Cancer attributable to occupational factors: a focus on primary prevention

Abstract

Background: Occupational cancers arise from exposure to carcinogenic agents during work activities and represent a significant public health challenge. In Korea, compensation for occupational cancers has been available since 1964, with asbestos related mesothelioma recognized in 1993. Estimating the population attributable fraction (PAF) using national surveys and epidemiological studies is critical for assessing regulatory impact and forecasting future disease burden. Current Concepts: The International Agency for Research on Cancer categorizes carcinogens into distinct groups, and nearly 47 agents have been identified as relevant to occupational exposures. Advanced assessment tools, including job exposure matrices and the CAREX (CARcinogen EXposure) program, have been developed to accurately estimate exposure prevalence across industries. Comparative studies from Korea, the United Kingdom, France, Canada, Italy, and China indicate that the occupational cancer PAF ranges from approximately 1% to 8%. Notably, asbestos, welding fumes, diesel engineexhaust and emerging exposures such as night shift work are consistently recognized as major contributors to occupational cancer risk. Discussion and Conclusion: Although regulatory measures have successfully reduced exposure to several known carcinogens, long latency periods and evolving industrial practices continue to sustain the burden of occupational cancers. Incorporating detailed occupational histories in clinical assessments can facilitate early detection and targeted interventions. Ongoing refinement of exposure estimation methods and international collaboration remain essential for updating PAF calculations. Ultimately, proactive primary prevention and evidence-based regulatory policies are imperative to mitigate the impact of occupational carcinogens on cancer incidence and mortality. These findings underscore the urgency of continuous monitoring and targeted occupational health initiatives.