Occupational agents/activities that are associated with increased risk for lung cancer are:
Mining and usage of asbestos in industry or manufacture (asbestos cement products, thermal and electrical insulation in construction and shipyard work, brakes, textile industry) ( 27, 28). It seems that asbestos fibers size (long and thin) is a strong predictor of lung cancer mortality ( 29). Even though there is still a controversy in the literature, probably chrysotile is considered less carcinogenetic than amphibole forms of asbestos ( 27, 30);
Usage of arsenic and arsenic compounds (antifungal outdoor wood preservatives, agricultural industry of pesticides, herbicides and insecticides, manufacture of non-ferrous alloys, glass-manufacturing, electronics industry) ( 31, 32);
Exposure to beryllium and beryllium oxide (nuclear technology, X-ray and radiation technology, dental applications and as beryllium-copper alloys in the electronics, aerospace technology, automotive) ( 33- 35);
Exposure to bis (chloromethyl) ether and chloromethyl methyl ether ( 36, 37). Nowadays the possibility for exposure is low because their uses is strictly regulated, are no longer produced in large quantities and almost always are used in closed containers for the synthesis of other chemicals. They are used as a reagent in the manufacture of plastics, ion-exchange resins and polymers;
Industrial use of cadmium ( 38, 39) [nickel-cadmium (Ni-Cd) batteries is its major use, pigments, coatings and plating in the form of cadmium-alloys, stabilizers for plastics];
Exposure to substances as a painter ( 40- 42). Paint is a complex substance that is composed of pigment particles (titanium dioxide, micro-crystalline carbon and azo pigments which are based on aromatic amines), a binder which is usually a resin or a drying oil, a volatile solvent or water and additives in small quantities that give special properties to paints or coatings. Painters are exposed to the chemicals during their application (mainly solvents) and removal (pigments, resins, silica);
Nickel-producing industries (mining, milling, smelting, and refining) as well as nickel-using industries (alloys and stainless steel manufacture is its major use, electroplating, welding, grinding and cutting) ( 43- 45). Workers in the former industries are exposed to insoluble nickel whereas soluble nickel is the predominant exposure in the later;
Exposure to chromium (VI) which occurs during production, use and welding of chromium-containing metals and alloys (manufacture of fabricated metal products, machinery and transport equipment); electroplating; production and use of chromium-containing compounds (pigments, paints, catalysts, chromic acid, tanning agents, and pesticides) ( 46);
Exposure to silica dust and its crystalline form (quartz) ( 47, 48). The three main commercial silica product categories are: sand and gravel (manufacture of glass, ceramics, foundry and abrasive activities), quartz crystals (jewellery, electronics and optical components industries) and diatomites (paint and paper industry, synthetic rubber goods, scourer in polishes and cleaners). Also workers in mines and quarries, constructions, crushed stone industries and sandblasting are severely exposed. The presence of silicosis increase further the risk for lung cancer ( 49);
Workers in aluminium production who are primarily exposed to polycyclic aromatic hydrocarbons and also to sulfur dioxide and fluorides, various aluminium compounds, chromium and nickel. The risk for lung cancer seems to be increased but studies are still controversial ( 50- 52);
Coke-ovens workers (coke production) are mainly exposed to polycyclic aromatic hydrocarbons. Increased risk for lung cancer has been proved by some but not all studies ( 53, 54);
Workers in the rubber-manufacturing industry are exposed to dusts and fumes as well as N-nitrosamines, polycyclic aromatic hydrocarbons, solvents and phthalates. There is sufficient evidence for excess lung cancer incidence and mortality ( 42, 55- 57);
Recently a Working Group of IARC concluded that diesel exhaust is a cause of lung cancer ( 58) but other authors believe that scientific data from occupational studies is not enough to support the above hypothesis ( 59);
Second-hand tobacco smoke (passive-smoking) represents an occupational exposure for workers in bars, restaurants, public buildings and educational institutions especially in countries without smoke free legislations in public places ( 60, 61);
There is some evidence that workers in the nuclear industry demonstrate an increased risk for lung cancer mortality ( 62).
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