致癌性重金属与类金属所致职业性肿瘤研究与展望  

Research and prospect on carcinogenic heavy metals and metalloids-induced occupational tumors

作　　者：季芝强 胡贵平 贾光[1] JI Zhiqiang;HU Guiping;JIA Guang(School of Public Health,Peking University,Beijing 100191,China)

机构地区：[1]北京大学公共卫生学院,北京100191 [2]北京航空航天大学医学科学与工程学院,北京100191

出　　处：《中国职业医学》2024年第5期481-487,495,共8页China Occupational Medicine

基　　金：国家自然科学基金(U2004202)。

摘　　要：恶性肿瘤是当前人类所面临的一个重要社会与公共卫生问题。职业性肿瘤是恶性肿瘤的重要组成部分;其中,致癌性重金属与类金属所致职业性肿瘤备受关注。国际劳工组织已明确地将职业性六价铬化合物、砷及其无机化合物、镉及其化合物和镍化合物所致的恶性肿瘤纳入职业病名单,我国仅将职业性六价铬化合物所致肺癌和职业性砷及其无机化合物所致肺癌、皮肤癌纳入职业病名单。在致癌性重金属与类金属所致职业性肿瘤的防治上,应遵循三级预防原则,重点在于将致癌物的接触评价与三级预防策略相结合,形成一个全面的防治体系,通过源头控制、病因诊断、生物标志物研究和高危人群筛查等多方面的努力,有效降低职业性肿瘤的发生风险,提高病例的生存质量。加强致癌性重金属与类金属所致职业性肿瘤机制研究和职业健康监护研究,可为其早期筛查、早期诊断和早期治疗提供良好的支撑。未来可结合致癌性重金属与类金属所致职业性肿瘤的病因、发病特征和三级预防内容,积极应用人工智能技术,构建全职业人群、全生命周期的职业性肿瘤预防模式,为职业性肿瘤的防治提供支撑。Malignant tumors are a prominent societal and public health challenges.Occupational tumors,as a subset of malignant tumors,have drawn considerable attention,particularly those caused by carcinogenic heavy metals and metalloids.The International Labor Organization has classified malignant tumors caused by hexavalent chromium compounds,arsenic and its inorganic compounds,cadmium and its compounds,and nickel compounds as occupational diseases,while China only classified lung cancer caused by hexavalent chromium compounds and lung and skin cancers caused by arsenic and its inorganic compounds as occupational diseases.In term of prevention and treatment of occupational tumors caused by carcinogenic heavy metals and metalloids,the principles of tertiary prevention should be followed,and the focus should be paid to combation of carcinogen exposure assessments and tertiary prevention strategies to set up a comprehensive system of prevention and treatment.Multiple effort on its source control,etiology diagnosis,biomarker research,and high-risk population screening can effectively reduce the risk of occupational tumors and improve patients′quality of life.Advancing research on the mechanisms of occupational tumors caused by carcinogenic heavy metals and metalloids and improving study on the occupational health surveillance are crucial for early screening,diagnosis,and treatment of occupational tumors.Future study on occupational tumors caused by carcinogenic heavy metals and metalloids should combine the etiology,pathogenesis,and tertiary prevention strategies with active application of artificial intelligence.Therefore,developing a preventive model that encompasses the entire occupational population and life cycle will offer support for the prevention and treatment of occupational tumors.

关 键 词：致癌 重金属 类金属 职业性肿瘤 三级预防 机制 生物标志物 职业健康监护 

分 类 号：R135.99[医药卫生—劳动卫生]