Occupational cancer in Germany

Our plain-English summary of Occupational cancer in Germany, by I. Brüske-Hohlfeld (Environmental Health Perspectives, 1999).

The study

• Author: I. Brüske-Hohlfeld
• Journal: Environmental Health Perspectives
• Published: 1999;107 Suppl 2(Suppl 2):253-8
• Type of article: Review
• Cited by: 11 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

As in probably mostly all other European countries, the incidence of occupational cancer in Germany increased steadily after World War II. In 1994 about 1,600 cases of occupational cancer were compensated--more than ever before. More than half of these cases were lung cancer, most caused either by asbestos (n=545) or by ionizing radiation ((italic)n(/italic)=306). Other frequent target organs of asbestos were the pleura and the peritoneum with 495 cases of mesotheliomas. Asbestos was the single most important risk factor for occupational cancer, causing more than 1000 deaths per year. All other malignant diseases, such as bladder cancer, leukemia, angiosarcoma of the liver, adenocarcinoma of the nose or nasal sinuses, and skin cancer, were comparatively rare. Although primary exposure to ionizing radiation in uranium ore mining occurred in the 1950s and attributable lung cancers seem to be on the decline, this is not true for asbestos, where the peak incidence in lung cancer and mesothelioma has not been reached yet.

In plain English

This article was an overview of occupational cancer in Germany, built from official statistics on cases compensated as occupational diseases. In 1994 about 1,600 occupational cancers were compensated. More than half were lung cancer: 545 attributed to asbestos and 306 to ionizing radiation. Another 495 were asbestos-caused mesotheliomas of the pleura, peritoneum, or pericardium. The author stated that asbestos was the single most important risk factor for occupational cancer, causing more than 1000 deaths per year. From 1978 to 1994, 5,175 people in Germany were compensated for asbestos-related lung cancer. Compensated cases in West Germany (1978 to 1990) and all Germany (1991 to 1994) included 2,944 pleural and 196 peritoneal mesotheliomas. Locksmiths, chemical workers, and plumbers and pipe fitters were the jobs named most often. From 1993, lung cancer could be compensated after at least 25 fiber-years of exposure without signs of asbestosis. The author concluded that peak incidence of asbestos-related lung cancer and mesothelioma had not yet been reached. The author cautioned that the figures were a rough, lower estimate because of underreporting.

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 overview (review) of official German statistics on compensated occupational cancers, part of a monograph on occupational cancer in Europe
• Who was studied: People compensated for occupational cancer in Germany: East Germany 1960 to 1990, West Germany 1978 to 1990, all Germany 1991 to 1994; about 1,600 compensated cases in 1994
• Exposure: Occupational carcinogens on the German list of occupational diseases. The main ones were asbestos (fiber types not specified) and ionizing radiation in uranium mining. Chemicals such as chromium, arsenic, aromatic amines and benzene were also covered. Asbestos imports to East Germany rose from 8,000 tons in 1960 to 74,000 tons in 1980. West German imports peaked around 1965 at 180,000 tons per year.
• Main results:
  • In 1994, more than half of compensated occupational cancers were lung cancer, mostly caused by asbestos (545 cases) or ionizing radiation (306 cases).
  • In 1994, 495 cases were compensated under occupational disease 4105. This category covers asbestos-caused mesothelioma of the pleura, peritoneum, or pericardium.
  • The author stated that asbestos was the single most important risk factor for occupational cancer in Germany, causing more than 1000 deaths per year.
  • Persons compensated for asbestos-related lung cancer: 2,945 in East Germany (1978 to 1990), 811 in West Germany (1978 to 1990) and 1,419 in all Germany (1991 to 1994), a total of 5,175.
  • In West Germany (1978 to 1990) and all Germany (1991 to 1994), 2,944 pleural mesotheliomas and 196 peritoneal mesotheliomas were compensated.
  • For compensated asbestos lung cancer cases, the most frequent jobs were locksmiths (347), chemical workers (234), and plumbers and pipe fitters (132). The same jobs led for mesothelioma: locksmiths (535), chemical workers (265), and plumbers and pipe fitters (194).
  • The definition of occupational disease 4104 changed in 1993. After that, lung cancer could be compensated with occupational asbestos exposure of at least 25 fiber-years, without signs of asbestosis, which made compensation easier.
  • The author noted a surprisingly short latency for asbestos-related lung cancer in East Germany. This may be explained by poor working conditions and high exposure in the late 1950s and early 1960s.
  • 33 cases of asbestos-induced cancer of the larynx were compensated by way of exception, before laryngeal cancer was added to the list in 1997.
• The authors' conclusion: The author concluded that asbestos-related lung cancer and mesothelioma had not yet reached peak incidence, unlike radiation-related lung cancer in uranium miners.
• Limitations the authors state:
  • Official statistics cover only compensated cases, which are the 'tip of the iceberg', because many diseases are not recognized as occupational.
  • Underreporting is very likely in Germany, so the figures are a rough and lower estimate.
  • It is not known whether the industries with the most compensated cases also had the highest asbestos consumption.

Topics

Medical terms in this study, explained in our Lexicon: Lung Cancer, Pleura, Peritoneum, Mesothelioma, Adenocarcinoma.

Related studies

• Occupational cancer in Italy — E. Merler, P. Vineis, et al. (1999)
• Cancer incidence in urban, rural, and densely populated districts close to core cities in Bavaria, Germany — M. Radespiel-Tröger, K. Geiss, et al. (2018)
• Use of asbestos, health risks and induced occupational diseases in the former East Germany — W. Sturm, B. Menze, et al. (1994)
• Occupational risk factors for lung cancer in women: results of a case-control study in Germany — I. Jahn, W. Ahrens, et al. (1999)
• Occupational cancer in Canada: what do we know? — K. Teschke, M.C. Barroetavena (1992)
• Trends in suspected and recognized occupational respiratory diseases in Germany between 1970 and 2005 — V. van Kampen, R. Merget, et al. (2008)

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