Estimating the incidence of lung cancer attributable to occupational exposure in Iran

Abstract

Objective: The aim of this study was to estimate the fraction of lung cancer incidence in Iran attributed to occupational exposures to the well-established lung cancer carcinogens, including silica, cadmium, nickel, arsenic, chromium, diesel fumes, beryllium, and asbestos.Methods: Nationwide exposure to each of the mentioned carcinogens was estimated using workforce data from the Iranian population census of 1995, available from the International Labor Organization (ILO) website. The prevalence of exposure to carcinogens in each industry was estimated using exposure data from the CAREX (CARcinogen EXposure) database, an international occupational carcinogen information system kept and maintained by the European Union. The magnitude of the relative risk of lung cancer for each carcinogen was estimated from local and international literature. Using the Levin modified population attributable risk (incidence) fraction, lung cancer incidence (as estimated by the Tehran Population-Based Cancer Registry) attributable to workplace exposure to carcinogens was estimated. Results:The total workforce in Iran according to the 1995 census identified 12,488,020 men and 677,469 women. Agriculture is the largest sector with 25% of the male and 0.27% of female workforce. After applying the CAREX exposure estimate to each sector, the proportion exposed to lung carcinogens was 0.08% for male workers and 0.02% for female workers. Estimating a relative risk of 1.9 (95% CI of 1.7-2.1) for high exposure and 1.3 (95% CI 1.2-1.4) for low exposure, and employing the Levin modified formula, the fraction of lung cancer attributed to carcinogens in the workplace was 1.5% (95% CI of 1.2-1.9) for females and 12% (95% CI of 10-15) for males. These fractions correspond to an estimated incidence of 1.3 and 0.08 cases of lung cancer per 100,000 population for males and females, respectively. Conclusion:The incidence of lung cancer due to occupational exposure is low in Iran and, as in other countries, more lung cancer is due to occupational exposure among males than females.

Epidemiological and Clinicopathological Characteristics of Lung Cancer in a Teaching Hospital in Iran

“…Regarding the retrospective nature of the present study and the possibility of failure in recording all cases of occupation-related lung cancer, the role of occupational risk factors associated with cancer should be higher than that found in this study. The contribution of lung cancer due to occupation-related carcinogens was estimated around 1.5% for women and 12% for men, a study in which a history of baking homemade bread was not considered as an occupation-related risk factor of lung cancer (Mosavi-Jarrahi et al, 2009).…”

Occupational and Environmental Cancer

“…Exposure to chemical oncogenes can cause mutations that result to cells to become out of control and cause cancer [33][34]. Mortality due to cancer and occupational cancer has increased because of an increase in life expectancy and a gradual reduction in other causes of death, such as infectious diseases and injuries [8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Ten major risk factors for occupational oncogenesis is responsible for around 85% of all occupational cancers.…”

“…One out of ten cases of lung is a result of occupational exposures [24]. Until recently, cancer was a disease in western and industrial countries, though, in 2008, 56% of new cases (7.1 million) and 63% of total cancer deaths (4.8 million) were reported to occur in low-income and middle-income countries (LMICs) [12][13][14][15][16][17][18][19][20][21][22][23][24][25]. Cancer in many Asian countries is a serious health threat and is the major cause of death in Asia and the Pacific, such as Japan and Korea [26].…”

“…Cancer in many Asian countries is a serious health threat and is the major cause of death in Asia and the Pacific, such as Japan and Korea [26]. Detected cancers in Asia are respectively related to lung, breast, colon, and rectum, and the main cause of death are cancers of lung, stomach, and liver [24,[26][27]. In 2000, there were more than 3 million new cases of cancer and more than 2 million cancer deaths in Asia, and it is predicted that if current management and protective strategies remain unchanged, new detected cases in Asia will arise to 1.7 million cases to 2020 [26].…”

Application of Bethesda terminology to categorize buccal epithelial smears among petroleum station workers in Taif city, KSA

“…The current permissible exposure level is 1 part per million (ppm) in air for 8 hours [3]. The association between exposure to benzene or benzene-containing mixtures with acute nonlymphocytic (myeloid) leukemia, hemato-toxicity and other bone marrow disorders has been shown in epidemiological studies in different countries [4], [5]. The carcinogenic mechanisms of benzene have been demonstrated through in vitro models.…”