Lung cancer accounts for almost 30% of all deaths and is the most malignant
neoplasm in industrialized countries. Estimates of the percentage of lung
cancers attributable to occupational factors range from 3% to 17%.
Cigarette smoking is the most important risk factor for lung cancer. The most
important lung carcinogen is asbestos. Occupations with high smoking
prevalence have an increased risk of cancer: wait stuff, cashiers, orderlies,
drivers, construction workers, watchmen. The effects of some occupational
carcinogens are greatly enhanced by smoking (asbestos, radon).
Workers may be exposed to a wide range of carcinogens. Multiple exposure
to carcinogens (cancer-causing agents) results in damage to DNA in the cells
of the body and cause cancer.
Known carcinogens and processes linked to human lung cancer:
talc containing asbestiform fibres
sulfuric acid mists
arsenic and arsenic compounds
beryllium and beryllium compounds
chromium ( VI )
cadmium and cadmium compounds
polyaromatic hydrocarbons ( benzo(a)pyren)
radon and radon daughters
diesel exhaust fumes
iron and steel founding
paint manufacture and painting
1 Empimed_Doctor’s Notes
9 August 2008
art glass manufacture
All histological types of lung cancer are linked to cigarette smoking.
There is no one cell type that is pathognomonic of an occupationally related
lung cancer, except some exposures.
Histologic types of lung cancer
1. Non-small cell lung cancer is more common than small cell lung cancer:
o squamose cell carcinoma ( epidermoid carcinoma ). It often begins in
the bronchi, more often located centrally, with associated hilar
adenopathy. The most common lung cancer in men.
o adenocarcinoma. It begins in the glandular cells, presents more
commonly as a peripheral nodule with pleural and chest wall
involvement. The most common lung cancer in women and in people
who have never smoked.
o large cell carcinoma. This tumor usually begins along the outer edges
of the lungs and is seen a large peripheral mass with associated
o Adenosquamose carcinoma. It begins in flatted cells that also have
o Undifferentiated carcinoma. It consists of abnormal-looking cells that
tend to multiply quickly.
2. Small cell lung cancer (oat cell carcinoma). It grows rapidly and quickly
spreads to other organs. A central lesion with atelectasis and both hilar
2 Empimed_Doctor’s Notes
9 August 2008
and mediastinal adenopathy are common features of small cell carcinoma.
Oat cell carcinoma of the lung predominates in cases of radiation induced
lung cancers, chloromethyl ethers ( CMME ) and bis( chloromethyl) ether
(BCE) exposure. Mustard gas?
3 Empimed_Doctor’s Notes
9 August 2008