Occupational Cancer

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This chapter provides an up-to-date review of the occurrence and causes of occupational cancer based on epidemiologic studies and discusses the epidemiology of occupational cancer, the characteristics, research priorities, prevention, and surveillance. Epidemiologic methods have been very successful in documenting cancer risks associated with agents. Epidemiologic data is useful when an exposure-response relationship can be demonstrated. Examples of agents for which epidemiologic studies provide evidence of an exposure-response relationship include benzene and myelogenous leukemia. Vinyl chloride causes liver cancer which is an example of associations between single agents and rare histologic types of cancer. It is more difficult to conduct epidemiologic studies to identify cancer risks associated with complex mixtures. Studies of diesel exhaust, lung cancer, and metal machining oils are cited as having employed advanced industrial hygiene and epidemiologic methods for studies of complex mixtures. At present, less than 20 known occupational carcinogenic agents have been evaluated based on studies in humans and animals by the International Agent for Research on Cancer. Furthermore, exciting developments in epidemiologic and animal studies will contribute to identifying additional carcinogenic agents in the workplace. New biologic markers of exposure and cancer-related outcomes must be identified and integrated into epidemiologic studies. Because epidemiologic data regarding the carcinogenicity of many exposures are not available, research methods to evaluate and improve the predictive value of animal and in vitro systems must be developed. A complete understanding of occupational cancer trends will be required further to research occupational cancer risks and means of prevention.