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National Toxicology Program 11th Report on Carcinogens “Known to be human carcinogens”

Aflatoxins
Alcoholic beverage consumption
4-Aminobiphenyl
Analgesic mixtures containing phenacetin
Arsenic compounds, inorganic
Asbestos
Azathioprine
Benzene
Benzidine
Beryllium and beryllium compounds
1,3-Butadiene
1,4-Butanediol dimethylsulfonate (busulfan, Myleran®)
Cadmium and cadmium compounds
Chlorambucil
1-(2-Chloroethyl)-3-(4-methylcyclohexyl)-1-nitrosourea (MeCCNU)
bis(chloromethyl) ether and technical-grade chloromethyl methyl ether
Chromium hexavalent compounds
Coal tar pitches
Coal tars
Coke oven emissions
Cyclophosphamide
Cyclosporin A (Ciclosporin)
Diethylstilbestrol (DES)
Dyes metabolized to benzidine
Environmental tobacco smoke
Erionite
Estrogens, steroidal
Ethylene oxide
Hepatitis B virus
Hepatitis C virus
Human papilloma viruses: some genital-mucosal types
Melphalan
Methoxsalen with ultraviolet A therapy (PUVA)
Mineral oils (untreated and mildly treated)
Mustard gas
2-Naphthylamine
Neutrons
Nickel compounds
Oral tobacco products
Radon
Silica, crystalline (respirable size)
Solar radiation
Soots
Strong inorganic acid mists containing sulfuric acid
Sunlamps or sunbeds, exposure to
Tamoxifen
2,3,7,8-Tetrachlorodibenzo-p-dioxin (TCDD); “dioxin”
Thiotepa
Thorium dioxide
Tobacco smoking
Vinyl chloride
Ultraviolet radiation, broad spectrum UV radiation
Wood dust
X-radiation and gamma radiation

International Agency for Research on Cancer “Probably carcinogenic to humans” (Group 2A)

Agents and groups of agents

 

Acrylamide

Adriamycin

Androgenic (anabolic) steroids

Aristolochic acids (naturally occurring mixtures of)

Azacitidine

Bischloroethyl nitrosourea (BCNU)

Captafol

Chloramphenicol

a-Chlorinated toluenes (benzal chloride, benzotrichloride, benzyl chloride) and benzoyl chloride (combined exposures)

1-(2-Chloroethyl)-3-cyclohexyl-1-nitrosourea (CCNU)

4-Chloro-ortho-toluidine

Chlorozotocin

Cisplatin

Clonorchis sinensis (infection with)

Cyclopenta[cd]pyrene

Dibenz[a,h]anthracene

Dibenzo[a,l]pyrene

Diethyl sulfate

Dimethylcarbamoyl chloride

1,2-Dimethylhydrazine

Dimethyl sulfate

Epichlorohydrin

Ethyl carbamate (urethane)

Ethylene dibromide

N-Ethyl-N-nitrosourea

Etoposide

Glycidol

Indium phosphide

IQ (2-Amino-3-methylimidazo[4,5-f]quinoline)

Kaposi’s sarcoma herpesvirus/human herpesvirus 8

Lead compounds, inorganic

5-Methoxypsoralen

Methyl methanesulfonate

N-Methyl-Ń-nitro-N-nitrosoguanidine(MNNG)

N-Methyl-N-nitrosourea

Nitrate or nitrite (ingested) under conditions that result in endogenous nitrosation

Nitrogen mustard

N-Nitrosodiethylamine

N-Nitrosodimethylamine

Phenacetin

Procarbazine hydrochloride

Styrene-7,8-oxide

Teniposide

Tetrachloroethylene

Trichloroethylene

1,2,3-Trichloropropane

Tris(2,3-dibromopropyl) phosphate

Ultraviolet radiation A

Ultraviolet radiation B

Ultraviolet radiation C

[Urethane: see Ethyl carbamate]

Vinyl bromide (Note: For practical purposes, vinyl bromide should be considered to act similarly to the human carcinogen vinyl chloride.)

Vinyl fluoride (Note: For practical purposes, vinyl fluoride should be considered to act similarly to the human carcinogen vinyl chloride.)

 

 

National Toxicology Program 11th Report on Carcinogens “Reasonably anticipated to be human carcinogens”

 

Acetaldehyde

2-Acetylaminofluorene

Acrylamide

Acrylonitrile

Adriamycin® (doxorubicin hydrochloride)

2-Aminoanthraquinone

o-Aminoazotoluene

1-Amino-2,4-dibromoanthraquinone

1-Amino-2-methylanthraquinone

2-Amino-3,4-dimethylimidazo[4,5-f]quinoline (MeIQ)

2-Amino-3,8-dimethylimidazo[4,5-f]quinoxaline (MeIQx)

2-Amino-3-methylimidazo[4,5-f]quinoline (IQ)

2-Amino-1-methyl-6-phenylimidazo[4,5-b]pyridine (PhIP)

Amitrole

o-Anisidine hydrochloride

Azacitidine (5-Azacytidine®, 5-AzaC)

Benz[a]anthracene

Benzo[b]fluoranthene

Benzo[j]fluoranthene

Benzo[k]fluoranthene

Benzo[a]pyrene

Benzotrichloride

Bromodichloromethane

2, 2-bis-(bromoethyl)-1,3-propanediol (technical grade)

Butylated hydroxyanisole (BHA)

Carbon tetrachloride

Ceramic fibers (respirable size)

Chloramphenicol

Chlorendic acid

Chlorinated paraffins (C12, 60% chlorine)

1-(2-chloroethyl)-3-cyclohexyl-1-nitrosourea

Bis (chloroethyl) nitrosourea

Chloroform

3-Chloro-2-methylpropene

4-Chloro-o-phenylenediamine

Chloroprene

p-Chloro-o-toluidine and p-chloro-o-toluidine hydrochloride

Chlorozotocin

C.I. basic red 9 monohydrochloride

Cisplatin

Cobalt sulfate

p-Cresidine

Cupferron

Dacarbazine

Danthron (1,8-dihydroxyanthraquinone)

2,4-Diaminoanisole sulfate

2,4-Diaminotoluene

Diazoaminobenzene

Dibenz[a,h]acridine

Dibenz[a,j]acridine

Dibenz[a,h]anthracene

7H-Dibenzo[c,g]carbazole

Dibenzo[a,e]pyrene

Dibenzo[a,h]pyrene

Dibenzo[a,i]pyrene

Dibenzo[a,l]pyrene

1,2-Dibromo-3-chloropropane

1,2-Dibromoethane (ethylene dibromide)

2,3-Dibromo-1-propanol

Tris (2,3-dibromopropyl) phosphate

1,4-Dichlorobenzene

3,3’-Dichlorobenzidine and 3,3’-dichlorobenzidine dihydrochloride

Dichlorodiphenyltrichloroethane (DDT)

1,2-Dichloroethane (ethylene dichloride)

Dichloromethane (methylene chloride)

1,3-Dichloropropene (technical grade)

Diepoxybutane

Diesel exhaust particulates

Diethyl sulfate

Diglycidyl resorcinol ether

3,3’-Dimethoxybenzidine

4-Dimethylaminoazobenzene

3,3’-Dimethylbenzidine

Dimethylcarbamoyl chloride

1,1-Dimethylhydrazine

Dimethyl sulfate

Dimethylvinyl chloride

1,6-Dinitropyrene

1,8-Dinitropyrene

1,4-Dioxane

Disperse blue 1

Dyes metabolized to 3,3’-dimethoxybenzidine

Dyes metabolized to 3,3’-dimethylbenzidine

Epichlorohydrin

Ethylene thiourea

Di (2-ethylhexyl) phthalate

Ethyl methanesulfonate

Formaldehyde (gas)

Furan

Glasswool (respirable size)

Glycidol

Hexachlorobenzene

Hexachlorocyclohexane isomoers

Hexachloroethane

Hexamethylphosphoramide

Hydrazine and hydrazine sulfate

Hydrazobenzene

Indeno[1,2,3-cd]pyrene

Iron dextran complex

Isoprene

Kepone® (chlordecone)

Lead and lead compounds

Lindane and other hexachlorocyclohexane isomers

2-Methylaziridine (propylenimine)

5-Methylchrysene

4,4’-Methylenebis(2-chloroaniline)

4-4’-Methylenebis(N,N-dimethyl)benzenamine

4,4’-Methylenedianiline and 4,4’-methylenedianiline dihydrochloride

Methyleugenol

Methyl methanesulfonate

N-methyl-N’-nitro-N-nitrosoguanidine

Metronidazole

Michler’s ketone [4,4’-(dimethylamino) benzophenone]

Mirex

Naphthalene

Nickel (metallic)

Nitrilotriacetic acid

o-Nitroanisole

Nitrobenzene

6-Nitrochrysene

Nitrofen (2,4-dichlorophenyl-p-nitrophenyl ether)

Nitrogen mustard hydrochloride

Nitromethane

2-Nitropropane

1-Nitropyrene

4-Nitropyrene

N-nitrosodi-n-butylamine

N-nitrosodiethanolamine

N-nitrosodiethylamine

N-nitrosodimethylamine

N-nitrosodi-n-propylamine

N-nitroso-N-ethylurea

4-(N-nitrosomethylamino)-1-(3-pyridyl)-1-butanone

N-nitroso-N-methylurea

N-nitrosomethylvinylamine

N-nitrosomorpholine

N-nitrosonornicotine

N-nitrosopiperidine

N-nitrosopyrrolidine

N-nitrososarcosine

Norethisterone

Ochratoxin A

4,4’-Oxydianiline

Oxymetholone

Phenacetin

Phenazopyridine hydrochloride

Phenolphthalein

Phenoxybenzamine hydrochloride

Phenytoin

Polybrominated biphenyls (PBBs)

Polychlorinated biphenyls (PCBs)

Polycyclic aromatic hydrocarbons (PAHs)

Procarbazine hydrochloride

Progesterone

1,3-Propane sultone

beta-Propiolactone

Propylene oxide

Propylthiouracil

Reserpine

Safrole

Selenium sulfide

Streptozotocin

Styrene-7,8-oxide

Sulfallate

Tetrachloroethylene (perchloroethylene)

Tetrafluoroethylene

Tetranitromethane

Thioacetamide

4,4’-Thiodianaline

Thiourea

Toluene diisocyanate

o-Toluidine and o-toluidine hydrochloride

Toxaphene

Trichloroethylene

2,4,6-Trichlorophenol

1,2,3-Trichloropropane

Ultraviolet A radiation

Ultraviolet B radiation

Ultraviolet C radiation

Urethane

Vinyl bromide

4-Vinyl-1-cyclohexene diepoxide

Vinyl fluoride

Lung diseases from workplace exposure to materials

Exposure to workplace irritants can lead to a vast array of diseases. These diseases may last only as long as the exposure continues or may be chronic conditions that last a lifetime. Certain lung and respiratory illnesses that are caused by occupational exposure to chemicals, dangerous fibers or other substances can cause fatal diseases that currently have no known cure.

Many occupations hold greater risks for exposure due to the location, surrounding environment or nature of the required tasks. It was previously thought that only individuals such as coal miners were exposed to irritants that cause lung disease. This is no longer considered valid as individuals in other industries have been diagnosed with similar illnesses.

Several of the most well know lung diseases associated with occupational exposure are asbestosis, mesothelioma and lung cancer. These diseases were once very rare but have increased as the population of those who were exposed to asbestos on the job ages. Adult onset asthma is also on the rise and many researchers believe this is due to workplace irritants. Other lung and respiratory illnesses have increased in frequency due to the latency period of the disease.

The aging population that is now becoming ill from past workplace exposures is providing valuable information on other dangerous substances. The list below details some of the most common occupational lung and respiratory diseases found in the United States and worldwide:

Asbestosis

Asbestosis is a chronic condition of the lung. This disease develops slowly and often causes suffers to experience shortness of breath and chest pain. Many individuals can no longer live an ordinary life as the tolerance for physical activity decreases. Asbestosis is caused by inhalation of asbestos fibers. These fibers, which lodge into the lining of the lungs cause scarring. This scar tissue prevents the lung from properly inflating causing difficulty breathing. When the exposure to asbestos ends the disease does not progress further. Not every person that is exposed to asbestos gets asbestosis. Researchers believe genetics may play a role. There is no effective treatment for asbestosis and the disease progresses slowly. The occurrence of this disease is difficult to ascertain however, the American Academy of Family Physicians sites 20,000 hospital discharges with this diagnosis in the year 2000.

Malignant Mesothelioma

Malignant Mesothelioma is a rare but fatal lung disease caused mainly by exposure to asbestos. This cancer occurs in the lining which surround the internal organs such as the heart and lungs. There are two main types of mesothelioma, pleural and peritoneal. Some of the symptoms of these diseases include shortness of breath, chest pain, swelling in the abdomen and/or unexplained weight loss. Mesothelioma has no known cure and as it progresses the symptoms become more painful. According to the American Cancer Society between 2,000 and 3,000 people are diagnosed with mesothelioma each year.

Lung cancer

Lung cancer is the leading cause of cancer death for both men and women in the United States. There are many causes for lung cancer but on-the-job exposure to agents such as radon and asbestos may be to blame for many lung cancer occurrences. The symptoms associated with lung cancer are similar to those associated with other respiratory illnesses including shortness of breath, chest tightness or pain and chronic dry cough. Lung cancer has no known cure and 60 percent of patients with lung cancer die within one year of diagnosis. Individuals diagnosed in an early stage of the disease have the greatest chance of survival. The American Lung Association sites lung cancer as the leading occupational cancer.

COPD

According to the United States Department of Health and Human Services, chronic obstructive pulmonary disease (COPD) is the fourth leading cause of death in the United States. This disease describes a condition in which the airways of the lungs become obstructed, creating an inability to exhale properly. Individuals suffering from COPD experience a thickening of the walls of the airways and often the lungs lose elasticity. The increased production of mucus also causes clogging within the airways. The symptoms of COPD get worse as the disease progresses and include shortness of breath, tightness in the chest, increased production of mucus, persistent cough and frequent respiratory infections. The main cause of COPD and other lung illnesses is cigarette smoking but The National Institute of Health states that occupational irritants have also been known to cause COPD. The term COPD also refers to another serious lung disease called emphysema. Emphysema results in damaged air sacks, which causes difficulty breathing. There is no cure for COPD and the disease worsens over time sometimes making daily living difficult. According to the National Institute of Health over 12 million individuals in the U.S. are currently diagnosed with this disease.

Pneumoconiosis

Coal worker’s pneumoconiosis is another lung illness caused by occupational irritants, in this case, coal dust. This disease, also known as black lung disease, is a chronic lung condition in which sufferers experience shortness of breath, wheezing, tightness in the chest and a persistent cough. The disease can be broken down into two forms: simple and complicated. Most cases begin as simple pneumoconiosis and only a few progress into the complicated form, also known as progressive massive fibrosis. This illness rarely becomes serious in the simple form and many individuals suffer no symptoms. In the complicated form the disease may suddenly worsen but rarely leads to disability or death. There is no known cure for the damage caused by long-term exposure to coal dust there are however, effective treatments to help control symptoms.

Silicosis

Silicosis is the most common occupational lung disease in the world. The air of mines, foundries and manufacturing facilities often contain free crystalline silica. This dust can cause a lung condition called silicosis, which is characterized by the inflammation and scarring of the tissue of the lungs. The symptoms of silicosis are shortness of breath, fever, loss of appetite and in advanced cases, cyanosis (or bluing of the skin). As with many occupational lung diseases, symptoms may not present until years after exposure. Individuals with silicosis are more susceptible to the disease tuberculosis. Researchers are not certain why this correlation exists. There is no known cure for silicosis but it is preventable by limiting exposure to silica dust.

Brown lung disease (byssinosis)

Brown lung disease or byssinosis is caused by the inhalation of dust formed during the processing of hemp, flax and cotton. This lung disease affects the textile workers exposed to this dust in textile factories. The symptoms associated with byssinosis are cough, tightness in the chest and wheezing. These symptoms usually dissipate by the end of the workweek or when exposure stops. Individuals who already suffer from asthma may find the exposure to textile dust increases or worsens their asthma symptoms. Those who suffer byssinosis should eliminate their exposure or they may suffer more severe lung damage or chronic lung disease.

Occupational asthma

Occupational asthma is a form of asthma that is caused by exposure to irritants in the workplace. The U.S. Department of Labor estimates that approximately 11 million people are exposed to any one of numerous agents that can cause this illness. Over 15 percent of disabling asthma cases are attributed to on-the-job exposure. Asthma is characterized by shortness of breath (sometimes severe), tightness in the chest, wheezing and coughing. This illness can become serious and in rare cases is fatal however if it is caught at an early stage asthma may be reversible.


Occupational Irritants

The CDC is currently monitoring the occurrence of occupational respiratory disease and occupational lung disease in an effort to identify their cause and increase prevention of both.

There are many different diseases that can be caused by occupational irritants or substances. These include diseases of the respiratory units, diseases of the lungs and diseases of the airways. The skin (including eyes and nose) and lungs (including the airways leading to them) are the first organs to be exposed to environmental irritants. These organs are most susceptible to deposition of airborne particles. The lungs receive air via the trachea (or windpipe). The airways, which conduct air, are covered in cells with tiny projectiles called cilia. Mingled among these cells are mucus producing cells. The mucus producing cells work to cover the cilia creating a fluid barrier. The cilia cells then work in an undulating pattern to move forward in the airway and clear any dangerous dust or particles from the body. This is the body’s defense system that works to decrease the amount of dangerous substances in the body. The nose can also work as a filter to eliminate dangerous particles from entering and lodging in soft body tissue. The tiny cilia hairs protect the internal nasal passageways by trapping and filtering unwanted substances. The cilia move rhythmically to rid the nose and respiratory tract of foreign particles by pushing them toward the nostrils or pharynx. The particles are then either blown out through the nose or flushed through the body’s waste system.

Airborne particles come in many forms. They can be released as dust, vapors, gases or mists. These different forms are treated differently within the body. Vapors and gases can cause deprivation of oxygen to bodily tissues. They can also cause severe irritation to the airways and lungs and damage surrounding tissues. Dusts are the solid particles that can be found in the air while mists are liquid droplets that have become airborne. When either of these types of particles come into contact with an airway they begin the process of deposition. Gravity, airstream changes, collision with other particles and the general size and shape of the particle itself will determine when and where the particle will become deposited within the airway or lung. Some are immediately lodged into soft tissue while fluids carry other particles to surrounding tissue. Some of these particles are flushed out of the body through the body’s waste system. Others are filtered by special “scavenger cells” that render particles harmless. The mucus produced by cells in the body cover small particles and allows them to be coughed out. However, sometimes the body cannot fight off the harmful particles and disease develops.

Seeking Medical Advice for Occupational Disease

Individuals that experience symptoms associated with occupational diseases should seek medical advice as soon as they notice symptoms.  The sooner these types of diseases are diagnosed and treated the better the prognosis is for patients.

There are doctors who specialize in occupational medicine but they are very rare.  Of the 800,000 physicians in the United States only 10,000 of them specialize in occupational medicine.

The first point of contact for most individuals is the family physician.  This physician should do a thorough screening and can assist patients in recognizing the possibility of an occupational illness.  Providing the physician with information about workplace irritants will help attain an accurate diagnosis.

Individuals should also consult the “materials supervisor” at the workplace.  This person should be able to give detailed information via a “materials safety data sheet” about the types of toxic compounds found at the work site.

Occupational illnesses tend to be diagnosed infrequently however, they are responsible for approximately 860,000 illnesses annually.  These illnesses lead to 60,300 deaths in the United States every year.  Detecting, diagnosing and treating these diseases in the earliest stages may increase the chance of reversal and/or survival.

It is also important to be aware of dangerous substances prior to beginning a job and to ensure that proper protection is available.   Prevention is the best means to avoid lung and respiratory disease and proper equipment may keep workers safe from dangerous airborne particles.  Respirators, proper ventilation and other types of equipment should be provided on the job.

Symptoms of occupational lung diseases

Occupational lung and respiratory diseases have a wide variety of symptoms. These symptoms may seem insignificant at first but anyone who suspects on-the-job exposure to dangerous substances should seek medical advice. The most common symptoms of lung disease may not be highly indicative of lung disease at all. The symptoms often resemble other medical conditions and therefore are more difficult to diagnose.

What to do if you experience these symptoms?

According to the American Academy of Family Physicians a person who suspects workplace exposure to harmful substances should keep a written record of all symptoms. The record should include when the symptoms began and the frequency of occurrence. The individual should also keep track of the times when symptoms are most severe and how those times relate to their personal work schedule. A list of possible workplace hazards, as well as any required safety procedures should also accompany this record. It would also be prudent to speak with other employees to see if they are experiencing similar symptoms.

Persistent cough

The first symptom many individuals notice is a persistent cough. The cough may be dry or productive and continues without relief. Shortness of breath, especially when doing minor tasks or daily duties may often follow. This shortness of breath is persistent and begins to make routine living more difficult. Some individuals may experience a scratchy throat or runny nose accompanied by a fever. These symptoms may be a sign of a work-related disorder if they are noticed soon after beginning a new job or being moved to a new location.

Tightness in the chest

A persistent tightness in the chest may also be a sign of a serious lung disease. Chest pain may also accompany this tightness and will often continue to worsen. Individuals with lung or respiratory diseases may experience abnormal breathing patterns or worsening shortness of breath. These symptoms may often come and go or may be persistent.

Wheezing or trouble breathing

Adults that develop asthma for the first time should consider that a workplace irritant might be the cause. Symptoms of asthma include wheezing or trouble breathing and a persistent dry cough. Asthma that is left untreated can become serious and sometimes even fatal.

Fatigue

Another serious lung disease, emphysema, can be caused by on-the-job exposure to dangerous dusts. The symptoms of emphysema are cough, difficulty breathing and fatigue. Emphysema is a chronic lung condition and there is no known cure. The symptoms often worsen until breathing with the help of oxygen is necessary.

Additional symptoms

Other symptoms may include swelling in the abdomen or changes in bowel habits. These symptoms may indicate a serious disease such as peritoneal mesothelioma, caused by exposure to asbestos. Additional symptoms such as sudden weight loss, pain in the abdomen, coughing up blood and chronic respiratory infections may also indicate serious respiratory or lung disease.

More on prevention of occupational diseases

Government agencies also help in the prevention of occupational disease by posing regulations on workplace safety. In 1970 the government established laws that created two National health agencies. The first, the National Institute for Occupational Safety and Health (NIOSH), was formed to oversee and research safety in workplace activities. This agency was established within the U.S. department of Health and Human Services (USDHHS). The second agency was established within the U.S. Department of Labor. The Occupational Safety and Health Administration (OSHA) was designed to set government standards for health and safety in the workplace and also enforce these standards.

NIOSH has created the National Occupational Research Agenda (NORA) which is a comprehensive list of areas that address workplace dangers. This agenda explores toxicology, identifies emerging technology dangers and evaluates how the combinations of substances in the workplace may effect workers. The reports garnered from this research may help to provide insight into new and dangerous substance as they arise.

Occupational irritants are found worldwide and the knowledge of their danger has helped to decrease the occurrence of disease in many industrialized nations. These developed countries such as the United States have begun major prevention programs. Unfortunately, less developed nations are just beginning to see the effects of imported, dangerous materials. It is the hope of world organizations such as the World Health Organization and the International Labor Office to begin prevention programs worldwide to help stop these diseases.

 

More on Harmful Materials

Fumes

Fumes such as those given off during welding, smelting, rubber and plastic manufacturing, pottery making and other industries where items are heated and rapidly cooled can also be dangerous. These fumes often irritate the eyes, throat and nose before they enter the lungs. Exposure to these fumes can cause immediate symptoms or symptoms can present day, weeks or even years later.

Agricultural toxins

Agricultural toxins including those found in grains, hay and animal dander pose a health risk to workers. The mold, hair, feathers and bacteria often found during farming and other agricultural pursuits can cause respiratory illnesses.

Vapors

Vapors given off by solvents, paints, cleaning agents, hair sprays, pesticides and other products that cause irritation to the nose and throat can also affect the lungs. These vapors usually cause immediate discomfort to the nose and throat but after prolonged exposure can damage the lungs causing disease.

Latex

Latex allergies have become more and more prevalent in the United States due to the required use of gloves for healthcare workers. Latex related asthma now affects 1 in 50 healthcare workers.

Crystalline silica

The dust from crystalline silica can also be the cause of lung disease. The dust is found in the air in mines, around blasting operations and in manufacturing facilities that produced stone, glass and clay. In the U.S. nearly two million workers are exposed to “respirable silica”. The National Institute for Occupational Safety and Health (NIOSH) states that hundreds of individuals become disabled each year from silicosis and approximately 250 deaths can be attributed to the disease annually.

Hemp, Flax and Cotton

The dust from hemp, flax and cotton processing has also been found to be dangerous.

Radon

Radon is an odorless, colorless gas that occurs naturally and can affect indoor air quality. This gas can accumulate in confined spaces and cause the air to be polluted. Radon is a worldwide problem and can be found in spring waters as well as hot springs. The U.S. Environmental Protection Agency reports that radon is the second leading cause of lung cancer and the 6th leading cause of death by cancer causing more than 21,000 lung cancer deaths in the U.S. every year.

Lead

Lead poisoning is the oldest known occupational health hazard. It has been noted as harmful to humans for 2,000 years yet is still prevalent in industry today. Lead fumes or lead dust particles are the dangerous forms of the mineral that can lead to disease. Manufacturing industries from plastics to chemicals can cause lead exposure. Other dangerous jobs can include gas station attendants, jewelers, lead miners, firing range instructors, battery manufacturing workers, construction and demolition workers, welders and a host of other jobs.

Harmful Materials

The Center for Disease Control and Prevention along with The American Lung Association and American Academy of Family Physicians has compiled a lit of possible on-the-job irritants that may cause respiratory and/or lung disease. The American Lung Association makes two names two distinct classes of occupational lung disease: pneumoconiosis, diseases contracted by inhaling dust into the lungs, and hypersensitivity diseases, like asthma, that occur when the lungs overreact to particular airborne pollutant. Bronchitis, lung cancer and byssinosis are also classified as occupational lung disease. The following list includes many of the dangerous substances found in workplaces in the United States and around the world. There may be others that are still being discovered.

Asbestos

Asbestos is a naturally occurring mineral that was used in many industries before it was discovered to be dangerous. Today, it can be found in homes, offices, hospitals and schools and poses a serious health risk to those who are exposed. Asbestos is not dangerous unless it is released into the air where the fine particles are breathed into the lungs. Workers in industries such as mining, construction, demolition and electrical work are most at risk. Since the mid-1970’s asbestos use has been highly regulated by the government. The American Lung Association sites 2,000 to 3,000 new cases of cancer develop each year due to asbestos exposure.

Dust and particulate matter (PM)

Dust or particulate matter (PM) from materials such as wood, cotton, asbestos, coal, silica and textile manufacturing can be dangerous. Particulate matter is simply small particles released into the air that can potentially cause lung disease. This may include a combination of dust, mold, dirt, soil and ash. The sources of particulate matter are factories, car exhaust, mining, farming and construction. The particles released from these sources become airborne and are breathed into the lungs where they can cause severe damage. The smaller the particles the more damage they can do within the soft tissue of the body.

 

To  be continued in a future post.

 

Survival statistics: disease-free and progression-free

For calculating five-year relative survival rates, all those individuals are included who may still be living for five years after cancer is detected. These include patients who may be in remission (brief or permanent absence of cancer), or those who may still be receiving treatment. More specific survival statistics, for example, disease-free and progression-free survival statistics, are generally used to evaluate cancer treatments.

  • Disease-free survival rates describe only that percentage of patients who may have achieved a complete remission after the completion of treatment.
  • Progression-free survival rates refer to the percentage of patients with no new tumor growth or cancer spread for the duration of and after treatment. These include individuals whose disease may have either responded partially or completely to treatment, or those with a stable disease (the cancer still exists, but has stopped advancing).

Survival statistics and the theory of “cure”

In the medical world, a disease is said to have been cured when it is treated successfully and does not reoccur. It is difficult to apply the concept of “cure” to cancer because in specific cases, some cancer cells can remain undetected. These cells can cause the cancer to return after a certain period of time (called relapse or recurrence). Most types of cancers are categorized as “cured” if there is no relapse or recurrence of cancer five years after cancer is detected. However, a relapse can occur even after five years.

Predicting prognosis

When cancer is diagnosed, one of the most common questions people ask is whether or not the cancer can be successfully treated. This is referred to as a prognosis – the expected course of cancer, its potential outcome and the patient’s chances of recovery. To make a prognosis, doctors usually rely on survival statistics. For instance, it can be said that an individual diagnosed with testicular cancer has a favorable prognosis because the overall five-year relative survival rate, as relevant to testicular cancer, is 95%.

As with survival statistics, a prognosis is based on the cancer’s stage at the time of diagnosis – how early the diagnosis has been made and the cancer’s spread, if any. For instance, if an early diagnosis is achieved, the five-year survival rate, as relevant to colorectal cancer, is more than 90%. For colorectal cancer patients in advanced stages of the disease (cancer that has spread to other areas of the body), the five-year relative survival rate is around 10%.

Important Points to remember

  • Statistics only provide an estimate of trends prevalent amongst large population groups. They are not indicative of what actually may happen to an individual.
  • Survival statistics, as relevant to different stages of cancer, age groups, or time durations, can vary significantly. People need to talk to their doctor about the most appropriate statistics, as relevant to their specific medical condition.
  • As with most other types of medical information, ask your doctor to provide a clarification in case cancer-related statistics appear unclear to you.

Evaluating treatment choices

Five-year relative survival rates allow doctors to evaluate and compare available treatment options. While an individual who is still living five years after diagnosis cannot be described as being completely “cured”, the five-year relative survival statistic does indicate that the disease is responding properly to treatment. It also shows that the treatment is helping extend the cancer patient’s life. Using survival statistics, doctors can determine which treatment protocol will prove most beneficial for cancer patients, and whether the associated benefits of a treatment will outweigh its potential risks (for example, discomforting side effects).

Important points to remember

  • Since five-year survival statistics relate to patients who may have received treatment at least five years earlier, they may not be indicative of the latest, more advanced treatment options.
  • While survival statistics provide valuable information for evaluating treatment options, they should only be used as a specific component of a comprehensive treatment plan devised by a doctor who is well aware of the patient’s individual condition.