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Introdução/enquadramento/objetivos: Existem patologias oncológicas em que se acredita que algumas exposições laborais possam modular o seu surgimento. Pretendeu-se com esta revisão resumir de forma sucinta e prática o que mais relevante e recente se publicou sobre o tema na literatura internacional, em relação ao Cancro Esofágico. Metodologia: Trata-se de uma Revisão Bibliográfica, iniciada através de uma pesquisa realizada em janeiro de 2022 nas bases de dados “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina e RCAAP”. Conteúdo: Os fatores de risco ocupacionais associados ao Cancro Esofágico são os asbestos, hidrocarbonetos aromáticos policíclicos, acetaldeído, nitrosaminas e alguns solventes da limpeza a seco. Contudo, estudos laborais são razoavelmente escassos. Várias entidades classificaram os asbestos como agentes cancerígenos em relação ao pulmão e pleura; contudo, em relação ao esófago, a evidência é menos intensa. Ainda assim, alguns estimam que os asbestos aumentem este risco oncológico em 2,38 vezes, apesar de a relação não ser compreendida na totalidade. Eles estão classificados como pertencentes ao grupo 1 (carcinogénios para humanos). Após inalação, as fibras não são todas eliminadas pelos macrófagos; a acumulação destas potencia a produção de radicais livres, causando eventuais alterações no DNA. Se as fibras forem removidas rapidamente, não há toxicidade; logo, a deposição e o clearence destas irá influenciar o potencial oncológico. A resposta inicial é proporcionada pelos macrófagos que, por sua vez, causam inflamação e dano tecidual. Os hidrocarbonetos aromáticos policíclicos, como por exemplo o benzopireno, surgem a partir da combustão de matéria orgânica; são provavelmente carcinogénicos e mutagénicos em humanos. A nível Ocupacional existem nas fundições, limpeza de chaminés, forneiros, restauração e incineradoras; neste contexto as principais vias de entrada são a inalatória e a cutânea. Alguns polimorfismos genéticos influenciam o dano destes agentes. Discussão e Conclusões: Existem alguns setores/tarefas/agentes associados ao Cancro Esofágico com maior ou menor consenso na literatura internacional. Todos os profissionais da Saúde e Segurança Ocupacionais a atuar nessas áreas e todos os trabalhadores envolvidos deverão estar a par (pelo menos de forma sucinta) das condições associadas, de forma a atenuar o risco. Seria interessante avaliar os conhecimentos destes em relação a este tema e perceber, entre os setores mais relevantes a nível nacional, que medidas de proteção concretas (coletivas e individuais) são tomadas e qual aparenta ser a respetiva eficácia das mesmas.
Introduction/framework/objectives: There are oncological pathologies in which it is possible that some occupational exposures can modulate their appearance. The aim of this review was to sumarize, in a succinct and practical way, the most relevant and recent published data on the subject, in the international literature, in relation to Esophageal Cancer. Methodology: This is a Bibliographic Review, initiated through a search carried out in January 2022, in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Contents: Occupational risk factors associated are asbestos, polycyclic aromatic hydrocarbons, acetaldehyde, nitrosamines and some dry cleaning solvents. However, occupational studies are reasonably scarce. Several entities have classified asbestos as carcinogens in relation to the lung and pleura; however, in relation to the esophagus, the evidence is less intense. Still, some estimate that asbestos increases the risk by 2.38 times, even though the relationship between asbestos occupational exposure is not fully understood. They are classified as belonging to group 1 (human carcinogens). After inhalation, not all of the fibers are eliminated by macrophages; the accumulation of these potentiates the production of free radicals, causing eventual alterations in the DNA. If the fibers are removed quickly, there is no toxicity; therefore, their deposition and clearance will influence the oncological potential. The initial response is provided by macrophages, which in turn cause inflammation and tissue damage. Polycyclic aromatic hydrocarbons, such as benzopyrene, arise from the combustion of organic matter; are likely carcinogens and mutagens in humans. At the Occupational level, there are found in foundries, chimney sweeps, ovens, catering and incinerators; in this context, the main routes of entry are inhalation and cutaneous. Some genetic polymorphisms influence the damage. Discussion and Conclusions: There are some sectors/tasks/agents associated with Esophageal Cancer, with greater or lesser consensus in the international literature. All Occupational Health and Safety professionals working in these areas and all workers involved must be aware (at least briefly) of the associated conditions, in order to mitigate the risk. It would be interesting to assess their knowledge on this topic and understand, among the most relevant sectors at the national level, which concrete protection measures (collective and individual) are taken and what their respective effectiveness appears to be.
Introduction/framework/objectives: There are oncological pathologies in which it is possible that some occupational exposures can modulate their appearance. The aim of this review was to sumarize, in a succinct and practical way, the most relevant and recent published data on the subject, in the international literature, in relation to Esophageal Cancer. Methodology: This is a Bibliographic Review, initiated through a search carried out in January 2022, in the databases “CINALH plus with full text, Medline with full text, Database of Abstracts of Reviews of Effects, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, Cochrane Methodology Register, Nursing and Allied Health Collection: comprehensive, MedicLatina and RCAAP”. Contents: Occupational risk factors associated are asbestos, polycyclic aromatic hydrocarbons, acetaldehyde, nitrosamines and some dry cleaning solvents. However, occupational studies are reasonably scarce. Several entities have classified asbestos as carcinogens in relation to the lung and pleura; however, in relation to the esophagus, the evidence is less intense. Still, some estimate that asbestos increases the risk by 2.38 times, even though the relationship between asbestos occupational exposure is not fully understood. They are classified as belonging to group 1 (human carcinogens). After inhalation, not all of the fibers are eliminated by macrophages; the accumulation of these potentiates the production of free radicals, causing eventual alterations in the DNA. If the fibers are removed quickly, there is no toxicity; therefore, their deposition and clearance will influence the oncological potential. The initial response is provided by macrophages, which in turn cause inflammation and tissue damage. Polycyclic aromatic hydrocarbons, such as benzopyrene, arise from the combustion of organic matter; are likely carcinogens and mutagens in humans. At the Occupational level, there are found in foundries, chimney sweeps, ovens, catering and incinerators; in this context, the main routes of entry are inhalation and cutaneous. Some genetic polymorphisms influence the damage. Discussion and Conclusions: There are some sectors/tasks/agents associated with Esophageal Cancer, with greater or lesser consensus in the international literature. All Occupational Health and Safety professionals working in these areas and all workers involved must be aware (at least briefly) of the associated conditions, in order to mitigate the risk. It would be interesting to assess their knowledge on this topic and understand, among the most relevant sectors at the national level, which concrete protection measures (collective and individual) are taken and what their respective effectiveness appears to be.
Description
Keywords
Cancro do esófago Segurança no trabalho Saúde ocupacional e medicina do trabalho Esophageal cancer Safety at work Occupational health and occupational medicine