Discovering Occupational Carcinogens in Population-Based Case-Control Studies: Review of Findings from an Exposure-Based Approach and a Methodologic Comparison of Alternative Data Collection Strategies

Abstract

The identification of environmental carcinogens is one of the main public health problems of our era. Many, if not most known carcinogens are occupational exposures (Doll and Peto 1981). There are two reasons for this. It is much easier to identify persons as having a common occupation or occupational exposure than it is to identify them as having common exposure to a dietary, atmospheric, psychosocial, or other type of environment. Also, the work environment has tended to be more polluted than the domestic or general environment. However, of the thousands of substances to which workers are exposed in the workplace, only a handful have ever been assessed in epidemiologic studies for carcinogenic potential. It is reasonable to suspect that many occupational carcinogens have not yet been discovered. Considering the enormous number of chemical and physical agents in the workplace, what kind of epidemiologic monitoring approach can be applied to the problem to flag potential carcinogens?