Occupational exposure in lung cancer patients: contribution of remote past work

Occupational exposures have been recognized for a number of years as contributing to disease risk for certain cancers. Although disease risk may be attributed to personal behaviors, such as cigarette smoking, occupational exposure may enhance the risk. Obtaining occupational histories is therefore important to the study of the etiology of cancer. However, the availability of occupational information in the medical record and vital registries can be incomplete or of poor quality and is often restricted to current, most recent, or usual occupation. This article reports the contribution of remote past work, data not ordinarily collected in the medical record, as an exposure source to potential lung carcinogens in a group of lung cancer patients. Twenty-six of the 114 lung cancer patients interviewed (23%) reported remote work consistent with past exposure to lung carcinogens. This occupational risk would have been undetected by usual history-taking methods and highlights the significant limitations of occupational data collection methods by vital registries.