Physicians should ask about their patient’s “profession”. Why?

Moon Song-myeon, who worked in a factory manufacturing mercury thermometers, died in July 1988. Moon was 17 at the time and the cause of his death was mercury poisoning. Thirty-four years have passed, but Moon’s case is still considered a typical example of death from occupational disease.

However, the reality is that we still cannot know how many victims like Moon exist in Korea. To overcome this reality, physicians should be more active in

The National Cancer Center and the Planning Group to Promote Conquering Cancer co-hosted the 75th Forum to Conquer Cancer under the title “Current Status and Development of Occupational Cancer in Korea last Friday.

Experts have pointed out that occupational cancer patients are underestimated in the forum and doctors should step in to properly understand the situation. Occupational cancer refers to cancer that occurs due to occupational exposure to carcinogens or those that increase in specific occupational groups and industries, although no specific carcinogens have been identified so far.

According to Lee Kyeong-eun, a senior researcher at the Occupational Safety and Health Research Institute, the number of occupational cancers recognized as an industrial disaster in Korea has risen from 50 in 2011 to 414 in 2021. Still, there remains much lower than in other countries. , including Europe.

Lee specifies that the rates of recognition of occupational cancers per 100,000 members of insurance against industrial disasters are 15.1 in Germany and 11.39 in France but remain at 1.8 in Korea.

Lee Kyeong-eun, a senior researcher at the Occupational Safety and Health Research Institute, gave a presentation at the 75th Forum to Conquer Cancer co-hosted by the National Cancer Center and Planning Group to Promote Cancer Conquest co -organized last Friday.

“A foreign study in 2021 estimated that the size of cancer caused by occupational exposure is 2-5% of the total. The World Health Organization puts the rate at 4%,” Lee said. “In Korea, recognized occupational cancer is only 0.1% of the total, less than one-twentieth of the foreign study’s lower estimate.”

When asked why Korea’s occupational cancer approval rate as an industrial disaster was as high as 73.5% in 2018, Lee said, “It’s because most of the cases were lymphomas. and malignant mesothelioma whose industrial accident approval rates were over 80% when there were few. applications for the rest.

There are fewer cancers recognized as industrial disasters in Korea because cancer is a disease that makes it difficult for workers to voluntarily claim work injuries, according to Lee.

“In cases of acute illnesses, workers find causes in the current work environment and ask for work accidents,” she said. “However, in the case of cancer, the period between exposure and outbreak is long, which makes it difficult to trace past occupational exposure factors. Additionally, workers often lack information about the materials they have handled, making it difficult to file a workers’ compensation claim independently. »

Lee said she planned an active epidemiological investigation using big data to overcome these limitations.

It carried out 24 workplace cancer surveillance data by integrating unemployment insurance, cancer registration data, and cause-specific death data to Statistics Korea. The probe collected cumulative cancer outbreaks among people who worked at a location for two or more years and monitored them.

Lee selected high-risk jobs by analyzing workplace disease data and conducting active epidemiological investigation, including work environment investigation, targeting the waste disposal industry.

Professor Kim In-ah from the Department of Occupational Environmental Medicine at Hanyang University Hospital is speaking at the same forum.
Professor Kim In-ah from the Department of Occupational Environmental Medicine at Hanyang University Hospital is speaking at the same forum.

Kim In-ah, professor of occupational environmental medicine at Hanyang University Hospital, highlighted the role of doctors as they can discover occupational cancer patients in their offices.

“How should hospitals find patients with occupational cancer? To address the issues of under-reporting, we can consider the surveillance system for lung cancer and cancer of the hematopoietic system that we operated from 2011 to 2016,” said Professor Kim, also deputy director of the Security Center at the work from Seoul to the hospital. “We operated a system in which physicians assessed patients’ illnesses and their professional relationships and guided them towards a work injury claim if necessary.”

The university hospital plans to expand the system by applying Seoul St. Mary’s leukemia case review system and pushing for a comprehensive lung cancer count jointly with it and Samsung Medical Center.

“I think we could at least estimate the approximate number of occupational cancers. We are forced to rely on patient statements in the medical field. However, we can tell when occupational disease-related exposures occurred based on such statements,” Kim said. “Once our center has developed a case-based model in Seoul, we plan to expand it to other hospitals and regions.”

A government representative recognized the importance of the role of physicians in the discovery of occupational cancers and the compilation of related statistics.

“We need to create institutional factors that suspect the possibility of occupational cancer,” said Kim Jeong-yeon, director of the Industrial Health Standards Division at the Ministry of Labor and Employment. “In this regard, the government is opening six work safety centers this year.”

Noting that it is now that occupational cancers occur frequently, as about four decades have passed since Korea began its industrialization in earnest in the 1970s and 1980s, Kim stressed that all parties concerned should work hard to raise awareness among the public to this problem and strengthen preventive measures.

“Korea does not have relevant data on occupational cancers. Even the reports are not done properly compared to other countries, said NCC director Suh Hong-guan. “Doctors should ask about the professions of cancer patients. This is how they can pave the way for declaring cancers and other occupational diseases and preventing them.

Michael A. Bynum