Overview of occupational cancer in painters in Korea

Our plain-English summary of Overview of occupational cancer in painters in Korea, by J.P. Myong, Y. Cho, M. Choi, et al (Annals of Occupational and Environmental Medicine, 2018).

The study

• Authors: J.P. Myong, Y. Cho, M. Choi, H.R. Kim
• Journal: Annals of Occupational and Environmental Medicine
• Published: 2018;30:10
• Type of article: Review
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Comprehensive consideration is necessary for setting guidelines to evaluate evidence of occupational cancer in painters due to work-related exposure to carcinogens in paint (a phenomenon termed herein as "work-relatedness"). The aim of the present research is to perform a comprehensive review and to suggest criteria for the provision of compensation for occupational neoplasm among painters in Korea. In order to perform a comprehensive review, this study assessed and evaluated scientific reports of carcinogenicities from the International Agency for Research on Cancer (IARC) and the Industrial Injuries Advisory Council (IIAC), as well as reviewed the existing literature about occupational exposure among painters in Korea and the epidemiologic investigations of claimed cases of cancer among painters in Korea. The IARC declares that occupational exposures in commercial painting are classified as Group 1 carcinogens for lung cancer and bladder cancer among painters. The epidemiologic studies show consistent causal relationships between occupational exposure in painters and cancers such as lung cancer [meta relative risk: 1.34 (95% confidence intervals (CIs): 1.23-1.41)] and bladder cancer [meta relative risk: 1.24 (95% CIs: 1.16-1.33)]. In reviewing occupational cancer risks for commercial painters, the Industrial Injuries Advisory Council (IIAC) confirms occupational cancer risks for lung and bladder cancer among commercial painters. According to the IIAC, however, the elevated cancer risks reported in existing literature are not doubled in either lung or bladder cancer in commercial painters relative to the risks of these cancers in the general population. Based on our review of existing Korean articles on the topic, painters are exposed to potential carcinogens including polycyclic aromatic hydrocarbons (PAHs), benzene, hexavalent chrome, crystalized silica, asbestos, and other agents, and relative levels are estimated within commercial painting processes. However, the cancer risks of occupational exposure to Group 1 carcinogens for lung and bladder cancer in painters per se are not fully assessed in existing Korean articles. Total work duration, potential carcinogens in paint, mixed exposure to paints across various industries such as construction and shipbuilding, exposure periods, latent periods, and other factors should be considered on an individual basis in investigating the work-relatedness of certain types of cancer in commercial painters.

In plain English

This was a review aiming to suggest compensation criteria for work-related cancer in Korean painters. The authors examined reports from the International Agency for Research on Cancer (IARC) and the UK Industrial Injuries Advisory Council (IIAC), 31 Korean articles on painters' exposures, and 10 Korean investigations of lung cancer in painters. They reported that the IARC classifies occupational exposure in commercial painting as Group 1 carcinogens for lung and bladder cancer. IARC meta-analyses gave meta-relative risks of 1.34 (95% CI 1.23-1.41) for lung cancer and 1.24 (95% CI 1.16-1.33) for bladder cancer. According to the IIAC, these risks were not doubled compared with the general population, and smoking might partly explain them. Korean articles described exposure to PAHs, benzene, hexavalent chrome, crystalized silica and asbestos. One cited Korean report gave asbestos geometric means of 1.6 fibers/cm3 in automobile repair and 2.45 fibers/cm3 in ship repair. Seven of the 10 investigated painters were approved. The authors concluded that work duration, carcinogens in paint, industry, exposure periods and latent periods should be considered case by case.

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 IARC and IIAC reports, Korean exposure literature, and Korean work-relatedness investigations of cancer claims
• Who was studied: 31 Korean articles on painters' exposures (Table 2, 1989-2010), plus 10 epidemiologic investigations of lung cancer in commercial painters by KOSHA and the Occupational Lung Diseases Institute (Table 3, 2000-2012)
• Exposure: Occupational exposure as a commercial painter, including potential carcinogens in paint: polycyclic aromatic hydrocarbons (PAHs), benzene, hexavalent chrome, crystalized silica, asbestos and other agents
• Main results:
  • The IARC classifies occupational exposures in commercial painting as Group 1 carcinogens for lung cancer and bladder cancer (reported from IARC documents, not new data).
  • An IARC-cited meta-analysis of 17 cohort and linkage studies and 29 case-control studies gave a meta-relative risk for lung cancer in painters of 1.34 (95% CI 1.23-1.41).
  • An IARC-cited meta-analysis of 11 cohort and record-linked studies and 28 case-control studies gave a meta-relative risk for bladder cancer in painters of 1.24 (95% CI 1.16-1.33).
  • According to the IIAC review, elevated lung and bladder cancer risks in painters were not doubled relative to the general population, and confounding factors such as smoking might be one reason for the elevation.
  • A cited 1989 Korean report gave geometric means of asbestos exposure of 1.6 fibers/cm3 in automobile repair and 2.45 fibers/cm3 in ship repair processes. A separate cited study found asbestos undetected in automobile manufacturing companies' products after 1998.
  • A cited 1999 study of five domestic shipyards found lead chromate and zinc potassium chromate in 8% of paints, and silicon dioxides in 27 samples (8.8%) of painting materials.
  • Of 10 Korean investigations of lung cancer in commercial painters, 7 painters were approved. Asbestos was noted as a possible co-exposure in two approved cases: possibly in filler in a metal manufacture case, and with welding fume in a boiler manufacture case.
• The authors' conclusion: The authors concluded that no guidelines yet exist in Korea, or in any country, for occupational cancer in painters. They concluded that total work duration, potential carcinogens in paint, mixed exposure across industries such as construction and shipbuilding, exposure periods, latent periods and other factors should be considered individually when investigating work-relatedness.
• Limitations the authors state:
  • The authors stated that existing Korean articles have not fully assessed the cancer risks of occupational exposure to Group 1 carcinogens for lung and bladder cancer in painters.
  • The authors noted that the IARC states the epidemiological evidence on painters does not specify which carcinogenic agents in paint are responsible.

Topics

Medical terms in this study, explained in our Lexicon: Neoplasm, IARC, Occupational Exposure, Lung Cancer, Relative Risk, confidence interval.

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