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A longterm follow-up of occurrence of professional malignant tumours of the respiratory tract in Slovakia – 1st part


Authors: J. Buchancová 1;  Ľ. Legáth 2;  I. Bátora 3;  O. Osina 4;  M. Machata 5;  V. Švihrová 1;  H. Hudečková 1;  T. Záborský 6
Authors‘ workplace: Ústav verejného zdravotníctva JLF UK Martin, vedúca prof. MUDr. Henrieta Hudečková, PhD., 2Klinika pracovného lekárstva a klinickej toxikológie UPJŠ Košice, vedúci doc. MUDr. Ľubomír Legáth, PhD., 3Klinika pracovného lekárstva a toxikológie LF UK, Kramáre 1
Published in: Pracov. Lék., 62, 2010, No. 3, s. 109-124.
Category: Review Article

Overview

The respiratory tract is the entrance gate and the most frequent target organ for majority of carcenogens from the working environment. Malignant tumours are the most serious occupational diseases with frequent unfavourable prognosis and with the high measure of deterioration of social inclusion. Authors presented a review of knowledge on professional carcenogens, factors of working activities related to onset, development, prognosis, and diagnostic process of respiratory tract tumours. They also evaluated the situation in Slovakia. Numbers of workers at risk in the 3rd and 4th categories of risk working positions have decreasing trend in the Slovak Republic in the last decade. However, in 1999 10 598 employees worked at risk of ionizing radiation in the health care system and mining industry, 3 367 workers at risk of chemical carcenogens (the most frequent was asbestos – 1829 workers), 1466 workers at risk of cytostatic drugs (including 1270 females). 183 cases of malignant tumours of lungs caused by ionizing radiation, 41 cases of malignant tumours of lungs caused by asbestos including malignant mesotheliomas and 16 malignant tumours of lungs and respiratory tract (including malignant mesotheliomas located in the upper part of the respiratory tract) caused by chemical carcenogens (altogether 240 malignant tumours of the respiratory tract) were reported in SR in the 25-year period between 1984 and 2008. Authors presented the more detailed analysis of the occurrence of malignant tumours of lungs caused by radon and malignant tumours caused by asbestos (predominantly from asbestos and cement factories) accompanied by the age structure of patients and several selected short case studies from mines in Slovakia (the first case was reported as an occupational disease in 1982). They described also the working process of glass adjustment using the glass powder Tripolit and the clinical picture of rapidly progressing lung fibrosis in glass-makers with malignant transformation of lung tissue. The occurrence of professional malignant tumours of the respiractory tract varied between 0.91 and 1,94 % of the overall number of reported occupational diseases in Slovakia in last 15 years (1994–2008).

Diseases developed after a longterm exposure to proved professional carcenogens. The professional malignant tumour manifested in the age over 60 years in 63.11 % of workers.

Professional malignant tumours caused by ionizing radiation represented 9 % of all professional diseases of the respiratory tract in SR. Before 2002, malignant tumours caused by radon prevailed in SR, since 1998, the proportion of malignant tumours caused by asbestos increased. After the registration of the item No. 46 into the List of Occupational Diseases in 2003, 16 cases of malignant tumours of the respiratory tract caused by different proved chemical carcenogens were reported between 2004 and 2008. Professional malignant tumours of the respiratory tract are mainly male diseases in SR, there were only 4 females in the sample of 240 patients (1.66 % – 3 malignant tumors caused by asbestos and 1 malignant tumour caused by cancerogens in the worker from the steel factory after 31 year exposure).

The percentage of professional malignant tumours of the respiratory tract in relation to average number of workers in SR varied between 0.0008 % (1994) and 0.0003 % (2008).

Professional malignant tumours are preventable diseases. Authors stressed the need for improving central statistical data, whereas better analysis of causal agents and factors related to development of the diseases may be used for the implementation of preventive measures for health protection of workers.

Key words:
professional malignant tumours, respiratory tract, miners in ore mines, radon, asbestos, malignant mesotheliomas, glass powder – Tripolit


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Hygiene and epidemiology Hyperbaric medicine Occupational medicine
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