Les facteurs de risque professionnels des cancers bronchopulmonaires Quelle surveillance médicale après exposition à des cancérogènes pulmonaires professionnels ?

Lung cancers are the most frequent of occupational cancers, with to date numerous etiologies or situations of exposure for which the link is retained as certain in man by the International Agency for Research on Cancer: asbestos, crystalline silica, diesel exhaust, X and Y radiations, radon-222 and its decay products, plutonium, arsenic, nickel compounds, hexavalent chromium compounds, beryllium, cadmium, bischloromethylether and chloromethyl methyl ether, Acheson process, several sources of exposure to polycyclic aromatic hydrocarbons (aluminum production, coal gasification, coke production, soots, iron and steel foundry), underground hematite mining, painting, rubber production, secondhand tobacco smoke, welding fumes. The identification of exposures and the implementation of preventive actions to eliminate or minimize them are an essential step for occupational health actors. A recommendation of good practice was drawn up in France in 2015 under the auspices of the French Society of Occupational Medicine, the French Society of Pneumology and the French Society of Radiology, which advocates to assess in some departments the feasibility and relevance of screening for lung cancer by low-dose chest CT-scan in populations at high risk for lung cancer. The chest physician must also be vigilant in identifying prior occupational exposures to occupational carcinogens for any incident case of lung cancer, due to the important medico-social issues at the individual and collective level.