Work-related cancer: The Brazilian National Cancer Institute’s Experience in Updating the Ministry of Health’s 2020 List of Work-Related Diseases

Otero, Ubirani Barros; Nogueira, Fernanda de Albuquerque Melo; Madeira, Christiane Soares Pereira; Silva Junior, João Silvestre; Bandini, Marcia

doi:10.1590/2317-6369/07525pt2025v50edoc1

person Ubirani Barros Otero

contributed to the conception of the study · data collection, analysis, and interpretation · drafting the manuscript

schoolInstituto Nacional de Câncer, Coordenação de Prevenção e Vigilância, Área Técnica Ambiente, Trabalho e Câncer. Rio de Janeiro, RJ, Brazil.

0000-0003-1464-2410

person Fernanda de Albuquerque Melo Nogueira

contributed to the conception of the study · data collection, analysis, and interpretation · drafting the manuscript

schoolInstituto Nacional de Câncer, Coordenação de Prevenção e Vigilância, Área Técnica Ambiente, Trabalho e Câncer. Rio de Janeiro, RJ, Brazil.

0000-0003-0331-3873

person Christiane Soares Pereira Madeira

contributed to the conception of the study · data collection, analysis, and interpretation · drafting the manuscript

schoolInstituto Nacional de Câncer, Coordenação de Prevenção e Vigilância, Área Técnica Ambiente, Trabalho e Câncer. Rio de Janeiro, RJ, Brazil.

0000-0002-6819-1945

person João Silvestre Silva Junior

contributed to the conception of the study and the critical review of the manuscript

schoolCentro Universitário São Camilo. São Paulo, SP, Brazil.schoolFaculdade de Medicina da Universidade de São Paulo, Departamento de Medicina Legal, Bioética, Medicina do Trabalho e Medicina Física e Reabilitação. São Paulo, SP, Brazil.

0000-0001-7541-5946

person Marcia Bandini

contributed to the conception of the study and the critical review of the manuscript

schoolUniversidade Estadual de Campinas, Faculdade de Ciências Médicas, Departamento de Saúde Coletiva. Campinas, SP, Brazil.

0000-0003-2899-090X

personContact: Ubirani Barros Otero E-mail: uotero@inca.gov.br

The authors have approved the final version and assume full public responsibility for the work carried out and the content published.

Competing interests:

The authors declare that there are no competing interests.

Responsible editors:

Victor Wünsch Filho

Eduardo Algranti

ICD-10	Type of malignant neoplasm	Occupational agents and/or risk factors - LWRD 1999	Occupational agents and/or risk factors - LWRD 2020
C16	Stomach	Asbestos	Exposure to chemical agents used in the rubber production process, including the vulcanization process; and/or asbestos; and/or inorganic lead compounds; and/or chemical agents used in the production and processing of fabrics, in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays) in work activities.
C22.3	Liver angiosarcoma	Arsenic and its arsenical compounds; vinyl chloride	Not included in LWRD 2020
C25	Pancreas	Vinyl chloride; epichloridine; aliphatic and aromatic hydrocarbons from the petroleum industry	Exposure to ionizing radiation (thorium-232 and its decay products; and/or X-rays and/or gamma rays) in work activities.
C30 to C31	Nasal cavity and paranasal sinuses	Ionizing radiation; nickel and its compounds; wood dust and other organic dust from the furniture industry; dust from the leather industry; organic dust (in the textile industry and bakeries), oil industry	C30 Nasal cavity	Exposure to chemical agents used in the production process of isopropyl alcohol; and/or hexavalent chromium and its compounds; and/or formaldehyde; and/or nickel and its compounds; and/or dust from the leather industry; and/or wood dust; and/or glues and solvents used in carpentry and joinery activities; and/or organic dust, in work activities; Exposure to ionizing radiation (radium-226 and/or radium-228, and products of their decay) in work activities.
			C31 Sinuses	Exposure to chemical agents used in the production process of isopropyl alcohol; and/or hexavalent chromium and its compounds; and/or formaldehyde; and/or nickel and its compounds; and/or dust from the leather industry; and/or wood dust; and/or glues and solvents used in carpentry and joinery activities; and/or organic dust from the furniture industry, during work activities; Exposure to ionizing radiation (radium-226 and radium-228, and their decay products) in work activities.
C32	Larynx	Asbestos	Exposure to asbestos; and/or acid mists; and/or chemical agents used in the rubber production process, including the vulcanization process; and/or mustard gas, and/or chemical agents used in the production and processing of fabrics, during work activities; Exposure to human papillomavirus type 16 in work activities.
C34	Bronchi and lung	Arsenic and its arsenical compounds; asbestos; beryllium, cadmium, or their compounds; chromium and its toxic compounds, vinyl chloride; chloromethyl ethers; free silica; tar, pitch, bitumen, mineral coal, paraffin, and waste products of these substances; ionizing radiation; coke oven emissions; nickel and its compounds; acrylonitrile; aluminum industry (foundries); mineral oil mists (cutting oil); metal foundries	Exposure to chemical agents from aluminum production; and/or arsenic and its compounds; and/or asbestos; and/or beryllium and its compounds; and/or bis chloromethyl ether and chloromethyl methyl ether; and/or cadmium and its compounds; and/or hexavalent chromium and its compounds; and/or coal gasification; and/or coal tar; and/or emissions from coke ovens; and/or emissions from diesel engine exhaust; and/or emissions from the iron and steel smelting process; and/or antineoplastic drugs MOPP (vincristine-prednisone-nitrogen-mustard-procarbazine mixture); and/or nickel and its compounds; and/or particulate matter and atmospheric air pollution; and/or organic solvents; and/or chemical agents used in the rubber production process, including the vulcanization process; and/or crystalline free silica dust; and/or soot; and/or welding fumes; and/or mustard gas; and/or acid mists; and/or benzene; and/or biomass fuel (mainly wood); and/or bitumen and its residues; and/or carbon electrode manufacturing; and/or silicon carbide; and/or coal electrode production; and/or combination of alpha-chlorinated toluenes and benzoyl chloride; and/or diazinone; and/or pesticides; and/or pigments and solvents used in printing processes; and/or 2,3,7,8-TCDD; and/or chemical agents used in the production and processing of fabrics, in work activities; Exposure to ionizing radiation (plutonium; and/or radium-222 and its decay products; and/or radon; and/or X-rays; and/or gamma rays) in work activities.
C40	Bones and articular cartilage of the limbs (including bone sarcoma)	Ionizing radiation	Exposure to ionizing radiation (radium-224 and/or radium-226 and/or radium-228, and their decay products; and/or plutonium; and/or X-rays and/or gamma rays; and/or radioactive iodine, including iodine-131) in work activities.
C44	Other skin neoplasms	Arsenic and its arsenical compounds; tar, pitch, bitumen, mineral coal, paraffin, and waste products of these substances causing skin epithelioma; ionizing radiation; ultraviolet radiation	Exposure to arsenic and its compounds; and/or coal tar; and/or soot; and/or coal distillation (coal); and/or untreated mineral oil; and/or shale oil; and/or creosote; and/or hydrocarbons from the oil refining process; and/or azathioprine; and/or cyclosporine; and/or organophosphorus pesticides (parathion) in work activities; Exposure to non-ionizing radiation (ultraviolet); and/or ionizing radiation (X-rays and/or gamma rays) in work activities; Exposure to HIV; and/or human papillomavirus types 5 and/or 8, in work activities.
C45	Mesothelioma, Mesothelioma of the pleura (C45.0), Mesothelioma of the peritoneum (C45.1), and Mesothelioma of the pericardium (C45.2)	Asbestos	Exposure to asbestos; and/or erionite; and/or fluoroedenite in work activities; and/or painting activities.
C67	Bladder	Tar, pitch, bitumen, mineral coal, paraffin, and waste products of these substances; aromatic amines and their derivatives (Beta-naphthylamine, 2-chloroaniline, benzidine, o-toluidine, 4-chloro-ortho-toluidine), coke oven emissions	Exposure to arsenic and its compounds; and/or chemical agents resulting from the production of aluminium; and/or chemical agents used in the production of magenta; and/or chemical agents used in the production of auramine; and/or organic solvents; and/or chemical agents used in the rubber production process, including the vulcanization process; and/or aromatic amines (4-aminobiphenyl; and/or 2-naphthylamine; and/or 4-chloro-ortho-toluidine; and/or ortho-toluidine; and/or benzidine; and/or toluidine); and/or coal tar; and/or perchloroethylene and other agents used in dry cleaning processes; and/or diesel engine exhaust emissions; and/or formaldehyde and other chemical substances used in cosmetic hair products; and/or 2-mercaptobenzothiazole; and/or pigments and solvents used in printing processes; and/or soot; and/or tetrachloroethylene; and/or cyclophosphamide; and/or chemical agents used in the production and processing of fabric, in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays) in work activities; Exposure to Schistosoma haematobium in work activities.
C91 to C95	Leukemia	Benzene, ionizing radiation, ethylene oxide, antineoplastic agents, electromagnetic fields, chlorinated pesticides (chlordane and heptachlor)	Exposure to benzene; and/or organochlorine pesticides (lindane, pentachlorophenol, DDT) and organophosphates (diazinone, glyphosate, malathion); and/or 1,3-butadiene; and/or formaldehyde; and/or dichloromethane; and/or methylene chloride; and/or chemical agents used in the rubber production process, including the vulcanization process; and/or ethylene oxide; and/or organic solvents; and/or hydrocarbons from the oil refining process; and/or PCBs; and/or polychlorophenols or their sodium salts; and/or styrene; and/or trichloroethylene; and/or 2,3,7,8- TCDD; and/or antineoplastic drugs (azathioprine, bussulfan, chlorambucil, cyclophosphamide, cyclosporine, etoposide with cisplatin and bleomycin, bischloroethyl nitrosourea - BCNU, melphalan, mitroxanthone, nitrogen mustard, MOPP, semustine (methyl-CCNU), teniposide, thiotepa, treosulfan); and/or dichlorophenoxyacetic acid (2, 4-D); and/or chemical agents used in the production and processing of fabrics, in work activities; Exposure to ionizing radiation (fission products, including strontium-90; and/or phosphorus-32; and/or thorium-232 and its decay products; and/or X-rays and/or gamma rays) in work activities; Exposure to hepatitis C virus (HCV); and/or HIV; and/or hepatitis B virus (HBV); and/or human T-cell lymphotropic virus type 1 (HTLV 1); and/or Epstein-Barr virus; and/or Plasmodium falciparum, in work activities.

ICD-10 code	Type of malignant neoplasm	Occupational agents and/or risk factors
C00	Malignant neoplasm of the lip	Exposure to non-ionizing radiation (ultraviolet) in work activities.
C06	Malignant neoplasm of other and unspecified parts of the mouth	Exposure to human papillomavirus type 16 and/or 18 during work activities.
C08	Malignant neoplasm of other and unspecified major salivary glands	Exposure to ionizing radiation (X-rays and/or gamma rays; and/or radioactive iodine, including iodine-131) in work activities.
C09	Malignant neoplasm of the tonsil	Exposure to HPV type 16 during work activities.
C11	Malignant neoplasm of the nasopharynx	Exposure to formaldehyde and/or wood dust and/or Epstein-Barr virus during work activities.
C14	Malignant neoplasm of other sites and ill-defined sites of the lip, oral cavity and pharynx	Exposure to wood dust and/or HPV type 16 during work activities.
C15	Malignant neoplasm of the oesophagus	Exposure to perchloroethylene and other agents used in dry cleaning processes; and/or chemical agents used in the rubber production process, including the vulcanization process; and/or chemical agents used in the production and processing of fabrics, in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays) in work activities.
C18	Malignant neoplasm of the colon	Exposure to asbestos in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays) in work activities; Working night shifts.
C20	Malignant neoplasm of the rectum
C21	Malignant neoplasm of the anus and anal canal	Exposure to HPV type 16 and/or 18 and/or 33 and/or HIV during work activities.
C22	Malignant neoplasm of the liver and intrahepatic bile ducts	Exposure to aflatoxin; and/or vinyl chloride; and/or 1,2-dichloropropane; and/or arsenic and its compounds; and/or organochlorine pesticides (DDT); and/or trichloroethylene; and/or dichloromethane in work activities; Exposure to ionizing radiation (plutonium and/or thorium-232 and their decay products; and/or X-rays and/or gamma rays) in work activities; Exposure to HBV; and/or HCV; and/or HIV in work activities.
C23	Malignant neoplasm of the gallbladder	Exposure to ionizing radiation (thorium-232 and its decay products) in work activities.
C41	Malignant neoplasm of bone and articular cartilage of other and unspecified localizations	Exposure to ionizing radiation (radium-224 and/or radium-226 and/or radium-228, and their decay products; and/or plutonium, X-rays and/or gamma rays; and/or radioactive iodine, including iodine-131) in work activities.
C43	Malignant melanoma of the skin	Exposure to PCBs in work activities; Exposure to non-ionizing radiation (ultraviolet and/or infrared) in work activities.
C46	Kaposi’s sarcoma	Exposure to herpes simplex type 1 (HVS-1) and/or HIV in work activities.
C49	Malignant neoplasm of connective tissue and other soft tissues	Exposure to 2,3,7,8- TCDD; and/or polychlorophenols or their sodium salts in work activities; Exposure to ionizing radiation (radioactive iodine, including iodine-131) in work activities.
C50	Malignant neoplasm of the breast	Exposure to organochlorine pesticides (dieldrin); and/or ethylene oxide; and/or PCBs in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays) in work activities. Working night shifts.
C51	Malignant neoplasm of the vulva	Exposure to human papillomavirus type 18 and/or 33 and/or HIV during work activities.
C52	Malignant neoplasm of the vagina	Exposure to human papillomavirus type 16 and/or HIV during work activities.
C53	Malignant neoplasm of the cervix	Exposure to human papillomavirus type 16 and/or 18 and/or 26 and/or 31 and/or 33 and/or 35 and/or 39 and/or 45 and/or 51 and/or 52 and/or 53 and/or 56 and/or 58 and/or 59 and/or 66 and/or 67 and/or 68 and/or 70 and/or 73 and/or 82 and/or HIV in work activities.
C56	Malignant ovarian neoplasm	Exposure to asbestos in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays) during work activities.
C60	Malignant neoplasm of the penis	Exposure to human papillomavirus type 16 and/or 18; and/or HIV in work activities.
C61	Malignant neoplasm of the prostate	Exposure to arsenic and its compounds; and/or cadmium and its compounds; and/or organophosphorus pesticides (malathion); and/or chemical agents used in the rubber production process, including the vulcanization process; and/or chemical agents used in the production and processing of fabrics, in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays; and/or thorium-232 and its decay products) in work activities; Working night shifts.
C62	Malignant neoplasm of the testicles	Exposure to organochlorine pesticides (DDT); and/or N, N-dimethylformamide; and/or perfluorooctanoic acid in work activities.
C64	Malignant neoplasm of the kidney, except renal pelvis	Exposure to trichloroethylene; and/or arsenic and its compounds; and/or cadmium and its compounds; and/or perfluorooctanoic acid; and/or pigments and solvents used in printing processes; and/or welding fumes in work activities; Exposure to ionizing radiation (X-rays and/or gamma rays; and/or thorium-232 and its decay products) in work activities.
C65	Malignant neoplasm of the renal pelvis	Exposure to aristolochic acid during work activities.
C66	Malignant neoplasm of the ureters	Exposure to aristolochic acid during work activities.
C69	Malignant neoplasm of the eye and appendages	Exposure to non-ionizing radiation (ultraviolet); and/or HIV in work activities.
C71	Malignant neoplasm of the brain	Exposure to ionizing radiation (X-rays and/or gamma rays); and/or non-ionizing radiation (radiofrequency electromagnetic fields - including those from cordless phones) in work activities.
C72	Malignant neoplasm of the spinal cord, cranial nerves and other parts of the central nervous system
C73	Malignant neoplasm of the thyroid gland	Exposure to ionizing radiation (X-rays and/or gamma rays; and/or radioactive iodine - including iodine-131) in work activities.
C82 to C85	Lymphomas	Exposure to benzene; and/or organochlorine pesticides (lindane, pentachlorophenol, DDT) and organophosphates (diazinone, glyphosate, malathion); and/or 1,3-butadiene; and/or formaldehyde; and/or dichloromethane; and/or methylene chloride; and/or chemical agents used in the rubber production process, including the vulcanization process; and/or ethylene oxide; and/or organic solvents; and/or hydrocarbons from the oil refining process; and/or PCBs; and/or polychlorophenols or their sodium salts; and/or styrene; and/or trichloroethylene; and/or 2,3,7,8-TCDD; and/or antineoplastic drugs (azathioprine, bussulfan, chlorambucil, cyclophosphamide, cyclosporine, etoposide with cisplatin and bleomycin, bischloroethyl nitrosourea - BCNU, melphalan, mitroxanthone, nitrogen mustard, MOPP, semustine (methyl-CCNU), teniposide, thiotepa, treosulfan); and/or dichlorophenoxyacetic acid (2, 4-D); and/or chemical agents used in the production and processing of fabrics, in work activities; Exposure to ionizing radiation (fission products, including strontium-90; and/or phosphorus-32; and/or thorium-232 and its decay products; and/or X-rays and/or gamma rays) in work activities; Exposure to HCV; and/or HIV; and/or HBV; and/or human T-cell lymphotropic virus type 1 (HTLV 1); and Epstein-Barr virus; and/or Plasmodium falciparum in work activities.

[TFN1001] MOPP: vincristine–prednisone–nitrogen mustard–procarbazine combination; TCDD: tetrachlorodibenzo-p-dioxin; HIV: human immunodeficiency virus; DDT: dichloro-diphenyl-trichloroethane; PCB: polychlorinated biphenyls.