Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress
Clinical Collections
Advances in Alzheimer’s

Keynote webinar | Spotlight on medication adherence

LIVE: Thursday 27th June 2024, 18:00-19:30 (CEST)
Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.
ADVANCED SEARCH
Log in
Top
BMC Public Health
Published in: BMC Public Health 1/2017

Open Access 01-12-2017 | Correspondence

Medical follow-up of workers exposed to lung carcinogens: French evidence-based and pragmatic recommendations

Authors: Fleur Delva, Jacques Margery, François Laurent, Karine Petitprez, Jean-Claude Pairon, RecoCancerProf Working Group

Published in: BMC Public Health | Issue 1/2017

Login to get access

Abstract

Background

The aim of this work was to establish recommendations for the medical follow-up of workers currently or previously exposed to lung carcinogens.

Methods

A critical synthesis of the literature was conducted. Occupational lung carcinogenic substances were listed and classified according to their level of lung cancer risk. A targeted screening protocol was defined.

Results

A clinical trial, National Lung Screnning Trial (NLST), showed the efficacy of chest CAT scan (CT) screening for populations of smokers aged 55–74 years with over 30 pack-years of exposure who had stopped smoking for less than 15 years. To propose screening in accordance with NLST criteria, and to account for occupational risk factors, screening among smokers and former smokers needs to consider the types of occupational exposure for which the risk level is at least equivalent to the risk of the subjects included in the NLST. The working group proposes an algorithm that estimates the relative risk of each occupational lung carcinogen, taking into account exposure to tobacco, based on available data from the literature.

Conclusion

Given the lack of data on bronchopulmonary cancer (BPC) screening in occupationally exposed workers, the working group proposed implementing a screening experiment for bronchopulmonary cancer in subjects occupationally exposed or having been occupationally exposed to lung carcinogens who are confirmed as having high risk factors for BPC. A specific algorithm is proposed to determine the level of risk of BPC, taking into account the different occupational lung carcinogens and tobacco smoking at the individual level.
Appendix
Available only for authorised users
Footnotes
1
List of Classifications by cancer sites with sufficient or limited evidence in humans, Volumes 1 to 112, IARC
 
Literature
1.
2.
Imbernon E. Estimation du nombre de cas de certains cancers attribuables à des facteurs professionnels en France. France: Institut de Veille Sanitaire; 2002.
3.
Nurminen M, Karjalainen A. Epidemiologic estimate of the proportion of fatalities related to occupational factors in Finland. Scand J Work Environ Health. 2001;27(3):161–213.CrossRefPubMed
4.
Ameille J, Monnet I, Pairon J. Cancer bronchopulmonaire. In: Pairon JC, Brochard P, Le Bourgeois JP, Ruffié P, editors. Les cancers professionnels Tome, vol. 1. 2000. p. 371–401.
5.
Ng G, Christiani D. Lung cancer. In: Hendrick DJ, Burge PS, Beckett WS, Churg A, editors. Occupational disorders of the lung Recognition, management and prevention. WB Saunders, Elsevier; 2002. p. 305–26.
6.
Steenland K, Loomis D, Shy C, Simonsen N. Review of occupational lung carcinogens. Am J Ind Med. 1996;29(5):474–90.CrossRefPubMed
7.
Groome PA, Bolejack V, Crowley JJ, Kennedy C, Krasnik M, Sobin LH, et al. The IASLC Lung Cancer Staging Project: validation of the proposals for revision of the T, N, and M descriptors and consequent stage groupings in the forthcoming (seventh) edition of the TNM classification of malignant tumours. J Thorac Oncol. 2007;2(8):694–705.CrossRefPubMed
8.
Consensus development conference for the elaboration of a clinical medical surveillance strategy for people exposed to asbestos. Paris, France, 15 January 1999. Rev Mal Respir. 1999;16(6 Pt 2):1187–362.
9.
Haute Autorité de Santé. Post-professional follow-up after asbestos exposure. Rev Mal Respir. 2010;27(7):e17-33.
10.
Mastrangelo G, Marangi G, Ballarin MN, Bellini E, De Marzo N, Eder M, et al. Post-occupational health surveillance of asbestos workers. La Medicina del lavoro. 2013;104(5):351–8.PubMed
11.
Aberle DR, Adams AM, Berg CD, Black WC, Clapp JD, Fagerstrom RM, et al. Reduced lung-cancer mortality with low-dose computed tomographic screening. N Engl J Med. 2011;365(5):395–409.CrossRefPubMed
12.
13.
Bach PB, Mirkin JN, Oliver TK, Azzoli CG, Berry DA, Brawley OW, et al. Benefits and harms of CT screening for lung cancer: a systematic review. JAMA. 2012;307(22):2418–29.CrossRefPubMedPubMedCentral
14.
Couraud S, Cortot AB, Greillier L, Gounant V, Mennecier B, Girard N, et al. From randomized trials to the clinic: is it time to implement individual lung-cancer screening in clinical practice? A multidisciplinary statement from French experts on behalf of the French intergroup (IFCT) and the groupe d’Oncologie de langue francaise (GOLF). Ann Oncol. 2013;24(3):586–97.CrossRefPubMed
15.
Detterbeck FC, Mazzone PJ, Naidich DP, Bach PB. Screening for lung cancer: Diagnosis and management of lung cancer, 3rd ed: American College of Chest Physicians evidence-based clinical practice guidelines. Chest. 2013;143(5 Suppl):e78S–92.CrossRefPubMedPubMedCentral
16.
Frauenfelder T, Puhan MA, Lazor R, von Garnier C, Bremerich J, Niemann T, et al. Early detection of lung cancer: a statement from an expert panel of the Swiss university hospitals on lung cancer screening. Respiration; Int Rev Thorac Dis. 2014;87(3):254–64.
17.
Jaklitsch MT, Jacobson FL, Austin JH, Field JK, Jett JR, Keshavjee S, et al. The American Association for Thoracic Surgery guidelines for lung cancer screening using low-dose computed tomography scans for lung cancer survivors and other high-risk groups. J Thorac Cardiovasc Surg. 2012;144(1):33–8.CrossRefPubMed
18.
Kauczor HU, Bonomo L, Gaga M, Nackaerts K, Peled N, Prokop M, et al. ESR/ERS white paper on lung cancer screening. Euro Respir J. 2015;46(1):28–39.CrossRef
19.
Roberts H, Walker-Dilks C, Sivjee K, Ung Y, Yasufuku K, Hey A, et al. Screening high-risk populations for lung cancer: guideline recommendations. J Thorac Oncol. 2013;8(10):1232–7.CrossRefPubMed
20.
Vansteenkiste J, Crino L, Dooms C, Douillard JY, Faivre-Finn C, Lim E, et al. 2nd ESMO Consensus Conference on Lung Cancer: early-stage non-small-cell lung cancer consensus on diagnosis, treatment and follow-up. Ann Oncol. 2014;25(8):1462–74.CrossRefPubMed
21.
Wender R, Fontham ET, Barrera Jr E, Colditz GA, Church TR, Ettinger DS, et al. American Cancer Society lung cancer screening guidelines. CA Cancer J Clin. 2013;63(2):107–17.CrossRefPubMedPubMedCentral
22.
23.
24.
Infante M, Cavuto S, Lutman FR, Passera E, Chiarenza M, Chiesa G, et al. Long-term Follow-up Results of the DANTE Trial, a Randomized Study of Lung Cancer Screening with Spiral Computed Tomography. Am J Respir Crit Care Med. 2015;191(10):1166–75.CrossRefPubMed
25.
Pastorino U, Rossi M, Rosato V, Marchiano A, Sverzellati N, Morosi C, et al. Annual or biennial CT screening versus observation in heavy smokers: 5-year results of the MILD trial. Eur J Cancer Prev. 2012;21(3):308–15.CrossRefPubMed
26.
Wille MM, Dirksen A, Ashraf H, Saghir Z, Bach KS, Brodersen J, et al. Results of the Randomized Danish Lung Cancer Screening Trial with Focus on High-Risk Profiling. Am J Respir Crit Care Med. 2016;193(5):542–51.CrossRefPubMed
27.
Field JK, Duffy SW, Baldwin DR, Brain KE, Devaraj A, Eisen T, et al. The UK Lung Cancer Screening Trial: a pilot randomised controlled trial of low-dose computed tomography screening for the early detection of lung cancer. Health Technol Assess (Winchester, England). 2016;20(40):1–146.CrossRef
28.
Ru Zhao Y, Xie X, de Koning HJ, Mali WP, Vliegenthart R, Oudkerk M. NELSON lung cancer screening study. Cancer Imaging. 2011;11 Spec No A:S79–84.CrossRefPubMed
29.
Simonato L, Agudo A, Ahrens W, Benhamou E, Benhamou S, Boffetta P, et al. Lung cancer and cigarette smoking in Europe: an update of risk estimates and an assessment of inter-country heterogeneity. Int J cancer J Int du Cancer. 2001;91(6):876–87.CrossRef
30.
Société Française de Médecine du Travail. Paris FRA, Société de Pneumologie de Langue Française FRA, Société d’Imagerie Thoracique FRA, Ministère de l’Emploi et de la Solidarité. Paris FRAc. Conférence de consensus : Elaboration d’une stratégie de surveillance médicale clinique des personnes exposées à l’amiante. Energies Sante. 1999;10(2–93):218–30.
31.
de Koning HJ, Meza R, Plevritis SK, ten Haaf K, Munshi VN, Jeon J, et al. Benefits and harms of computed tomography lung cancer screening strategies: a comparative modeling study for the U.S. Preventive Services Task Force. Ann Intern Med. 2014;160(5):311–20.CrossRefPubMedPubMedCentral
32.
Fitzgerald NR, Flanagan WM, Evans WK, Miller AB. Eligibility for low-dose computerized tomography screening among asbestos-exposed individuals. Scand J Work Environ Health. 2015;41(4):407–12.CrossRefPubMed
33.
Kovalchik SA, Tammemagi M, Berg CD, Caporaso NE, Riley TL, Korch M, et al. Targeting of low-dose CT screening according to the risk of lung-cancer death. N Engl J Med. 2013;369(3):245–54.CrossRefPubMedPubMedCentral
34.
McKee BJ, Hashim JA, French RJ, McKee AB, Hesketh PJ, Lamb CR, et al. Experience With a CT Screening Program for Individuals at High Risk for Developing Lung Cancer J Am Coll Radiol. 2015;12(2):192–7.PubMed
35.
Tammemagi MC, Church TR, Hocking WG, Silvestri GA, Kvale PA, Riley TL, et al. Evaluation of the Lung Cancer Risks at Which to Screen Ever- and Never-Smokers: Screening Rules Applied to the PLCO and NLST Cohorts. PLoS Med. 2014;11(12):e1001764.CrossRefPubMedPubMedCentral
36.
Humphrey L, Deffebach M, Pappas M, Baumann C, Artis K, Mitchell JP, et al. Screening for Lung Cancer: Systematic Review to Update the US Preventive Services Task Force Recommendation. U.S. Preventive Services Task Force Evidence Syntheses, formerly Systematic Evidence Reviews. Rockville (MD). 2013.
37.
Xu DM, Gietema H, de Koning H, Vernhout R, Nackaerts K, Prokop M, et al. Nodule management protocol of the NELSON randomised lung cancer screening trial. Lung Cancer (Amsterdam, Netherlands). 2006;54(2):177–84.CrossRef
38.
Black WC, Gareen IF, Soneji SS, Sicks JD, Keeler EB, Aberle DR, et al. Cost-Effectiveness of CT Screening in the National Lung Screening Trial. N Engl J Med. 2014;371(19):1793–802.CrossRefPubMedPubMedCentral
39.
Coureau G, Salmi LR, Etard C, Sancho-Garnier H, Sauvaget C, Mathoulin-Pelissier S. Low-dose computed tomography screening for lung cancer in populations highly exposed to tobacco: A systematic methodological appraisal of published randomised controlled trials. Eur J Cancer (Oxford, England : 1990). 2016;61:146–56.CrossRef
Metadata
Title
Medical follow-up of workers exposed to lung carcinogens: French evidence-based and pragmatic recommendations
Authors
Fleur Delva
Jacques Margery
François Laurent
Karine Petitprez
Jean-Claude Pairon
RecoCancerProf Working Group
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Public Health / Issue 1/2017
Electronic ISSN: 1471-2458
DOI
https://doi.org/10.1186/s12889-017-4114-1

Other articles of this Issue 1/2017

BMC Public Health 1/2017 Go to the issue

Research article

Processes and challenges of community mobilisation for latrine promotion under Nirmal Bharat Abhiyan in rural Odisha, India

Research article

Perceptions of activity-supportive environment and motorcycle use among urban Taiwanese adults

Research article

“What do you know?”——knowledge among village doctors of lead poisoning in children in rural China

Research article

The short-term health and psychosocial impacts of domestic energy efficiency investments in low-income areas: a controlled before and after study

Erratum

Erratum to: understanding how perceptions of tobacco constituents and the FDA relate to effective and credible tobacco risk messaging: a national phone survey of U.S. adults, 2014–2015

Research article

Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya