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Adenocarcinoma of the lungs in a cook caused by long-term exposure to oily smoke-A first case identified in Taiwan

  • Last updated:2021-10-18

    In a first instance in Taiwan, after the Ministry of Labor assessed a case of adenocarcinoma of the lungs in a cook who had undergone long-term exposure to oily smoke while frying, cooking, and roasting in a restaurant as being connected with the individual''s implementation of his work duties, the Bureau of Labor Insurance will provide occupational injury and disease subsidies.

    Working as a cook for approximately 34 years, the 51-year-old Mr. Yang suffered from adenocarcinoma of the lungs. Although his disease was suspected by a physician of being caused by occupational factors, it is difficult to indicate a connection between lung cancer and cooking work due to the lack of international epidemiological evidence. In view of the fact that the nature of cooking in Taiwan differs from that in other countries, The Ministry of Labor analyzed cancer registry data from the Ministry of Health and Welfare, and established a localized epidemiological research basis for this case after more than two years of research. Finally, the Occupational Disease Assessment Committee concluded that Mr. Yang''s case of adenocarcinoma was connected with his work duties, and can be considered as occupational disease.

    According to the Ministry of Labor, the classification of occupational carcinogens is based on standards issued by the International Agency for Research on Cancer (IARC), which classifies carcinogens as four types: Group 1 carcinogens consist of substances with sufficient evidence of carcinogenicity in humans; Group 2 includes substances with still limited evidence of carcinogenicity in humans; Group 3 includes substances with insufficient evidence of carcinogenicity; and Group 4 includes substances with evidence suggesting no carcinogenicity. Taiwan''s current "Expanded Schedule of Occupational Diseases for Labor Insurance" lists cancer among occupational diseases in accordance with these standards, and requires that cancer have a close "correspondence" with work, which implies that affected persons must have clear on-the-job exposure to such specific substances as asbestos, benzidine, β-naphthylamine, hexavalent chromium and its compounds, coal tar, benzene, or inorganic nickel. In this case, although cooks work in an environment where they are exposed to oily smoke from high-temperature frying, they do not have exposure to definite designated carcinogens. The IARC classifies oily smoke from frying in oil in Group 2A. Because the determination of an occupational basis for cancers in Taiwan has chiefly focused on whether there is exposure to Group 1 substances—i.e., confirmed exposure to human carcinogens—there had previously been no cases in which lung cancer in cooks was considered an occupational disease.

    The Ministry of Labor emphasizes that there are objective, rigorous standards for determining occupational diseases, and it must perform judgments reflecting the sum of evidence concerning existence of an illness, the time sequence of the illness'' appearance, exposure to risk factors, and individual factors. In Mr. Yang''s case, apart from considering the IARC standards, the judgment also reflected the amount and length of exposure. Compared with other occupational diseases, occupational cancers have the lowest diagnosis rate. To safeguard workers’ rights, The Ministry of Labor has currently commissioned the establishment of nine occupational illness and injury prevention centers nationwide, and has also established an occupational illness and injury treatment service network consisting of 64 specialists. This system can provide workers with diagnosis of causal relationship, investigate cases of occupational diseases, and offer relevant consulting services.

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  • Publication Date:2014-07-15
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