Bilim ve teknolojinin her ge\u00e7en g\u00fcn\u00a0h\u0131zla geli\u015fmesi sonucu, ortaya yeni\u00a0kanserojenlerin \u00e7\u0131kmas\u0131yla beraber her\u00a0g\u00fcn baz\u0131 maddelerin kanserojen oldu\u011fu\u00a0veya olmad\u0131\u011f\u0131 \u015feklinde yay\u0131mlar olmaktad\u0131r.\u00a0Bu konudaki zorlu\u011fun ba\u015fl\u0131ca nedeni,\u00a0kanserojen oldu\u011fundan \u015f\u00fcphe edilen etken\u00a0ile kar\u015f\u0131la\u015ft\u0131ktan y\u0131llar sonra hastal\u0131\u011f\u0131n\u00a0ortaya \u00e7\u0131kmas\u0131d\u0131r.<\/p>\n
Kanserlerin bu \u00f6zelli\u011fi nedeni ile aradan\u00a0ge\u00e7en y\u0131llar i\u00e7inde, izlenen ki\u015filer kaybolmakta\u00a0ve sonu\u00e7lar\u0131n de\u011ferlendirilmesi\u00a0g\u00fc\u00e7l\u00fckler do\u011furmaktad\u0131r. Bu durum, \u00f6zellikle\u00a0mesleksel kanserler i\u00e7in s\u00f6z konusudur.\u00a0Kanserojen oldu\u011fu d\u00fc\u015f\u00fcn\u00fclen etken\u00a0ile \u00e7al\u0131\u015fan bir ki\u015finin herhangi bir nedenle\u00a0i\u015ften ayr\u0131lmas\u0131, olay\u0131n takibini zorla\u015ft\u0131rd\u0131\u011f\u0131\u00a0gibi sonu\u00e7lar\u0131 da anlams\u0131z k\u0131lmaktad\u0131r.<\/p>\n
Kanserler, nedenleri \u00e7ok de\u011fi\u015fik olan\u00a0bir grup hastal\u0131kt\u0131r. Kanserin etyolojisi kesin\u00a0olarak ortaya konmam\u0131\u015f olmakla birlikte,\u00a0insanlardaki kanserlerin b\u00fcy\u00fck b\u00f6l\u00fcm\u00fcn\u00fcn\u00a0(%80 kadar\u0131) \u00e7evresel etkiler ve\u00a0ya\u015fam bi\u00e7imi \u00f6zellikleri sonucu meydana\u00a0geldi\u011fi bilinmektedir.<\/p>\n
Bu fakt\u00f6rler aras\u0131nda en b\u00fcy\u00fck pay\u0131 sigara\u00a0i\u00e7ilmesi ve beslenme ile ilgili hatal\u0131 uygulamalar\u00a0almaktad\u0131r. Kanserin nedenleri\u00a0aras\u0131nda mesleksel fakt\u00f6rlerin de rol\u00fc vard\u0131r.\u00a0\u0130nsanlardaki kanserlerin %4-5 kadar\u0131\u00a0\u00e7al\u0131\u015fma s\u0131ras\u0131nda kar\u015f\u0131la\u015f\u0131lan fakt\u00f6rlerin etkisi\u00a0ile meydana gelmektedir. Ortalama\u00a0olarak % 4-5 dolay\u0131nda olan mesleksel fakt\u00f6rlerin\u00a0pay\u0131 baz\u0131 kanser t\u00fcrlerinde (\u00f6rne\u011fin\u00a0akci\u011fer kanserinde) % 10-15 dolay\u0131na\u00a0kadar \u00e7\u0131karken, sindirim sistemi kanserlerinde\u00a0% 1-2 dolay\u0131nda \u00e7ok daha d\u00fc\u015f\u00fck pay\u00a0almaktad\u0131r.<\/p>\n
Mesleksel maruziyet sonucu meydana\u00a0gelen kanserler, di\u011fer nedenlerle meydana\u00a0gelen kanserlere g\u00f6re daha gen\u00e7 ya\u015flarda\u00a0ortaya \u00e7\u0131kmaktad\u0131r. Bunda \u00e7al\u0131\u015fma ortam\u0131ndaki\u00a0etkilenmenin s\u00fcrekli ve y\u00fcksek\u00a0dozda olmas\u0131n\u0131n rol\u00fc oldu\u011fu d\u00fc\u015f\u00fcn\u00fclmektedir.\u00a0Kanserin olu\u015fum ve geli\u015fmesi \u00e7ok\u00a0uzun bir zaman s\u00fcresini kapsad\u0131\u011f\u0131ndan,\u00a0mesleksel riskle kanser aras\u0131ndaki nesnellik\u00a0ba\u011f\u0131 kurmada g\u00fc\u00e7l\u00fckler olmaktad\u0131r.\u00a0Hastan\u0131n herhangi bir sebepten (hastal\u0131k,\u00a0\u00f6l\u00fcm, i\u015f de\u011fi\u015ftirme vb.) \u00f6t\u00fcr\u00fc i\u015fyerinden\u00a0ayr\u0131lmas\u0131ndan y\u0131llar sonra hastal\u0131\u011f\u0131n te\u015fhis\u00a0edilmesi sebep-sonu\u00e7 ili\u015fkisinin ortaya konulmas\u0131n\u0131\u00a0\u00f6nlemektedir.<\/p>\n
Bunun sonucu olarak hastal\u0131\u011f\u0131n mesleki\u00a0y\u00f6n\u00fc g\u00f6r\u00fclmekte, insidans ve prevalans\u00a0k\u00fc\u00e7\u00fck g\u00f6sterilmektedir.<\/p>\n
Bu nedenle Uluslararas\u0131 Kanser Ara\u015ft\u0131rma\u00a0Ajans\u0131 (IARC), \u201ckanserli hastalar\u0131 takip\u00a0eden klinisyenlerin, \u00f6zellikle elleri ile\u00a0\u00e7al\u0131\u015fan, burun, akci\u011fer, plevra, deri, mesane\u00a0ve hematopoetik sistem gibi mesleksel\u00a0kanserojenlerden etkilenen b\u00f6lgelerde\u00a0kanserli hastalar\u0131n mesleksel anamnezlerinin\u00a0\u00e7ok ayr\u0131nt\u0131l\u0131 olarak al\u0131nmas\u0131n\u0131\u201d tavsiye\u00a0etmektedir.<\/p>\n
Mesleksel kanserlerin tan\u0131 ve tedavisi,\u00a0kanserin t\u00fcr\u00fcne g\u00f6re \u00f6zellik arz eder. Ancak\u00a0tan\u0131 bak\u0131m\u0131ndan \u00e7al\u0131\u015fma \u00f6yk\u00fcs\u00fcn\u00fcn\u00a0iyi de\u011ferlendirilmesi, kanserin mesleksel\u00a0nedeninin ayd\u0131nlat\u0131lmas\u0131 bak\u0131m\u0131ndan\u00a0\u00f6nemlidir. \u00d6zellikle akci\u011fer kanseri, mezotelyoma,\u00a0mesane kanseri, l\u00f6semi olgular\u0131ndan\u00a0mesleksel etyoloji hat\u0131rlanmal\u0131 ve\u00a0hastalar\u0131n \u00e7al\u0131\u015fma \u00f6yk\u00fcs\u00fc ayr\u0131nt\u0131l\u0131 olarak\u00a0\u00f6\u011frenilmelidir.<\/p>\n
Mesleksel Kanserlerin Tarihsel\u00a0Geli\u015fimi<\/strong><\/p>\n Kanser olu\u015funda mesleksel fakt\u00f6rlerin\u00a0rol\u00fcne ilk kez 1775 y\u0131l\u0131nda Londra\u2019da\u00a0St.Bartholomew Hastanesi doktorlar\u0131ndan\u00a0Dr.Percival Pott i\u015faret etmi\u015ftir. Dr. Pott, o\u00a0zamana kadar venereal nedenli olarak d\u00fc\u015f\u00fcn\u00fclen\u00a0bu kanserin nedeninin baca i\u00e7inde\u00a0birikmi\u015f olan kurum ve katran oldu\u011funu\u00a0iddia etmi\u015ftir. Sonralar\u0131 \u00e7al\u0131\u015fmalar\u0131ndan\u00a0dolay\u0131 krali\u00e7e taraf\u0131ndan \u201cSir\u201d \u00fcnvan\u0131 ile\u00a0\u00f6d\u00fcllendirilen Dr. Pott, \u0130ngiltere\u2019de baca\u00a0temizleme i\u015finde \u00e7al\u0131\u015fan \u00e7ocuklar aras\u0131nda\u00a0ileri ya\u015flarda skrotum kanserinin s\u0131k olarak\u00a0g\u00f6r\u00fclmesine dikkat \u00e7ekmi\u015ftir. Bu bulu\u015fun\u00a0sonucu olarak, gen\u00e7 i\u015f\u00e7ilerin bacalarda\u00a0\u00e7al\u0131\u015fmas\u0131n\u0131 \u00f6nleyen kanun \u00e7\u0131kar\u0131lm\u0131\u015ft\u0131r\u00a0(1840). Hen\u00fcz mikrobun bulunmad\u0131\u011f\u0131\u00a0ve hastal\u0131klar\u0131n nedenleri konular\u0131ndaki\u00a0bilgilerin \u00e7ok s\u0131n\u0131rl\u0131 oldu\u011fu bir d\u00f6nemde\u00a0b\u00f6ylesine bir saptaman\u0131n yap\u0131lm\u0131\u015f\u00a0olmas\u0131 \u00e7ok \u00f6nemlidir.<\/p>\n Kanserin nedeni konusundaki bu g\u00f6zlem,\u00a0mesleksel kanser konusunda ilk tespit\u00a0olmas\u0131n\u0131n \u00f6tesinde \u00e7o\u011fu kaynakta kanser\u00a0epidemiyolojisinin de ba\u015flang\u0131c\u0131 olarak de\u011ferlendirilmektedir.<\/p>\n Percival Pott taraf\u0131ndan bu bilginin ortaya\u00a0konmas\u0131ndan 150 y\u0131l kadar sonra,\u00a01932 y\u0131l\u0131nda bu kansere yol a\u00e7an kimyasal\u00a0etken (katran; 1-2 dibenz antrasen) ilk\u00a0kimyasal kanserojen madde olarak tan\u0131mlanm\u0131\u015ft\u0131r.\u00a0Mesleki kanserler i\u00e7inde s\u0131k rastlanan\u00a0\u201cmesane kanserleri\u201d ilk belirlenenler\u00a0aras\u0131nda yer almaktad\u0131r. Boya sanayi,\u00a019\u2019uncu yy ortalar\u0131nda geli\u015fmeye ba\u015flam\u0131\u015ft\u0131r.\u00a0Percival Pott\u2019un g\u00f6zleminden uzunca bir zaman sonra 1895 y\u0131l\u0131nda Rehn, boya\u00a0sanayisinde \u00e7al\u0131\u015fanlar aras\u0131nda mesane\u00a0kanserinin s\u0131k g\u00f6r\u00fcld\u00fc\u011f\u00fcne i\u015faret etmi\u015ftir.<\/p>\n \u00d6nceleri bu kanserin, boya i\u015flerinde s\u0131k\u00a0olarak kullan\u0131lan anilin nedeni ile meydana\u00a0geldi\u011fi san\u0131lm\u0131\u015f ve bu nedenle boya\u00a0i\u015finde \u00e7al\u0131\u015fanlarda g\u00f6r\u00fclen mesane kanserlerine\u00a0\u201canilin kanseri\u201d ad\u0131 verilmi\u015ftir.\u00a0Ancak 1950 ve izleyen y\u0131llarda Case ve arkada\u015flar\u0131n\u0131n\u00a0yapt\u0131klar\u0131 \u00e7al\u0131\u015fmalar sonunda,\u00a0mesane kanserine neden olan maddenin\u00a0anilin de\u011fil, naftil amin oldu\u011fu ortaya konmu\u015ftur.<\/p>\n Son y\u0131llarda da asbeste ba\u011fl\u0131 solunum\u00a0yollar\u0131 kanserlerinde\u00a0art\u0131\u015f g\u00f6zlenmi\u015ftir. Asbest\u00a0bir yandan asbestozise\u00a0(akci\u011ferlerde diff\u00fcz fibrozis\u00a0ve plevra kal\u0131nla\u015fmas\u0131\u00a0ile tan\u0131nan interstisyel fibrozis)\u00a0neden olurken bir\u00a0yandan da metaplazik de\u011fi\u015fikliklere\u00a0neden olmaktad\u0131r.<\/p>\n Sigara t\u00fcketimi, riski daha\u00a0da artt\u0131rmaktad\u0131r. B\u00f6ylece sigara\u00a0t\u00fcketimi ile asbest aras\u0131nda\u00a0akci\u011fer kanseri y\u00f6n\u00fcnden\u00a0bir sinerjizm vard\u0131r.<\/p>\n T\u00fcrkiye\u2019deki ve D\u00fcnyadaki\u00a0Durumu<\/strong><\/p>\n D\u00fcnyada her y\u0131l 8 milyonun\u00a0\u00fczerinde insan kansere yakalanmakta\u00a0ve 7 milyondan fazla insan da kanser nedeniyle\u00a0hayat\u0131n\u0131 kaybetmektedir. \u00c7e\u015fitli\u00a0ara\u015ft\u0131rmalar mesleksel kanserlerin, t\u00fcm\u00a0kanserler i\u00e7indeki oran\u0131n\u0131n % 2-8 aras\u0131nda\u00a0oldu\u011funu yazmaktad\u0131rlar.\u00a0\u00dclkemizde mesleksel kanserlere ili\u015fkin\u00a0kesin veri yoktur. Sosyal Sigortalar Kurumu\u00a0y\u0131ll\u0131k istatistiklerinde mesleksel kanserler\u00a0g\u00f6sterilmemektedir. Bu nedenle \u00fclkenin\u00a0t\u00fcm\u00fcne ili\u015fkin bir say\u0131 ifade edilememektedir.\u00a0\u00dclkemizde mesleksel kanserler,\u00a0\u00e7al\u0131\u015fanlarda g\u00f6r\u00fclen kanser vakalar\u0131n\u0131n\u00a0% 2-8 aras\u0131nda olaca\u011f\u0131n\u0131 d\u00fc\u015f\u00fcnd\u00fcrmektedir.<\/p>\n Sosyal Sigortalar Sa\u011fl\u0131k \u0130\u015flemleri T\u00fcz\u00fc\u011f\u00fc, hangi hastal\u0131klar\u0131n mesleksel oldu\u011funu\u00a0s\u0131ralam\u0131\u015ft\u0131r.<\/p>\n Mesleksel Kanserlerden Korunma<\/strong><\/p>\n Mesleksel kanserler bir t\u00fcr meslek hastal\u0131\u011f\u0131d\u0131r.\u00a0Bu nedenle korunma bak\u0131m\u0131ndan\u00a0meslek hastal\u0131klar\u0131ndan korunma ilkeleri\u00a0ge\u00e7erlidir. Ger\u00e7ekte insanlardaki kanser olgular\u0131n\u0131n\u00a0\u00f6nemli bir b\u00f6l\u00fcm\u00fcnde kanserin\u00a0nedeni a\u00e7\u0131k olarak bilinmemektedir. Oysa\u00a0mesleksel kanserlerde korunma di\u011fer kanserlere\u00a0oranla daha olanakl\u0131d\u0131r. Korunma\u00a0bak\u0131m\u0131ndan teknik ve t\u0131bbi \u00f6nlemler s\u00f6z\u00a0konusudur.<\/p>\n Teknik Korunma \u00d6nlemleri<\/strong><\/p>\n Mesleksel kanserlerden korunma bak\u0131m\u0131ndan\u00a0teknik korunma \u00f6nlemlerinin\u00a0amac\u0131, kanserin nedeni olan\u00a0maddenin\u201ckayna\u011f\u0131nda\u201d kontrol alt\u0131na al\u0131nmas\u0131d\u0131r.\u00a0Bu ama\u00e7la yap\u0131lacak en kesin uygulama,\u00a0kanserojen maddenin kullan\u0131mdan\u00a0kald\u0131r\u0131lmas\u0131 ve hi\u00e7 kullan\u0131lmamas\u0131d\u0131r.\u00a0Bu maddenin yerine kullan\u0131labilecek ba\u015fka\u00a0maddeler bulunabilir ve kanserojen madde\u00a0yerine, kanser yap\u0131c\u0131 etkisi olmayan di\u011fer\u00a0maddeler kullan\u0131labilir.\u00a0Asbest yerine lifsel yap\u0131da sentetik baz\u0131\u00a0maddelerin kullan\u0131m\u0131 veya benzen yerine\u00a0toluen, ksilen veya hekzan gibi ba\u015fka\u00a0\u00e7\u00f6z\u00fcc\u00fclerin kullan\u0131lmas\u0131 bu konunun iyi\u00a0bilinen \u00f6rnekleridir. Ancak baz\u0131 durumlarda\u00a0bu olanakl\u0131 de\u011fildir ve \u00e7al\u0131\u015fma hayat\u0131n\u0131n\u00a0s\u00fcrmesi bak\u0131m\u0131ndan s\u00f6z konusu\u00a0maddenin kullan\u0131lmas\u0131 gerekmektedir. Bu\u00a0durumda da etkili havaland\u0131rma sistemleri\u00a0kurulmas\u0131, i\u015flemin kapal\u0131 sistem i\u00e7inde\u00a0yap\u0131lmas\u0131 \u015feklinde \u00e7o\u011funlukla m\u00fchendislik\u00a0uygulamalar\u0131 \u015feklinde koruyucu yakla\u015f\u0131mlar\u00a0s\u00f6z konusudur. Ancak kayna\u011fa y\u00f6nelik\u00a0olan bu uygulamalara ek olarak maske,\u00a0eldiven vb. ki\u015fisel koruyucu ara\u00e7lar\u0131n\u00a0kullan\u0131lmas\u0131 da korunma bak\u0131m\u0131ndan yarar\u00a0sa\u011flar. Kimi zamanda kanserojen maddenin\u00a0kullan\u0131m\u0131 tamamen\u00a0kapat\u0131lm\u0131\u015f d\u00fczenekler i\u00e7inde\u00a0yap\u0131l\u0131r veya bu i\u015flerin\u00a0s\u00fcrd\u00fcr\u00fclmesinde robotlardan\u00a0yararlan\u0131l\u0131r. Bu uygulamalar\u00a0radyoaktif maddelerin\u00a0kullan\u0131ld\u0131\u011f\u0131 i\u015fler i\u00e7in\u00a0s\u00f6z konusudur.<\/p>\n T\u0131bbi Korunma\u00a0\u00d6nlemleri<\/strong><\/p>\n Meslek hastal\u0131klar\u0131ndan\u00a0korunmada t\u0131bbi\u00a0yakla\u015f\u0131mlar, i\u015fe giri\u015f\u00a0muayenesi, aral\u0131kl\u0131 kontrol\u00a0muayenesi ve sa\u011fl\u0131k\u00a0e\u011fitimi \u015feklinde \u00f6zetlenebilir.\u00a0\u0130\u015fe giri\u015f muayenesinde\u00a0\u00e7al\u0131\u015fma ortam\u0131 ve\u00a0kar\u015f\u0131la\u015f\u0131lan maddeler bak\u0131m\u0131ndan risk yaratabilecek\u00a0\u00f6zellikler y\u00f6n\u00fcnden de\u011ferlendirme\u00a0yap\u0131l\u0131r ve sak\u0131ncal\u0131 olanlar\u0131n ba\u015fka\u00a0i\u015flere y\u00f6nlendirilmesi sa\u011flan\u0131r. \u00d6rne\u011fin sigara\u00a0i\u00e7en bir ki\u015finin asbest maruziyeti olan\u00a0bir i\u015fte \u00e7al\u0131\u015fmas\u0131 veya kan hastal\u0131\u011f\u0131 olan bir\u00a0ki\u015finin benzen veya radyasyon maruziyeti\u00a0olan bir i\u015fte \u00e7al\u0131\u015fmas\u0131 sak\u0131ncal\u0131d\u0131r.\u00a0Aral\u0131kl\u0131 kontrol muayenelerinde hastal\u0131\u011f\u0131n\u00a0t\u00fcr\u00fcne g\u00f6re erken tan\u0131 olana\u011f\u0131 sa\u011flayabilecek\u00a0muyeneler yap\u0131l\u0131r. \u00d6rne\u011fin boya\u00a0ve lastik sanayinde \u00e7al\u0131\u015fan bir ki\u015fide mesane\u00a0kanserinin erken tan\u0131s\u0131 amac\u0131 ile aral\u0131kl\u0131\u00a0olarak idrar sitolojisi yap\u0131lmas\u0131 uygun\u00a0olur. \u00c7al\u0131\u015f\u0131lan i\u015fin niteli\u011fine g\u00f6re olas\u0131 riskler\u00a0ve korunma yollar\u0131 konular\u0131 da sa\u011fl\u0131k\u00a0e\u011fitiminin konular\u0131n\u0131 olu\u015fturur.<\/p>\n","protected":false},"excerpt":{"rendered":" Bilim ve teknolojinin her ge\u00e7en g\u00fcn\u00a0h\u0131zla geli\u015fmesi sonucu, ortaya yeni\u00a0kanserojenlerin \u00e7\u0131kmas\u0131yla beraber her\u00a0g\u00fcn baz\u0131 maddelerin<\/p>\n","protected":false},"author":1,"featured_media":409,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[8],"tags":[],"_links":{"self":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/153"}],"collection":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/comments?post=153"}],"version-history":[{"count":3,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/153\/revisions"}],"predecessor-version":[{"id":489,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/posts\/153\/revisions\/489"}],"wp:featuredmedia":[{"embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/media\/409"}],"wp:attachment":[{"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/media?parent=153"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/categories?post=153"},{"taxonomy":"post_tag","embeddable":true,"href":"http:\/\/www.istesaglikdergisi.com.tr\/index.php\/wp-json\/wp\/v2\/tags?post=153"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}