title: Work-relatedness of lung cancer by smoking and histologic type in Korea.
abstract: OBJECTIVE
  This study investigated the distribution of causative agents related to occupational lung cancer, their relationships with work, and associations between work-relatedness and the histologic type of lung cancer.
  
  
  METHODS
  We used data from the occupational surveillance system in Korea in 2013. In addition, data from 1,404 participants diagnosed with lung cancer were collected through interviews. We included the patients' longest-held job in the analysis. Work-relatedness was categorized as "definite," "probable," "possible," "suspicious," "none," or "undetermined."
  
  
  RESULTS
  Among the subjects, 69.3% were men and 30.7% were women. Regarding smoking status, current smokers were the most prevalent (35.5%), followed by non-smokers (32.3%), ex-smokers (32.2%). Regarding the causative agents of lung cancer, asbestos (1.0%) and crystalline silica (0.9%) were the most common in definite work-related cases, while non-arsenical insecticide (2.8%) was the most common in probable cases followed by diesel engine exhaust (1.9%) and asbestos (1.0%). Regarding histologic type, adenocarcinoma was the most common (41.7%), followed by squamous cell carcinoma (21.2%). Among current smokers, squamous cell carcinoma was the most common among definite and probable cases (13.4%), while non-small cell lung cancer was the least common (7.1%). Among non-smokers, squamous cell carcinoma was the most common (21.4%), while the least common was adenocarcinoma (1.6%).
  
  
  CONCLUSIONS
  Approximately, 9.5% of all lung cancer cases in Korea are occupational-related lung cancer. Well-known substances associated with lung cancer, such as crystalline silica, asbestos, and diesel engine exhaust, are of particular concern. However, the histologic types of lung cancer related to smoking were inconsistent with previous studies when work-relatedness was taken into account. Future studies are required to clarify the incidence of occupational lung cancer in agricultural workers exposed to non-arsenical insecticides and the associations between work-relatedness and the histologic type of lung cancer.
authors.affiliation: Department of Occupational and Environmental Medicine, Pusan National University, Yangsan Hospital, Yangsan, 626-770 South Korea.
authors.forename: Young-Il
authors.initials: YI
authors.lastname: Lee
authors.affiliation: Occupational Safety and Health Research Institute, Korea Occupational Safety and Health Agency, Jongga-ro 400, Jung-gu, Ulsan 681-230 Republic of Korea.
authors.forename: Sang-Gil
authors.initials: SG
authors.lastname: Lee
authors.affiliation: Department of Occupational and Environmental Medicine, Pusan National University, Yangsan Hospital, Yangsan, 626-770 South Korea.
authors.forename: Dong-Mug
authors.initials: DM
authors.lastname: Kang
authors.affiliation: Department of Occupational and Environmental Medicine, Pusan National University, Yangsan Hospital, Yangsan, 626-770 South Korea.
authors.forename: Jong-Eun
authors.initials: JE
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Pusan National University, Yangsan Hospital, Yangsan, 626-770 South Korea.
authors.forename: Young-Ki
authors.initials: YK
authors.lastname: Kim
authors.affiliation: Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, South Korea.
authors.forename: Jong-Han
authors.initials: JH
authors.lastname: Leem
authors.affiliation: Department of Occupational and Environmental Medicine, Inha University Hospital, Incheon, South Korea.
authors.forename: Hwan-Cheol
authors.initials: HC
authors.lastname: Kim
keywords: Histologic type; Occupational lung cancer; Work-relatedness