Annals of Occupational and Environmental Medicine

The Korean Society of Occupational & Environmental Medicine (대한직업환경의학회)
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Characteristics of Occupational Lung Cancer from 1999 to 2005

역학조사를 통해 직업성 폐암으로 판단된 사례분석

  • Lim, Jung-Wook (Department of Occupational and Environmental Medicine, Hangang Sacred Hospital) ;
  • Park, So-Young (Occupational Lung Diseases Institute) ;
  • Choi, Byung-Soon (Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency)
  • 임정욱 (한강성심병원 산업의학과) ;
  • 박소영 (직업성폐질환연구소) ;
  • 최병순 (한국산업안전보건공단 산업안전보건연구원)
  • Received : 2010.01.27
  • Accepted : 2010.08.05
  • Published : 2010.09.30
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Abstract

Objectives: The aim of this study was to investigate the characteristics of occupational lung cancer. Methods: We analyzed the characteristics of 53 occupational lung cancer cases among 128 lung cancer cases applied for industrial accident compensation insurance benefits and referred for the decision of work-relatedness between 1999 and 2005. Statistical analysis was conducted using the Chi-square test on 128 lung cancer cases. Results: The age of diagnosis, smoking history, and cell type of lung cancer cases were not significantly different between 53 cases of occupational lung cancer and 75 cases of non-occupational lung cancer (p>.05). Here is a list of occupational lung cancer case numbers associated with certain carcinogens were: 33(62.3%) cases with asbestos, 23(43.4%) cases with polycyclic aromatic hydro carbon (PAH), 17 cases(32.1%) with chromium VI (Oxidation state), 14 cases(26.4%) with crystalline silica, 12 cases (22.6%) with nickel compounds, 2 cases(3.8%) with radon daughters, and 1 case(1.9%) with arsenic. Eighteen cases(34.0%) of occupational lung cancer had exposures to a single carcinogen, and 35 cases (66.0%) had exposures to more than 2 carcinogens. Job types associated with occupational lung cancer cases were: 16 cases(30.2%) with maintenance, 13 cases(24.5%) with welding; 6 cases(11.3%) with grinding; 4 cases(7.5%) with foundry; 3 cases(5.7%) with driving, casting, and painting' and 14 cases (26.4%) with 'other'. Conclusions: This study identified the characteristics of occupational lung cancer through the analysis of the age of diagnosis, smoking history, cell type, job, and carcinogen. There is no difference between occupational lung cancer and non-occupational lung cancer except exposure to the carcinogens. these results indicate that past exposure to occupational carcinogens remains an important determinant of occupational lung cancer occurrence.

목적: 역학조사를 통해 업무 관련성이 높다고 판단된 직업성 폐암 사례의 특성을 살펴보고자 하였다. 방법: 폐암으로 진단된 후 근로복지공단에 산업재해보상보험에 의한 요양급여 또는 유족급여를 신청한 사례의 업무상 질병 여부 판정을 위해 근로복지공단이 1999년부터 2005년까지 7년간 산업안전보건연구원에 역학조사를 의뢰한 128예 중에서 업무 관련성이 높다고 판단된 직업성 폐암 53예의 진단 당시 연령, 흡연력, 세포형, 직업 및 발암물질을 분석하였다. 결과: 직업성 폐암 53예와 비직업성 폐암 75예는 연령, 흡연력, 세포형의 분포에 있어서 서로 유의한 차이가 없었다(p>0.05). 직업성 폐암의 발암물질로는 석면이 33예(62.3%)로 가장 많았고, 다핵방향족탄화수소 23예(43.4%), 6가 크롬 17예(32.1%), 결정형 유리규산 14예(26.4%), 니켈화합물 12예(22.6%)이었으며 그 외 라돈자핵종(2예), 비소(1예) 등이었다. 18예(34.0%)는 하나의 폐암 발암물질에 노출되었고, 둘 이상의 물질이 복합적으로 작용한 사례가 35예(66.0%)이었다. 폐암 발암물질에 노출된 직업은 보수, 설비, 정비 등 16예(30.2%), 용접 13예(24.5%), 연마 및 사상 6예(11.3%), 주물이 4예(7.5%), 운전, 조형, 도장이 각 3예(5.7%)이었고 그 외 14예(26.4%)이었다. 석면이 원인이었던 사례는 평균 19.8년 동안 석면에 노출되고 최초 노출로부터 평균 22.4년이 지나 폐암이 발생하였다. 다핵방향족탄화수소는 평균 노출기간과 잠재기가 각각 18.7년 및 22.8년, 6가 크롬은 21.4년 및 22.8년, 결정형 유리규산은 20.5년 및 26.6년, 니켈화합물은 23.6년 및 25.0년, 라돈 자핵종은 11.3년 및 13.6년, 비소는 27.3년 및 60.8년이었다. 결론: 역학조사를 통해 업무 관련성이 높다고 판단된 사례들의 진단 당시 연령, 흡연력, 세포형, 직업 및 발암물질 분석을 통해 직업성 폐암의 특성을 파악할 수 있었다.

Keywords

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