Epidemiologic characteristics of compensated occupational lung cancers among Korean workers

Our plain-English summary of Epidemiologic characteristics of compensated occupational lung cancers among Korean workers, by Y.S. Ahn, K.S. Jeong (Journal of Korean Medical Science, 2014).

The study

• Authors: Y.S. Ahn, K.S. Jeong
• Journal: Journal of Korean Medical Science
• Published: 2014;29(11):1473-81
• Cited by: 17 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

An understanding of the characteristics of occupational lung cancer is important to establish policies that prevent carcinogen exposure and to compensate workers exposed to lung carcinogens. This study analyzed the characteristics of occupational lung cancers in workers who were compensated under the Industrial Accident Compensation Insurance Law between 1994 and 2011. A total of 179 occupational lung cancers were compensated. The main carcinogenic exposure was asbestos, followed by crystalline silica and hexavalent chromium. The mean exposure duration and latency were 19.8 and 23.2 yr. The most common industry was manufacturing, followed by construction and transportation. The most common occupation was maintenance and repair, followed by foundry work, welding, painting, and spinning or weaving. Although asbestos was predominant carcinogen, the proportion of these cases was relatively low compared to other developed countries. Proper surveillance system is needed to monitor occupational lung cancer and improve prevention measures.

In plain English

This study reviewed all 179 lung cancers accepted as occupational by Korea's workers' compensation agency (KCOMWEL) from 1994 to 2011. Lung cancers in miners with pneumoconiosis greater than grade 1 were excluded. Asbestos was the main cause named in 87 cases (48.6%), followed by crystalline silica (42 cases, 23.5%) and hexavalent chromium (26 cases, 14.5%). Asbestos fiber types were not reported. Across all cases, mean exposure duration was 19.8 years, and mean latency, from first exposure to diagnosis, was 23.2 years. Median latency in asbestos-related cases was 24.0 years. Exposure duration and latency did not differ significantly by carcinogen. Manufacturing (112 cases) and construction (30 cases) were the leading industries, and maintenance and repair, foundry work and welding were the commonest jobs. Of 59 asbestos-related cases with known pathology, 34 (57.6%) were adenocarcinomas and 15 (25.4%) squamous cell carcinomas. The authors concluded that the asbestos share was relatively low compared with European countries. They noted that, because they used secondary data, they could not assess cumulative exposure dose or asbestos fibers in the lung.

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 review of compensation records (case series) of all lung cancers compensated as occupational, supplemented by government epidemiological investigation reports and surveys
• Who was studied: 179 workers whose lung cancers were compensated as occupational by KCOMWEL under Korea's Industrial Accident Compensation Insurance between 1994 and 2011. Of these, 169 (94.4%) were men, and mean age at diagnosis was 53.5 years. Lung cancers in miners with pneumoconiosis greater than grade 1 were excluded.
• Exposure: Occupational lung carcinogens judged to be the major cause: asbestos (87 cases, 48.6%), crystalline silica (42, 23.5%) and hexavalent chromium (26, 14.5%). Other agents were welding fume, diesel engine exhaust, rubber dust, coal tar pitch volatiles or PAH, and coke oven emissions. Asbestos fiber types were not specified.
• Main results:
  • Annual recognition rates per 100,000 insured workers ranged from 0 to 0.15 (mean 0.09) for all occupational lung cancers and from 0.00 to 0.09 (mean 0.05) for asbestos-related lung cancers
  • All 179 cases: mean duration of exposure to lung carcinogens was 19.8 years (SD 9.9)
  • All 179 cases: mean latency period was 23.2 years
  • Median latency was 24.0 years in asbestos-related, 21.5 years in silica-related and 21.0 years in chromium-related (including welding) lung cancers
  • Mean exposure duration and latency did not differ significantly by type of major carcinogen
  • Leading industries among the 179 cases were manufacturing (112 cases, 62.6%) and construction (30 cases, 16.8%)
  • Most common occupations among the 179 cases were maintenance and repair (29, 16.2%), foundry work (23, 12.8%), welding (22, 12.3%) and painting (13, 7.3%)
  • Among 59 asbestos-related lung cancers with known pathology, 34 (57.6%) were adenocarcinoma and 15 (25.4%) squamous cell carcinoma
  • Among 160 cases with assessed smoking history, 74 (46.3%) were current smokers and 65 (40.1%) were non-smokers
  • Chest imaging was available in only 23 cases. Two showed pleural plaques and two showed pleural thickening, and only 6 cases of pulmonary fibrosis appeared related to asbestosis.
  • Among the 42 included silica-related lung cancers, 8 (19.0%) had pneumoconiosis
• The authors' conclusion: The authors concluded that asbestos was the predominant carcinogen, but that the share of asbestos-related compensated lung cancers in Korea was relatively low compared with Germany, France and Belgium. They also concluded that a proper surveillance system is needed.
• Limitations the authors state:
  • The study used secondary data, so cumulative exposure dose, asbestos fiber or asbestos body burden in the lung, and other clinical information could not be assessed
  • Clinical information such as radiology and pathology was insufficient for all cases
  • Lung cancers in miners with pneumoconiosis greater than grade 1 were excluded
  • Only cases covered by the compensation insurance were included. Self-employed and some atypical workers are not covered.
  • Work-relatedness was judged by expert panels without consistent objective criteria

Topics

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

Medical terms in this study, explained in our Lexicon: Lung Cancer, Carcinogenic, Crystalline, Latency.

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