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04 January 2012

Identification of the risk factors

The International Agency for Research  on Cancer (IARC, 2002) has classified 150 chemical or biological agents as known or probable human carcinogens, and exposures to many of these carcinogens (e.g. asbestos, cadmium and benzene) occur in occupational settings.  Occupational exposure is defined as any contact between the human body and a potentially harmful agent or environment in the workplace.
Specific exposures are related to the type  of work that people do (i.e. occupation), where they do it (e.g. the industrial sector − also called the economic sector) and the measures that are taken to limit exposures.  The probability that a worker will develop cancer is influenced by the total dose of carcinogen received, the potency of the carcinogen, the presence of other exposures (notably tobacco smoking), and individual susceptibility.  Excess exposure to carcinogens can lead to changes at the cellular level, resulting in  the uncontrolled growth of abnormal cells that invade and destroy normal tissues in the lung, blood system, etc.  
IARC has classified 87 agents, mixtures, or exposure circumstances as Group 1 Carcinogenic to Humans, including various chemical compounds, pharmaceuticals, and bacterial and viral infections.  An additional 63 agents, mixtures, or exposure  circumstances have been classified as Group 2A Probably Carcinogenic to Humans (IARC, 2001).  
With the exceptions described below, the analysis in this document includes IARC Group 1 and 2A carcinogens associated with cancers  of the lung, leukaemia, and malignant mesothelioma.
The most important lung carcinogens in occupational settings are asbestos, radon, arsenic, chromium, silica, beryllium, nickel, cadmium and diesel exhaust.  The most important agents for leukaemia are benzene, ionizing radiation and ethylene oxide.
Asbestos is a causal agent of asbestosis, lung cancer and malignant mesothelioma, and silica causes silicosis in addition to lung cancer (the role of asbestos in asbestosis and silica in silicosis is also considered in a forthcoming guide in the EBD series, on occupational airborne particulates). 

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