Epidemiological Characteristics of Occupational Cancers Reported - China, 2006-2020

Our plain-English summary of Epidemiological Characteristics of Occupational Cancers Reported - China, 2006-2020, by X. Li, D. Wang, A. Liu, et al (China CDC Weekly, 2022).

The study

• Authors: X. Li, D. Wang, A. Liu, W. Hu, X. Sun
• Journal: China CDC Weekly
• Published: 2022;4(17):370-373
• Cited by: 6 articles, as counted by NIH iCite
• Read it: PubMed · Publisher · Free full text

Abstract

Introduction: Occupational cancers are a major threat to workers' health in China. The latest version of the Classification and Catalogue of the Occupational Diseases includes 11 occupational cancers. This study analyzed the epidemiological characteristics of occupational cancers in China reported to the National Occupational Disease Reporting System during 2006-2020.

Methods: Occupational cancers reported during 2016-2020 were obtained from the National Occupational Disease Reporting System. Epidemiological characteristics were analyzed by year, region, industry, gender, age at diagnosis, and exposure duration to occupational hazards.

Results: Overall, a total of 1,116 cases of occupational cancers were reported between 2006 and 2020. The main types reported were leukemia caused by benzene exposure (511, 45.79%), lung cancer caused by coke oven exhaust exposure (266, 23.84%), and lung cancer and mesothelioma caused by asbestos exposure (226, 20.25%). There were 6 provincial-level administrative divisions (PLADs) that had reported over 50 new cases in the last 15 years. Most cases (913, 81.18%) were distributed in the manufacturing industry. There were 870 (77.96%) male cases and 246 (22.04%) female cases. The average age at diagnosis of all reported cases was 51.91±15.85 years, and the median exposure duration to occupational hazards was 12 (5.29-23.25) years.

Conclusions: There is a large discrepancy between the high morbidity of occupational cancers and a low number of cases diagnosed and reported cases. Occupational cancers in China may be underestimated, and comprehensive measures should be taken to improve the diagnosis and reporting of occupational cancers.

Copyright and License information: Editorial Office of CCDCW, Chinese Center for Disease Control and Prevention 2022.

In plain English

This study described every case of occupational cancer reported to China's National Occupational Disease Reporting System from 2006 to 2020. The system covers occupational disease diagnostic institutions in mainland China. A total of 1,116 cases were reported. Leukemia caused by benzene accounted for 511 cases (45.79%), lung cancer caused by coke oven emissions for 266 (23.84%), and lung cancer and mesothelioma caused by asbestos for 226 (20.25%). The article counts asbestos-related lung cancer and mesothelioma together and does not name fiber types. Of the 226 asbestos cases, 159 (70.35%) were men and 67 (29.65%) were women. Their average age at diagnosis was 63.52 years and their median exposure duration was 18.54 years. In the mining and transportation industries, asbestos-related lung cancer and mesothelioma were the most commonly reported cancers. Across all 1,116 cases, 913 were in manufacturing and 870 (77.96%) were men. The authors concluded that occupational cancers may be underestimated in China and that diagnosis and surveillance should be strengthened. They suggested that limited worker awareness, long latency periods and frequent job changes make diagnosis difficult.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive analysis of national occupational disease surveillance (reporting system) data
• Who was studied: All occupational cancer cases reported to China's National Occupational Disease Reporting System, which covers all occupational disease diagnostic institutions in mainland China, from January 1, 2006 to December 31, 2020 (1,116 cases)
• Exposure: Carcinogens covered by China's list of 11 occupational cancers. These include asbestos (lung cancer and mesothelioma, reported together, fiber type not specified), benzene, coke oven emissions, hexavalent chromium, benzidine, arsenic and others.
• Main results:
  • A total of 1,116 occupational cancer cases were reported in 2006 to 2020.
  • The three main types were leukemia caused by benzene, 511 cases (45.79%); lung cancer caused by coke oven exhaust, 266 (23.84%); and lung cancer and mesothelioma caused by asbestos, 226 (20.25%).
  • Mining and transportation reported more asbestos-caused lung cancer and mesothelioma cases than any other occupational cancer type.
  • Among the 226 asbestos-caused lung cancer and mesothelioma cases, 159 (70.35%) were male.
  • Among the 226 asbestos cases, 67 (29.65%) were female.
  • For the asbestos cases, the average age at diagnosis was 63.52 years (standard deviation 11.19).
  • For the asbestos cases, the median exposure duration was 18.54 years (interquartile range 11.83 to 28.17).
  • Across all 1,116 cases, 870 (77.96%) were male and 246 (22.04%) were female.
  • 913 of the 1,116 cases were in manufacturing; the industry table gives this as 81.81%.
  • Guangdong Province reported the most cases of any provincial-level division: 335 (30.02%) of all cases.
• The authors' conclusion: The authors concluded that occupational cancers may be underestimated in China and that diagnosis and surveillance of occupational cancers should be strengthened.
• Limitations the authors state:
  • The authors suggested that reported numbers may be low because many workers likely lack relevant knowledge and awareness, and because the long latency period makes exposure history hard to determine.
  • The authors noted that workers move between employers, so the years worked at the last employer may not meet the diagnostic criteria for exposure duration.

Topics

Medical terms in this study, explained in our Lexicon: Occupational Disease, Lung Cancer, Mesothelioma, Asbestos Exposure.

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