Systematic Screening for Occupational Exposures in Lung Cancer Patients: A Prospective French Cohort

Abstract

Occupational lung cancers are under-reported and under-compensated worldwide. We assessed systematic screening for occupational exposure to carcinogens combining a self-administered questionnaire and an occupational consultation to improve the detection of occupational lung cancers and their compensation. Social deprivation and the costs of this investigation were estimated. Patients with lung cancer received a self-administered questionnaire to collect their job history, potential exposure to carcinogens and deprivation. A physician assessed the questionnaire and recommended an occupational consultation if necessary. During the consultation, a physician assessed if the lung cancer was work-related and, if it was, delivered a medical certificate to claim for compensation. Over 18 months, 440 patients received the self-administered questionnaire: 234 returned a completed questionnaire and a consultation was required for 120 patients. Compensation was judged possible for 41 patients. Among the 35 medical certificates delivered, 19 patients received compensation. Nearly half the patients (46%) were assessed as socially deprived and these patients took significantly longer to return the questionnaire compared with those who were not deprived. The mean cost of the process was €62.65 per patient. Our results showed a systematic self-administered questionnaire can be used to identify patients potentially exposed to carcinogens and to improve compensation.

Who Cares? the Impact on Caregivers of Suspected Mining-Related Lung Cancer

“…The first and second themes that arose from the worker representative interviews were consistent with the caregiver themes, as was underreporting and under-compensation of occupational lung cancer, such that some authors have recommended hospital-based systematic searches 42 , the use of a systematic self-administered questionnaire 43 , education both for workers at high risk for exposure and for health care providers 44 , and occupational cohort linkages to insurance claims 45 compensation for potential occupational-related lung cancer, the third, fourth, and fifth themes articulated by worker representatives appear to be recent findings that merit further future exploration. Given the lengthy and detailed compensation process and its impact on patients, families, and representatives, worker representative or adviser jobs are undoubtedly challenging, but potentially very rewarding when compensation for occupational lung cancer is successful and disheartening when it is not.…”

Occupational Lung Diseases: Underreported Diagnosis in Radiological Practice

“…47 Underreporting and undercompensation of lung cancer are wide problems for the various funding systems of various nations. 44,[48][49][50] From a radiological point of view, radiologists who are involved in the CT reporting of a lung cancer should always check to see if there are pleural plaques that would suggest correlation to an occupational exposure (Fig. 13).…”

Clinico-radiological and Pathological Characteristics of Lung Cancer and its Correlation with their Occupational Profile among Patients of— Employees State Insurance (ESI) Hospital— A Tertiary Care Center in North India

“…Occupational cancers are largely under-reported and compensated. 12 Lung cancer can be preventable because most risk factors of lung cancer can be prevented if people have sufficient knowledge about that and the government should make specific policy and guidelines on these environmental and occupational risk factors which attributed to lung cancer such as tobacco (smoke and smokeless) consumption. 13 Employees State Insurance Corporation (ESIC) is a statutory and an autonomous body under the Ministry of Labor and Employment, Government of India.…”