[Carcinogenic industrial substances--a review of the present information]

Abstract

The potential carcinogenic risks of chemical substances at the workplace show increasing importance in occupational and environmental medicine, but the problems are also discussed controversially. Based on national and international literature estimations according the portions of occupational cancer are given. In accordance with former estimations from our institute, it is concluded, that 1-2% of all cancer deaths are caused by work and profession. A review of data from newer literature shows, that the numbers of chemicals with carcinogenic potency vary considerably. This is mainly due to the largely unknown mechanism of carcinogenesis, aspects of syncarcinogenesis and cocarcinogenesis as well as the different evaluation of mutagenicity-, short-term- and animal-tests on the one hand and of epidemiologic as well as casuistic studies on the other hands regarding carcinogenicity of chemicals for humans. In this context, the importance of epidemiologic studies for detecting unknown cancerogenic risks for humans is emphasized. In the field of occupational medicine it is relevant to differ between compensation and prevention. According to this aspects, for compensation of a malignant tumor as an occupational disease, more strict criterias must be fulfilled to objectify the carcinogenicity of a substance for humans than for preventive measures. On the basis of the monographs as well as reviews of the International Agency for Research on Cancer (IARC) the single substances, mixture of substances and industrial processes with proven or probably carcinogenicity for humans are given. In comparison to the monograph of Hueper from 1963 it is concluded, that until now no critical increase of carcinogenic substances at the workplace has occurred. For preventive efforts at the workplace, the medical examinations are important. These are based on various regulations by law or by German Employers Liability Insurance. In conclusion, recommendations and demands are given regarding prevention, evaluation and compensation of malignant diseases as well as detection of unknown carcinogenic risks for humans at the workplace.