5. Respiratory Malignancies4.3 Letters of Support, Etc. | 5.1 Determination of Occupational Etiologies of Lung Cancer
Healthy People 2010 acknowledges “a continuing and vital need to foster new, innovative research on both the causes of cancer (including genetic and environmental causes) and on methods to translate biologic and epidemiologic findings into effective prevention and control programs for use by government and community organizations to reduce further the Nation’s cancer burden.” 133
Lung cancer is the most common malignancy in the U.S. and is ranked second only to bladder cancer in the proportion of cases thought to be due to occupational exposures.134 NIOSH has identified more than 150 chemical agents that are considered to be occupational carcinogens or potential occupational carcinogens (http://www.cdc.gov/niosh/npotocca.html) (A5-1). In 1996, it was estimated that approximately 9,000-10,000 men and 900-1,900 women developed lung cancer annually in the U.S. due to past exposure to occupational carcinogens. More than half of these lung cancers were attributed to asbestos.
The NORA Cancer Research Methods Team noted previously that millions of workers in the U.S. are exposed to substances that are carcinogenic to animals; and even though IARC has classified them as Group 2A or Group 2B (probable or possible carcinogens), OSHA has not yet subjected them to regulation. Moreover, less than two percent of chemicals in commerce have been tested for carcinogenicity.135
This chapter discusses several occupational lung cancer risk factors and approaches taken to mitigate them. The first section discusses the work of RDRP in the determination of occupational lung cancer burden in the U.S. and worldwide, general, and historical risk assessment considerations in the areas of exposures to beryllium, cadmium, chromium, silica, and x-rays, as well as in the area of construction work. More recent and detailed activities and products from the RDRP discuss rulemaking for chromium, silica, and diesel exhaust. A final section discusses progress in development of molecular diagnostic tools for lung cancer.
135. Toraason M, Albertini R, Bayard S, Bigbee W, Blair A, Boffetta P, Bonassi S, Chanock S, Christiani D, Eastmond D, Hanash S, Henry C, Kadlubar F, Mirer F, Nebert D, Rapport S, Rest K, Rothman N, Ruder A, Savage R, Schulte P, Siemiatycki J, Shields P, Smith M, Tolbert P, Vermeulen R, Vineis P, Wacholder S, Ward E, Waters M, Weston A . Applying new biotechnologies to the study of occupational cancer--a workshop summary. Environ Health Perspect. 112(4):413-6.