Occupational Lung Cancer

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Although cigarette smoking is the dominant cause of lung cancer throughout the world, occupational exposures continue to contribute to the causation of this rapidly fatal malignancy. Agents causally linked to lung cancer include arsenic, asbestos, chloro-methyl ethers, chromium, environmental tobacco smoke, nickel and nickel compounds, polycyclic aromatic hydrocarbons, radon, and vinyl chloride. Many other agents are probable or possible causes of lung cancer. This article covers the principal occupational carcinogens and addresses issues likely to be faced by pulmonologists as they provide care for patients with lung cancer. A key issue is the attribution of causation to a specific agent; however, it is unfortunate that we lack specific markers for individuals and need to rely on epidemiologic data for groups to make estimates for individuals of the probability of causation. Primary prevention through control of workplace exposures and smoking cessation will remain central in controlling the burden of occupational lung cancer.

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