Occupational lung cancer: the medico-legal aspect

Introduction: Lung cancer is a public health problem. In Tunisia, the incidence of these cancers is increasing. The part of professional exposures is not insignificant. Therefore, the recognition of occupational diseases is beneficial. Aim: Study elements that influence the procedure of reporting professional lung cancer. Methods: A retrospective study was performed with data from patients with histologically confirmed cases of lung cancer. A job-exposure matrix was used to infer exposure to lung carcinogens. Results: The population studied included 109 cases of lung cancer with an average age of 60±8,9 years. Patients was mostly male (90.8%). The most numerous histological type was Adenocarcinoma (38.5%). A total of 47 cases (43.2%) have got certain occupational cancers and two patients (1.8%) presented possible occupational cancers. Three cases of primary lung cancer due to asbestos exposure were reported as occupational diseases. No case of the 14 primary lung cancer due to crystalline silica exposure was declared. As for cancers due to chromium and nickel exposure, they were not reported because of the restrictive list of work in the 17th table. A report of lung cancers due to exposure to arsenic was not possible because of the exceed of the time limit compensation claim. Concerning cancers due to exposure to aliphatic hydrocarbons, they were not reported because the Minimum Exposure Period was respected. None of the 18 primary lung cancer due to the exposure to diezel exhaust gas were not reported. Conclusion : In our Tunisian context, the recognition of the link between lung cancer and a certain occupational exposure is crucial and has many implications, including the revision of the tables of occupational diseases.