[Occupational cancer in Tunisia]

Occupational cancers are cancers due to the exposition of the worker during his daily work to a carcinogenic agent. In Tunisia. the number of declared and compensate cases is still low. The aim of this study is to asses the role of occupational agents in the development of bronchial and pleural cancers and to discuss the causes of this under-assessment.

The occupational history of 107 patients with bronchial and pleural cancer was prospectively collected between Jun 2001 and July 2002. A detailed list of the possible occupational activities that would expose the worker to a carcinogenic agent incriminated in the genesis of bronchial or pleural carcinoma was used.

Seven cases among 107 bronchial and pleural cancers were thought to have a occupational origin (6.5%). Two patients had pleural mesothelioma due to an exposition to asbestos in the field of navy constructions and building. The 5 remaining patients had bronchial carcinomas of different histological types (3 squamous cell carcinoma, 1 adenocarcinoma and 1 small cell carcinoma). The suspected agents were Arsenic in 4/5 cases in fields of metallurgy (2 cases), mine digging (1 cases), agriculture (1 case). In 1/5 case the suspected agent was asbestos in brake- plates' maintenance in big engines. The mean duration of the exposition was 22 years and the latency period was 26 years.

The role of occupational agents in the development of bronchial and pleural cancer is important but not routinely assessed.