Lung carcinoma is the most common cause of cancer death in men, and is 2nd in women (after breast carcinoma). Occupational carcinogens cause approximately 5% of all lung cancers, with asbestos being the most common trigger at >90% (Herold 2022).
Barone- Adesi et al (2016) estimate the number of lung carcinomas triggered by asbestos exposure to be much higher than the number of mesotheliomas caused by asbestos.
After asbestos exposure, the risk of developing lung cancer is 20-fold higher in nonsmokers and 50-fold higher in smokers compared to people without asbestos exposure (Haustein 2008). If there is also an interaction with PAH (artificial mineral fibers), the probability of developing lung cancer is at least 50% (Herold 2022).
In Germany, asbestos-induced malignancies (see "Asbestos-related diseases") are the most common occupational cancer.
Due to the long latency period (15-50 years), diseases are expected to peak around 2020 (Herold 2022).According to the Guideline Program (2018), the rate of asbestos-triggered carcinomas has remained approximately constant since 1995, at about 700 cases per year.
Workers in cement plants and shipyards are particularly at risk, as are workers who handle insulating materials (Thomas 2010) or are involved in asbestos mining or processing. However, other groups are also at risk, such as those who wash clothes that have come into contact with asbestos (Nowak 2018), painters, electricians, those exposed to asbestos through road surfacing or playground materials, etc. (Kasper 2015).
Indirect exposures such as washing work clothes are not eligible for recognition because they are not occupational exposures (Nowak 2018).
Because the latency period for asbestos-related lung cancer is very long, asbestos-associated lung cancers have only been observed since 1975. At that time, there were only 15 proven cases. Then, in the following years, there was a rapid increase in the numbers (Ukena 2018).
Although the neoplastic effects of asbestos have been known since the mid-1930s, asbestos itself was used medically until the second half of the 20th century, e.g., in spontaneous pneumothorax or it was applied preoperatively to the pleural space to make it stick together (Ulmer 1976).