Asbestos-related occupational cancers compensated under the Industrial Accident Compensation Insurance in Korea

Our plain-English summary of Asbestos-related occupational cancers compensated under the Industrial Accident Compensation Insurance in Korea, by Y.S. Ahn, S.K. Kang (Industrial Health, 2009).

The study

• Authors: Y.S. Ahn, S.K. Kang
• Journal: Industrial Health
• Published: 2009;47(2):113-22
• Cited by: 15 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Compensation for asbestos-related cancers occurring in occupationally-exposed workers is a global issue; this is also an issue in Korea. To provide basic information regarding compensation for workers exposed to asbestos, 60 cases of asbestos-related occupational lung cancer and mesothelioma that were compensated during 15 yr; from 1993 (the year the first case was compensated) to 2007 by the Korea Labor Welfare Corporation (KLWC) are described. The characteristics of the cases were analyzed using the KLWC electronic data and the epidemiologic investigation data conducted by the Occupational Safety and Health Research Institute (OSHRI) of the Korea Occupational Safety and Health Agency (KOSHA). The KLWC approved compensation for 41 cases of lung cancer and 19 cases of mesothelioma. Males accounted for 91.7% (55 cases) of the approved cases. The most common age group was 50-59 yr (45.0%). The mean duration of asbestos exposure for lung cancer and mesothelioma cases was 19.2 and 16.0 yr, respectively. The mean latency period for lung cancer and mesothelioma cases was 22.1 and 22.6 yr, respectively. The major industries associated with mesothelioma cases were shipbuilding and maintenance (4 cases) and manufacture of asbestos textiles (3 cases). The major industries associated with lung cancer cases were shipbuilding and maintenance (7 cases), construction (6 cases), and manufacture of basic metals (4 cases). The statistics pertaining to asbestos-related occupational cancers in Korea differ from other developed countries in that more cases of mesothelioma were compensated than lung cancer cases. Also, the mean latency period for disease onset was shorter than reported by existing epidemiologic studies; this discrepancy may be related to the short history of occupational asbestos use in Korea. Considering the current Korean use of asbestos, the number of compensated cases in Korea is expected to increase in the future but not as much as developed countries.

In plain English

This study described all 60 cases of asbestos-related occupational cancer that the Korea Labor Welfare Corporation compensated from 1993 to 2007: 41 lung cancers and 19 mesotheliomas. The authors used compensation records, survey data and workplace investigation data. The article does not name the asbestos fiber types involved. Of the 19 mesothelioma cases, 16 were men and 15 arose in the pleura. Mean asbestos exposure was 16 years, and mean latency (time from first exposure to diagnosis) was 22.6 years. Of the 41 lung cancer cases, 39 were men. Mean exposure was 19.2 years and mean latency 22.1 years. Of 34 lung cancer cases with smoking data, 20 were current smokers and 7 were ex-smokers. Shipbuilding and repair was the most common industry for both cancers. The authors judged these latency periods shorter than in earlier studies. They attributed this to Korea's short history of occupational asbestos use and to younger compensated workers. They noted that exposure doses and lung fiber burdens were not available because they used secondary data.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive analysis of compensated workers' compensation cases (case series), using existing administrative and investigation data
• Who was studied: 60 workers compensated for asbestos-related cancer (41 lung cancer, 19 mesothelioma) by the Korea Labor Welfare Corporation (KLWC) from 1 January 1993 to 31 December 2007. 47 of the 60 had an epidemiologic investigation by the Occupational Safety and Health Research Institute.
• Exposure: Occupational asbestos exposure in jobs that manufactured, used or handled asbestos-containing products. Fiber type is not reported. Exposure duration was estimated from duration of employment.
• Main results:
  • Mesothelioma: 19 compensated cases, of which 16 (84.2%) were men.
  • Mesothelioma site: of the 19 mesothelioma cases, 15 (78.9%) were pleural, 3 peritoneal and 1 pericardial.
  • Mesothelioma exposure and latency: mean latency was 22.6 yr (median 22.0, minimum 8). Mean exposure duration was 16 yr (range 2 to 36).
  • Lung cancer: 41 compensated cases, of which 39 (95.1%) were men. Compensated lung cancer cases rose from 5 in 1993 to 1999 to 36 in 2000 to 2007.
  • Lung cancer exposure and latency: mean latency was 22.1 yr (range 9 to 38). Mean exposure duration was 19.2 yr.
  • Smoking in lung cancer cases: of 34 cases with smoking data, 20 (58.8%) were current smokers and 7 (20.6%) were ex-smokers.
  • Other carcinogens: 16 of the 41 lung cancer cases had also been exposed to other lung carcinogens, such as crystalline silica, hexavalent chromium, diesel engine exhaust, PAHs and radon progeny.
  • Lung cancer pathology: of 32 cases whose pathology was reviewed, 20 (62.5%) were adenocarcinomas, 6 small cell, 5 squamous cell and 1 large cell carcinoma.
  • Chest images: chest images of 16 lung cancer cases were re-read, and only 2 showed fibrosis that appeared asbestos-related.
  • Industries, mesothelioma: the most common industries were shipbuilding and repair (4 cases) and manufacture of asbestos textiles (3 cases).
  • Industries and jobs, lung cancer: the most common industries were shipbuilding and repair (7 cases), construction (6) and manufacture of basic iron and steel (4). The most common job was maintenance and repair (mechanics; 12 cases).
  • Coverage: from 2001 to 2006, 223 mesothelioma deaths occurred in the Korean general population, but only 5 deaths were covered by the compensation insurance.
• The authors' conclusion: The authors concluded that mesothelioma latency was shorter than in previous epidemiologic studies. They attributed this to Korea's short history of occupational asbestos use and relatively younger compensated workers, and said the same applied to lung cancer. They also said the criteria for compensating asbestos-related lung cancer need amending.
• Limitations the authors state:
  • Because secondary data were used, detailed exposure information such as cumulative exposure dose and lung fiber burden was not obtained.
  • Medical information on the cases, such as radiologic and pathology findings, was insufficient.
  • Work-relatedness was decided by a panel using a 50% probability threshold with no quantified method, which made consistency difficult.
  • Only cases compensated by this insurance were included. The insurance does not cover self-employed workers, some atypical workers, or groups such as government employees, who have their own insurance systems.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Asbestosis, Lung cancer, Mesothelioma.

Medical terms in this study, explained in our Lexicon: Lung Cancer, Mesothelioma, Asbestos Exposure, Latency, Asbestos Textiles.

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