Carcinogenicity of asbestos has been well established for decades and it has similar approval standards in most advanced countries based on a number of studies and international meetings. However, Korea has been lagging behind such international standards. In this study, we proposed the approval standards of an occupational cancer due to asbestos through intensive review on the Helsinki Criteria, post-Helsinki studies, job exposure matrix (JEM) based on the analysis of domestic reports and recognized occupational lung cancer cases in Korea. The main contents of proposed approval standards are as follows; ① In recognizing an asbestos-induced lung cancer, diagnosis of asbestosis should be based on CT. In addition, initial findings of asbestosis on CT should be considered. ② High Exposure industries and occupations to asbestos should be also taken into account in Korea ③ An expert’s determination is warranted in case of a worker who has been concurrently exposed to other carcinogens, even if the asbestos exposure duration is less than 10 years. ④ Determination of a larynx cancer due to asbestos exposure has the same approval standards with an asbestos-induced lung cancer. However, for an ovarian cancer, an expert’s judgment is necessary even if asbestosis, pleural plaque or pleural thickening and high concentration asbestos exposure are confirmed. ⑤ Cigarette smoking status or the extent should not affect determination of an occupational cancer caused by asbestos as smoking and asbestos have a synergistic effect in causing a lung cancer and they are involved in carcinogenesis in a complicated manner.

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Lead, which is widely used in industry, is a common element found in low concentrations in the Earth’s crust. Implementations to reduce environmental lead concentrations have resulted in a considerable reduction of lead levels in the environment (air) and a sustained reduction in the blood lead levels of the average citizen. However, people are still being exposed to lead through a variety of routes in everyday commodities.

Lead causes health problems such as toxicity of the liver, kidneys, hematopoietic system, and nervous system. Having a carcinogenic risk as well, the IARC classifies inorganic lead compounds as probably carcinogenic to humans (Group 2A). Occupational lead poisonings have decreased due to the efforts to reduce the lead concentrations in the working environment. In contrast, health hazards associated with long-term environmental exposure to low concentrations of lead have been reported steadily. In particular, chronic exposure to low concentrations of lead has been reported to induce cognitive behavioral disturbances in children.

It is almost impossible to remove lead completely from the human body, and it is not easy to treat health hazards due to lead exposure. Therefore, reduction and prevention of lead exposure are very important. We reviewed the toxicity and health hazards, monitoring and evaluation, and management of lead exposure.

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Several clinical practice guidelines related to the assessment and management of low back pain (LBP) have been published with varied scopes and methods. This paper summarises the first French occupational guidelines for management of work-related LBP (October 2013). There main originality is to treat all the three stages of primary, secondary and tertiary prevention of work-related LBP. The guidelines were written by a multidisciplinary working group of 24 experts, according to the Clinical Practice Guidelines method proposed by French National Health Authority, and reviewed by a multidisciplinary peer review committee of 50 experts. Recommendations were based on a large systematic review of the literature carried out from 1990 to 2012 and rated as strong (Level A), moderate (B), limited (C) or based on expert consensus (D) according to their level of evidence. It is recommended to deliver reassuring and consistent information concerning LBP prognosis (Level B); to perform a clinical examination looking for medical signs of severity related to LBP (Level A), encourage continuation or resumption of physical activity (Level A), identify any changes in working conditions and evaluate the occupational impact of LBP (Level D). In case of persistent/recurrent LBP, assess prognostic factors likely to influence progression to chronic LBP, prolonged disability and delayed return to work (Level A). In case of prolonged/repeated sick leave, evaluate the pain, functional disability and their impact and main risk factors for prolonged work disability (Level A), promote return to work measures and inter professional coordination (Level D). These good practice guidelines are primarily intended for professionals of occupational health but also for treating physicians and paramedical personnel participating in the management of LBP, workers and employers.

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