OCCUPATIONAL ASSOCIATIONS WITH LUNG-CANCER IN 2 ONTARIO CITIES

A death certificate based case-control study of lung cancer in two Ont ario cities was performed to estimate the risk of lung cancer attribut able to occupation in Ontario, and to estimate the proportion of occup ational lung cancers receiving compensation from the Workers' Compensa tion Board. Occupation and industry were identified from the death cer tificate. A priori occupations for analysis were those whose members h ad received compensation for occupational cancer from the Ontario Work ers' Compensation Board. Population attributable risks were computed u sing the relative risks observed in this study and employment data fro m the 1986 Census of Canada. Subjects were all men (N = 967) between t he ages of 35 and 75 years resident in the cities of Hamilton and Saul t Ste-Marie who died of lung cancer from 1979 to 1988. Controls (2,821 ) were matched on age, year of death, and city of residence. In agreem ent with other studies, an increased risk of lung cancer was observed for workers in the construction sector, for miners, and for truck driv ers. It was estimated that only a small proportion of lung cancers att ributable to occupation are compensated in Ontario. It is believed tha t many occupational cancers go uncompensated because of the failure to file claims, rather than because claims are rejected by Compensation Boards. Physicians are in a position to advise patients about the poss ibility of compensable disease and to act as advocates for them. By re cognizing compensable illness, physicians have the opportunity to ease the financial burden of patients and their families. The challenge is a difficult one, but it is well worth pursuing. (C) 1995 Wiley-Liss, Inc.