Renal Cell Carcinoma as an Occupational Disease
In their article the authors reported the risk factors for renal cell carcinoma and mentioned the most common causes, such as smoking, overweight, and hypertension. (1)
From the perspective of occupational medicine, it should be added that exposure to trichloroethylene in the workplace can also cause renal cell carcinoma under certain conditions. Several case studies from different European countries found a significant statistical association between several years of massive exposure to trichloroethylene and an increased incidence of renal cell carcinoma, which was confirmed in a meta-analysis (2–4). The statistical association is toxicologically plausible.
In such patients, renal cell carcinoma may therefore be an occupational disease (BK 1302: Erkrankungen durch Halogenkohlenwasserstoffe [documentation on occupational diseases of the German employer’s liability insurance association, leaflet BK 1302: diseases caused by halogenated hydrocarbons]) if several years of regular exposure in the so-called high-dose range (exposure to air concentrations of 300 ppm and higher) have been confirmed. An additional occupational cause of renal cell carcinoma is exposure to cadmium and cadmium compounds, although the causal association in the sense of an occupational disease—in this case BK 1104: diseases caused by cadmium and its compounds may apply—requires further study.
It should be pointed out that according to § 202 SGB [Sozialgesetzbuch, German Social Code] VII, the treating physician is obliged to bring a suspected occupational disease to the attention of the Social Accident Insurance without any further delay.
Prof. (em) Dr. med. Dipl.-Chem. Gerhard Triebig
Conflict of interest statement
The author declares that no conflict of interest exists.
|1.||Doehn C, Grünwald V, Steiner T, Follmann M, Rexer H, Krege S: The diagnosis, treatment and follow-up of renal cell carcinoma. Dtsch Arztebl Int 2016; 113: 590–6 VOLLTEXT|
|2.||Brüning T, Pesch B, Wiesenhütter B, et al.: Renal cell cancer risk and occupational exposure to trichloroethylene: Results of a consecutive case-control-study in Arnsberg, Germany. Am J Ind Med 2003: 274–85 CrossRef MEDLINE|
|3.||Charbotel B, Fevotte J, Hours M, et al.: Case-control-study on renal cell cancer and occupational exposure to trichloroethylene. Ann Occup Hyg 2006: 777–87 MEDLINE|
|4.||Karami S, Lan Q, Rothman N, et al.: Occupational trichloroethylene exposure and kidney cancer risk: a meta-analysis. Occup Environ Med 2012: 858–67 CrossRef MEDLINE|