Molecular biomarkers of occupational lung cancer

Occupational exposures to certain metals, hydrocarbons and ionizing radiation are associated with increased lung cancer in workers; because these exposures continue, lung cancer remains an important problem in industrialized nations. The gravity of the lung cancer, specifically the low cure rate associated with the disease, has forced researchers to focus efforts at developing biological indicators (biomarkers) of carcinogen exposure and early, reversible effects. This review examines critically the development of these biomarkers for occupational and environmental exposures to polycyclic aromatic hydrocarbons (PAH), a ubiquitous class of lung carcinogens. Biomarkers of several different stages of the carcinogenic process have been proposed. Industrial hygiene and occupational health emphasize exposure and disease prevention. For this reason, biomarkers useful in industrial hygiene practice are those which measure events prior to the initiation phase of carcinogenesis; markers of later events which have a greater positive predictive value may measure irreversible effects and are more appropriate for disease screening and epidemiology. One of the strengths of biological monitoring is that exposures and effects can be measured regardless of route. Data indicates that the dermal route may be a significant pathway for delivery of PAH to the lung. This finding has important ramifications because as airborne exposure limits decrease the relative impact of dermal absorption is increased.