[Aromatic amines in the work environment and urothelial tumors]

According to existing cancerology registers, 6500 new cases of cancer of the bladder are diagnosed and treated each year in males in France (and 1800 in females). Less than ten or so of these are considered as occupational diseases, whereas in European countries with similar industrial development 5 to 10% of carcinomas of the bladder are ascribed to an occupational exposure or a carcinogen. There are several reasons why the occupational origin of these tumors often escapes recognition in our country in spite of adequate professional medical monitoring: the usually long time interval--averaging 20 years--between exposure to the carcinogen and apparition of the tumor; difficulties in eliciting the complete occupational history and in ascertaining, within this history, a possible contaminating exposure; the restrictive nature of the current list of occupational diseases which includes only carcinogens that have been known for many years; the possible interaction between several carcinogenic factors, especially involving tobacco. General practitioners must be made aware of the necessity of investigating the occupational history of patients with bladder cancer who are no longer followed-up by industrial doctors. The main risks are found in chemical industries, particularly the dye industry, textile industries, rubber industries, laboratory occupations and handling of raticides.