Contribution of metals to respiratory cancer.

This paper reviews studies on the adverse health effects of exposure to metals, using arsenic and cadmium as examples. The carcinogenic potential of arsenic has been studied in various settings. Inhalation is clearly related to the development of lung cancer in (copper) smelting and arsenical pesticide manufacturing, and also in heavily exposed wine merchants who had an additional source of exposure by ingestion. Animal studies have shown cadmium to be a lung carcinogen, while a study by Thun et al. provides the best evidence to date that cadmium inhaled as CdO particles may be a human lung carcinogen. On the basis of this latter study, EPA estimates the risk due to cadmium at 1.8 X 10(-3) cases/micrograms/m3, which results in more than 100,000 excess lung cancers (lifetime). For arsenic, the risk estimate of 4.29 cases/1,000 micrograms/m3, based on epidemiologic data also results in more than 100,000 lung cancers (lifetime). This paper reviews the bases for these estimates and presents recommendations for further research. Lung cancer risks also exist for other metals such as nickel, chromium, and beryllium. Further study is required before a definitive conclusion can be reached about the significance and magnitude of environmental exposures to metals as a cause of lung cancer.