[Assessment of occupational cancer: important facts to consider]

Background | Persons suffering from malignant tumors who had been exposed to carcinogens at their workplace must be compensated if occupational exposure probably caused the disease. However, the assessment of the causes of cancers is particularly difficult.Method | For the evaluation the authors analyzed selectively researched literature and considered publications of the German Social Accident Insurance and legal regulations.Result | Often the quantification of the occupational exposure is not possible. Cumulative exposures neglect important factors, e.g. high peak concentrations. Even in the general population exposure to noxious agents occurs. This raises the question what amount of occupational exposure must be considered as sufficient for compensation and how non-occupational factors, such as genetic susceptibility, should influence the expert's opinion. Syncancerogenetic effects are currently not sufficiently considered in the legal ordinance on occupational diseases.Conclusion | At best, only a very rough estimate of the probability of causation can be stated. If there is insufficient scientific evidence then there is a need of "makeshift" recommendations within the social consensus, which occupational exposure is considered to be relevant for occupational disease. If there are no reliable data on occupational exposure due to failure of the employer, this should not be stacked against the insured.