Facteurs de risque professionnels des cancers bronchopulmonaires : données épidémiologiques, repérage des expositions et enjeux médico-sociaux: Occupational risk factors for bronchopulmonary cancer: epidemiological data, identification of exposure and medico-social issues

Abstract

Bronchopulmonary cancers are the most common occupational cancers. Recent epidemiological estimates show attributable risk fractions to work of 14.6% of cases of bronchopulmonary cancer (19.6% in men, 2.6% in women) in France, representing approximately 5,900 cases in 2015. These data contrast with the number of cases currently compensated annually as an occupational disease under the general social insurance system (1,000 to 1,200 cases per year during the last decade, the vast majority of cases being related to previous exposure to asbestos).Many aetiologies or occupational exposure situations are identified as definite carcinogens with an excess of bronchopulmonary cancers in humans by the International Agency for Research on Cancer. They justify preventive measures making it possible to eliminate or limit these exposures in the workplace. When caring for a patient with bronchopulmonary cancer, tools are available (particularly questionnaires for identifying occupational exposures, biometrological analysis of biological samples to better assess past exposure to asbestos), which allow any physician, in particular the pulmonologist, to identify significant previous exposure to occupational carcinogens. In this case, given the important medico-social issues, specific procedures (declaration for compensation as an occupational disease, additional request to the Compensation Fund for Asbestos Victims (FIVA) and sometimes early termination of activity for situations of exposure to asbestos) must be systematically considered and explained to the patient.© 2021 SPLF. Published by Elsevier Masson SAS. All rights reserved.