Occupational respiratory cancer in Korea

Our plain-English summary of Occupational respiratory cancer in Korea, by H.E. Lee, H.R. Kim (Journal of Korean Medical Science, 2010).

The study

• Authors: H.E. Lee, H.R. Kim
• Journal: Journal of Korean Medical Science
• Published: 2010;25(Suppl):S94-8
• Type of article: Review
• Cited by: 8 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Malignant mesothelioma and lung cancer are representative examples of occupational cancer. Lung cancer is the leading cause of cancer death, and the incidence of malignant mesothelioma is expected to increase sharply in the near future. Although information about lung carcinogen exposure is limited, it is estimated that the number of workers exposed to carcinogens has declined. The first official case of occupational cancer was malignant mesothelioma caused by asbestos exposure in the asbestos textile industry in 1992. Since then, compensation for occupational respiratory cancer has increased. The majority of compensated lung cancer was due to underlying pneumoconiosis. Other main causative agents of occupational lung cancer included asbestos, hexavalent chromium, and crystalline silica. Related jobs included welders, foundry workers, platers, plumbers, and vehicle maintenance workers. Compensated malignant mesotheliomas were associated with asbestos exposure. Epidemiologic studies conducted in Korea have indicated an elevated risk of lung cancer in pneumoconiosis patients, foundry workers, and asbestos textile workers. Occupational respiratory cancer has increased during the last 10 to 20 yr though carcinogen-exposed population has declined in the same period. More efforts to advance the systems for the investigation, prevention and management of occupational respiratory cancer are needed.

In plain English

This article was a review of occupational respiratory cancer, mainly lung cancer and malignant mesothelioma, in Korea. The authors brought together government exposure surveys, workers' compensation records, surveillance systems, epidemiological studies and case reports. They reported that the first officially reported occupational cancer in Korea, in 1992, was mesothelioma caused by asbestos exposure in the asbestos textile industry. In one reviewed analysis of 120 compensated lung cancer cases from 1994 to 2008, which excluded cases approved because of underlying pneumoconiosis, asbestos was the main carcinogen (45%). The national mesothelioma surveillance system recorded an incidence rising from 0.25 per million in 2001 to 1.14 per million in 2007. In a reviewed study of 222 retired asbestos textile workers, three died of malignant mesothelioma and six of lung cancer. Lung cancer risk in this group was significantly raised in women but not in men. The authors concluded that occupational respiratory cancer had increased over the previous 10 to 20 years. They also noted that national statistics and exposure data were limited, and that long-term cohort studies were very limited.

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: Review of published studies, official statistics, surveillance data and case reports on occupational respiratory cancer in Korea
• Who was studied: Workers in Korea with occupational lung cancer or malignant mesothelioma, as captured in compensation records, case investigations, surveillance systems and occupational cohorts, from the 1990s to about 2009
• Exposure: Occupational lung carcinogens, including asbestos (all kinds of asbestos were banned in Korea in 2009), hexavalent chromium, crystalline silica, diesel engine exhaust, polycyclic aromatic hydrocarbons (PAHs) and heavy metals
• Main results:
  • The first officially reported occupational cancer case in Korea was mesothelioma caused by asbestos exposure in the asbestos textile industry, in 1992
  • In a reviewed study of 120 compensated lung cancer cases (1994 to 2008, excluding cases approved for underlying pneumoconiosis), compensated cases rose from 15 during 1994 to 1999 to 105 during 2000 to 2008
  • Among these 120 compensated lung cancer cases, which excluded cases approved for underlying pneumoconiosis, the major carcinogen was asbestos (45%), followed by hexavalent chromium (30%) and crystalline silica (19%)
  • Among 19 compensated malignant mesothelioma cases (1993 to 2007), mean asbestos exposure was 16.0 years and mean latency 22.6 years. The most common industries were shipbuilding and repair (4 cases) and asbestos textile manufacturing (3 cases)
  • In OSHRI case investigations from 1992 to 2000, 14 of 46 lung cancer cases (30.4%) and 6 of 6 malignant mesothelioma cases (100%) were accepted as occupational cancer
  • The Occupational Lung Cancer Surveillance System received 3,353 reported cases during 2006 to 2009, of which 393 (11.7%) were classed as definite or probable occupational cases
  • Under the Mesothelioma Surveillance System, the incidence rate of malignant mesothelioma, using the total Korean population as the denominator, rose from 0.25 per million in 2001 to 1.14 per million in 2007
  • In a reviewed cohort of carcinogen-exposed workers, lung cancer was in excess among asbestos-exposed workers (SRR 7.87; 95% CI 1.87-33.15; 6 cases)
  • In a reviewed study of 222 retired workers of an asbestos textile company, three died of malignant mesothelioma and six died of lung cancer
  • In the asbestos textile workers, malignant mesothelioma risk was extremely elevated in females (SMR 4501.7; 95% CI 545.2-16262.0; 2 cases)
  • In the asbestos textile workers, lung cancer risk was not significantly elevated in males (SMR 1.4; 95% CI 0.0-7.6; 1 case)
  • In the asbestos textile workers, lung cancer risk was significantly elevated in females (SMR 41.4; 95% CI 13.5-96.7; 5 cases)
• The authors' conclusion: The authors concluded that occupational respiratory cancer in Korea had increased during the last 10 to 20 years. They called for more efforts to advance systems for the prevention and management of occupational cancer.
• Limitations the authors state:
  • National official statistics did not report the status and trends of compensation for respiratory cancer
  • Nationwide investigation of the population exposed to hazardous agents was quite limited
  • The Work Environment Survey did not cover asbestos exposure from demolition and repair of buildings and facilities
  • Few epidemiological studies had examined occupational respiratory cancer, and long-term cohort studies were very limited

Topics

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

Medical terms in this study, explained in our Lexicon: Malignant Mesothelioma, Lung Cancer, Asbestos Exposure, Asbestos Textile Industry, Pneumoconiosis, Crystalline.

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• Lung Cancer Risks Associated with Occupational Exposure to Pairs of Five Lung Carcinogens: Results from a Pooled Analysis of Case-Control Studies (SYNERGY) — A. Olsson, L. Bouaoun, et al. (2024)
• Occupational Burden of Asbestos-Related Diseases in Korea, 1998-2013: Asbestosis, Mesothelioma, Lung Cancer, Laryngeal Cancer, and Ovarian Cancer — D.M. Kang, J.E. Kim, et al. (2018)
• Transfer of occupational health problems from a developed to a developing country: lessons from the Japan-South Korea experience — J. Park, N. Hisanaga, et al. (2009)
• Occupational and environmental asbestos exposure and the risk of lung cancer in Korea: A case-control study in South Chungcheong Province of Korea — D.A. Huh, M.S. Kang, et al. (2021)
• Extensive changes to occupational exposure limits in Korea — J.Y. Jeong, S. Choi, et al. (2010)

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