Occupational associations with lung cancer in two Ontario cities

A death certificate based case-control study of lung cancer in two Ontario cities was performed to estimate the risk of lung cancer attributable to occupation in Ontario, and to estimate the proportion of occupational lung cancers receiving compensation from the Workers' Compensation Board. Occupation and industry were identified from the death certificate. A priori occupations for analysis were those whose members had received compensation for occupational cancer from the Ontario Workers' Compensation Board. Population attributable risks were computed using the relative risks observed in this study and employment data from the 1986 Census of Canada. Subjects were all men (N = 967) between the ages of 45 and 75 years resident in the cities of Hamilton and Sault Ste-Marie who died of lung cancer from 1979 to 1988. Controls (2,821) were matched on age, year of death, and city of residence. In agreement with other studies, an increased risk of lung cancer was observed for workers in the construction sector, for miners, and for truck drivers. It was estimated that only a small proportion of lung cancers attributable to occupation are compensated in Ontario. It is believed that many occupational cancers go uncompensated because of the failure to file claims, rather than because claims are rejected by Compensation Boards. Physicians are in a position to advise patients about the possibility of compensable disease and to act as advocates for them. By recognizing compensable illness, physicians have the opportunity to ease the financial burden of patients and their families. The challenge is a difficult one, but it is well worth pursuing.