OBJECTIVETo investigate the occupational health risk level of workers exposed to 2,4,6-trinitrotoluene (TNT) in arms industry, so as to provide basis for revising the standard of diagnosis for chronic TNT poisoning, and making protective measures for workers.

METHODSThe retrospective study about the morbidity of total malignant tumor was taken on the male workers exposed to TNT over one year from eight military factories during 1970 to 1995.

RESULTSThe morbidity of total malignant tumor in male TNT exposed workers were markedly higher than that of controls, and the relative risk (RR) was 2.32. Compared with the total malignant tumor mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, the standardized mortality ratio(SMR) were 71.8 and 179.6 respectively, the CI of 99% was 71.8-144.2, indicating that the morbidity of malignant tumor of male workers exposed to TNT was higher than that of normal populations. Liver cancer morbidity was 31.91% of the total malignant tumor, and its mortality was 3.97 times of the controls. Compared with the liver cancer mortality of male populations in large and medium cities in 1973 to 1975 and 1990 to 1992, SMR were 150.5 and 381.6 respectively, these data were significantly different, and CI of 99% was 59.3-184.0. The average death age of the TNT exposed workers (51.7 years old) was younger than that of the same factory control(54.1 years old) and male populations(55.6 years old) in large and medium cities. The incidence of liver cancer was closely related to the length of service, the kinds of job in a factory and the level exposed to TNT, and alcohol consumption was synergistic with TNT carcinogenesis.

CONCLUSIONThe morbidity of malignant tumor of male workers exposed to TNT was markedly higher than that of normal populations. Liver cancer was the most remarkable malignancy, and its incidence was closely related to the length of service and the kinds of job and the level exposed to TNT.

Humans ; Incidence ; Liver Neoplasms ; chemically induced ; epidemiology ; Male ; Occupational Exposure ; adverse effects ; Retrospective Studies ; Trinitrotoluene ; toxicity ; Weapons

OBJECTIVE: To assess the risk of aristolochic acid (AA)-associated cancer in patients with AA nephropathy (AAN). METHODS: A retrospective study was conducted on patients diagnosed with AAN at Peking University First Hospital from January 1997 to December 2014. Long-term surveillance and follow-up data were analyzed to investigate the influence of different factors on the prevalence of cancer. The primary endpoint was the incidence of liver cancer, and the secondary endpoint was the incidence of urinary cancer during 1 year after taking AA-containing medication to 2014. RESULTS: A total of 337 patients diagnosed with AAN were included in this study. From the initiation of taking AA to the termination of follow-up, 39 patients were diagnosed with cancer. No cases of liver cancer were observed throughout the entire follow-up period, with urinary cancer being the predominant type (34/39, 87.17%). Logistic regression analysis showed that age, follow-up period, and diabetes were potential risk factors, however, the dosage of the drug was not significantly associated with urinary cancer. CONCLUSIONS No cases of liver cancer were observed at the end of follow-up. However, a high prevalence of urinary cancer was observed in AAN patients. Establishing a direct causality between AA and HCC is challenging.
Humans ; Retrospective Studies ; Incidence ; Carcinoma, Hepatocellular ; Liver Neoplasms/epidemiology* ; Kidney Diseases/chemically induced* ; Aristolochic Acids/adverse effects*

Occupational hepatic disorders are classified into toxic hepatitis, viral hepatitis, and chemical-induced malignancy in Korea. Toxic hepatitis cases were reported in workers who were exposed to dimethylformamide, dimethylacetamide, or trichloroethylene. Pre-placement medical examination and regular follow-up are necessary to prevent the development of toxic hepatitis. Viral hepatitis was chiefly reported among health care workers such as doctors, nurses and clinical pathology technicians who could easily be exposed to blood. Preventive measures for these groups therefore include vaccination and serum monitoring programs. Hepatic angiosarcoma caused by vinyl chloride monomer (VCM) exposure is a very well known occupational disease and it has not been officially reported in Korea yet. Some cases of hepatocellular carcinoma were legally approved for compensation as an occupational disease largely by overwork and stress, but not supported by enough scientific evidence. Effort to find the evidence of its causal relationship is needed.
Adult ; Drug-Induced Liver Injury/epidemiology ; Female ; Health Personnel ; Hepatitis, Viral, Human/epidemiology/prevention & control ; Humans ; Liver Diseases/*epidemiology/prevention & control ; Liver Neoplasms/chemically induced/epidemiology ; Male ; Middle Aged ; Occupational Diseases/*chemically induced/*epidemiology/prevention & control ; Occupational Exposure/adverse effects ; Republic of Korea/epidemiology ; Young Adult

BACKGROUND/AIMS: Liver dysfunction and reactivation of hepatitis virus are well-described complications in cancer patients who receive cytotoxic chemotherapy and may result in varying degrees of liver damage. However, there has been just few reports on such complications and on the preemptive use of lamivudine in Korea. The aims of this study were to determine the prevalence of hepatitis B and C virus infection and the incidence of liver dysfunction in patients with malignancies who receive chemotherapy, to determine the reactivation rate of hepatitis B virus (HBV) in those patients, to evaluate the effect of preemptive use of lamivudine in patients with HBV infection. METHODS: Among 1,477 patients who received chemotherapy due to various malignancies from January 2000 to June 2005, 668 patients with incomplete viral studies or hepatitis related malignancy were excluded. A retrospective study was conducted by reviewing the medical records of remaining 809 patients. RESULTS: The overall prevalence rate of hepatitis B or C virus in patients receiving chemotherapy was 6.55% (53/809). The incidences of liver dysfunction was not significantly different between hepatitis virus positive group and negative group. Reactivation rate of hepatiris B or C virus after chemotherapy was 15% (6/40). In all patients who received lamivudine therapy, aspartate aminotransferase and alanine aminotransferase level were normalized and HBV DNA negativity achieved. CONCLUSIONS: The existence of hepatitis virus in patients receiving chemotherapy did not significantly influence the development of severe liver dysfunction, owing probably to the lamivudine therapy. Further prospective studies are required to ascertain the reactivation of hepatitis virus in patients receiving chemotherapy and the need for prophylactic lamivudine therapy in HBV positive patients.
Adult ; Antineoplastic Agents/*adverse effects ; Antiviral Agents/*therapeutic use ; Female ; Hepatitis B/diagnosis/epidemiology/*prevention & control ; Hepatitis C/diagnosis/epidemiology/*prevention & control ; Humans ; Lamivudine/*therapeutic use ; Liver Diseases/chemically induced/*diagnosis/epidemiology ; Male ; Middle Aged ; Neoplasms/complications/drug therapy ; Prevalence