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FROM THE AMERICAN ACADEMY OF PEDIATRICS: AMERICAN ACADEMY OF PEDIATRICS Section on Hematology/Oncology CHILDREN'S ONCOLOGY GROUP Long-term Follow-up Care for Pediatric Cancer Survivors Pediatrics 2009; 123: 906-915 [Abstract] [Full text] [PDF]

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Pediatric malignancy and occupational exposure to carcinogens

Heikki Savolainen   (3 March 2009)

Authors’ response to “Pediatric malignancy and occupational exposure to carcinogens”

Wendy Landier, Smita Bhatia, Jacqueline Casillas, Melissa M. Hudson   (4 March 2009)

Pediatric malignancy and occupational exposure to carcinogens 3 March 2009
Heikki Savolainen, Professor Dept. of Occup. Safety & Hlth., POB 536,Fin-33101 Tampere, Finland Send letter to journal: Re: Pediatric malignancy and occupational exposure to carcinogens heikki.savolainen{at}stm.fi Heikki Savolainen	Dear Editor, This very important statement is highly relevant also to practitioners of occupational medicine. As more and more patients survive to their adulthood thanks to improved care and start working they pose special problems to occupational health carers as to testing of their aptitude to work in jobs involving exposure to carcinogens (e.g. benzene in gasoline, diesel exhaust, tar products, welding etc.) or in their health surveillance. The problem is two-fold. One wonders whether the metabonomic basis that contributed to the early malignancy could be still operative and would render the subject susceptible to a new disease. The other question is whether a possible adult malignancy could be due to the early treatment or due to the exposure at work. Ideally, pediatricians and occupational health care specialists should formulate joint guidelines based on observational or other epidemiological studies. Conflict of Interest: None declared
Authors’ response to “Pediatric malignancy and occupational exposure to carcinogens” 4 March 2009
Wendy Landier, Clinical Director, Center for Cancer Survivorship City of Hope National Medical Center, Smita Bhatia, Jacqueline Casillas, Melissa M. Hudson Send letter to journal: Re: Authors’ response to “Pediatric malignancy and occupational exposure to carcinogens” wlandier{at}coh.org Wendy Landier, et al.	Dear Professor Savolainen, You raise important questions as to whether pediatric cancer survivors may be at increased risk related to occupational exposure to carcinogens and whether they may require increased health surveillance related to occupational exposures. We agree that observational or other epidemiological studies would help to answer these questions and could potentially provide the basis for formulation of guidelines addressing these issues. The Children’s Oncology Group Long-Term Follow-Up Guidelines include risk-stratified screening recommendations for common adult-onset cancers with intensified surveillance recommended for survivors whose childhood cancer treatment places them at increased risk for adult-onset cancers (e.g., breast cancer, colon cancer). In addition, the Guidelines emphasize health promotion behaviors aimed at reducing risk for adult-onset cancers (e.g., use of sunscreen to reduce skin cancer risk in survivors whose treatment included radiation). Incorporation of these recommendations in the occupational health setting as childhood cancer survivors enter the workforce would certainly be an appropriate application of these Guidelines. Wendy Landier, RN, MSN, CPNP Smita Bhatia, MD, MPH City of Hope National Medical Center, Duarte, CA Jacqueline Casillas, MD, MS Mattel Children’s Hospital at UCLA, Los Angeles, CA Melissa M. Hudson, MD St. Jude Children’s Research Hospital, Memphis, TN Conflict of Interest: None declared