Lung cancer in a nonsmoking underground uranium miner

Working in mines is associated with acute and chronic occupational disorder s. Most of the uranium mining in the United States took place in the Four C orners region of the Southwest (Arizona, Colorado, New Mexico, and Utah) an d on Native American lands. Although the uranium industry collapsed in the lace 1980s, the industry employed several thousand individuals who continue to be at increased risk for developing lung cancers. We present the case o f a 72-year-old Navajo male who worked for 17 years as an underground urani um miner and who developed lung cancer 22 years after leaving the industry. His total occupational exposure to radon progeny was estimated at 506 work ing level months. The miner was a life-long nonsmoker and had no other sign ificant occupational or environmental exposures. On the chest X-ray taken a t admission into the hospital, a right lower lung zone infiltrate was detec ted. The patient was treated for community-acquired pneumonia and developed respiratory failure requiring mechanical ventilation. Respiratory failure worsened and the patient died 19 days after presenting. On autopsy, a 2.5 c m squamous cell carcinoma of the right lung arising from the lower lobe bro nchus, a right broncho-esophageal fistula, and a right lower lung abscess w ere found. Malignant respiratory disease in uranium miners may be from seve ral occupational exposures; for example, radon decay products, silica, and possibly diesel exhaust are respiratory carcinogens that were commonly enco untered. In response to a growing number of affected uranium miners, the Ra diation Exposure Compensation Act (RECA) was passed by the U.S. Congress in 1990 to make partial restitution to individuals harmed by radiation exposu re resulting From underground uranium mining and above-ground nuclear tests in Nevada.