Das beruflich bedingte Harnblasenkarzinom – Die BK 1301-Matrix als Algorithmus und Entscheidungshilfe für eine Zusammenhangsbegutachtung

Abstract

Work-related bladder cancer – The BK 1301 matrix as an algorithm and decision aid in the context of an assessment of an occupational disease The risk of developing bladder cancer can be influenced by various occupational and non-occupational risk factors. These need to be evaluated in the context of an assessment of an occupational disease according to no. 1301 (BK 1301: Mucosal changes, cancer and other neoplasms of the urinary tract (hereinafter referred to as “bladder cancer”) caused by aromatic amines) of the Annex to the Ordinance on Occupational Diseases. The BK 1301 matrix presented here for the assessment of the causal relationship in urinary bladder cancers after proven and relevant occupational exposure to carcinogenic aromatic amines was derived as a convention by a working group, based on the results of a workshop with more than 230 participants. It can be applied even in the absence of an individual cumulative exposure dose. The decision matrix is intended to support experts experienced in occupational medicine in the field of BK 1301 in the assessment procedure. It also provides an overview of relevant aspects of work-related bladder cancer for the purposes of accident insurance institutions and courts. The BK 1301 matrix includes occupational indicators such as exposure duration, exposure frequency and exposure intensity, as well as the age of onset, the latency period and competing non-occupational risk factors such as smoking behaviour. Based on the BK 1301 matrix, the relevant arguments favouring or refuting a causal occupational relationship in the individual case can be evaluated in detail by the occupational physician, resulting in a recommendation for or against recognition of the bladder cancer as an occupational disease. This notwithstanding, the decision as to whether an occupational disease is indeed present is ultimately an administrative act of the responsible accident insurance institution, which may be subject to review by the social courts. Keywords: expert opinion – occupational disease 1301 – bladder cancer – aromatic amines – matrix – convention