职业卫生与职业医学课件职业与肿瘤

职业卫生与职业医学课件职业与肿教学目标拿握内农◆职业性致癌因素及职业肿瘤的概念;◆职业肿瘤的发病特点及识别和确认途径;◆职业肿瘤的诊断原则◆八种法定的职业肿瘤。了解内容◆职业性肿瘤的研究进展及各种职业性致癌因素;◆职业性肿瘤的预防原则。职业性肿瘤在工作环境中长期接触致癌因素,经过较长的潜伏期而患某种特定肿瘤。职业性孜癌因素能引起职业性肿瘤的职业性有害因素。我国法定职业病名单中职业肿瘤有八种联苯胺所致膀光癌◆石棉所致肺癌、间皮瘤◆苯所致白血病◆氯甲醚所致肺癌◆砷所致肺癌、皮肤癌◆氯乙烯所致肝血管肉瘤◆焦炉逸散物所致肺癌◆铬酸盐制造业所致肺癌职业性致癌因素◆物理因素:电离辐射、紫外线◆化学因素:在职业性致癌因素中居多。◆生物因素FigureINON-IONISING(IONISINGELECTROMAGNETICPARTICLEELFBANDRFBANDBctoRadiowavesMicrowavesintrax-rarsGammaray/s●●·neutrons3:702○原TVRadarMedical一远N-wasteReacterN-submarinefabricationNON-NUCLEARNUCLEARTheelectromagnetspectrumshowshowelectromagneticandparticeradiationsareassociatedwithvariousecoltelecommunications,nuclearandotheractivities3(lustrationtakenfromRodiationExposurebylesDaton,oSarbePublication1991)化学性数癌物Chemicalcarcinogens天然的如石棉(asbestos人造的,如氯乙烯(vinylchloride)◆工业副产品,如多环芳烃(polycyclicaromatichydrocarbons)多环芳烃和阴囊癌(cancerofthescrotum)Observationofcancerofthescrotum1775,PercivallPott,aLondonsurgeon,describedahighfrequencyofcancerofthescrotum(B4E)amongchimneysweeps,adiseaseknownatthetimeas“soot-war”(烟灰瘤)Acenturylater,otherscientistsnotedsimilarcancersamonggasplant(煤气车间)workersinGermanyandamongoilshale(油页岩)workersinScotland生物性致癌因素(Biologicalcarcinogens)Someviruseshavebeenimplicatedincausingcancer,eitherbydamagingcellsdirectly,forexample,theHepatitisBvirus,orbydecreasingtheabilityofthebodytocontrolabnormalcells,forexample,thehumanImmunodeficiencyvirus职业性致因素的作用特点有明确的病因潜伏期及发病年龄潜伏期通常需要15-20年,最短者要2-5年,长者可达3040年。由于职业性接触程度较强,职业性肿瘤发病年龄比非职业性同类肿瘤提前,如芳香胺引起的泌尿系统癌症,发病年龄以40-50岁多见,较非职业