rate of occupational cancers among all cancers is between 2-8%. There is no definitive data on occupational cancers in our country. Occupational cancers are not shown in the annual statistics of the Social Insurance Institution. For this reason, a number for the entire country cannot be expressed. In our country, occupational cancers suggest that the incidence of cancer among employees will be between 2-8%.

Social Insurance Health Procedures Regulation lists which diseases are occupational.

Protection from Occupational Cancers

Occupational cancers are a type of occupational disease. Therefore, in terms of protection, the principles of protection against occupational diseases are valid. In fact, in a significant portion of cancer cases in humans, the cause of cancer is not clearly known. However, prevention of occupational cancers is more possible than other cancers. There are technical and medical measures for protection.

Technical Protection Measures

The aim of technical protection measures in terms of protection from occupational cancers is to detect the substance that causes cancer at the "source". is to be taken under control. The most definitive action to be taken for this purpose is to remove the carcinogenic substance from use and never use it. is not to be used. There may be other substances that can be used instead of this substance, and other substances that do not have carcinogenic effects can be used instead of the carcinogenic substance. The use of some fibrous synthetic substances instead of asbestos or the use of other solvents such as toluene, xylene or hexane instead of benzene are well-known examples of this issue. However, in some cases, this is not possible and the substance in question must be used in order to continue working life. In this case, effective ventilation systems are installed and the process is carried out in a closed system. For example, it is unsafe for a smoker to work in a job that exposes them to asbestos, or for a person with a blood disease to work in a job that exposes them to benzene or radiation. During intermittent control examinations, examinations are performed that can provide early diagnosis depending on the type of disease. For example, it would be appropriate to perform urine cytology intermittently for the early diagnosis of bladder cancer in a person working in the paint and rubber industry. Possible risks and protection methods depending on the nature of the job are also the subjects of health education.