Outbreak of cholangiocarcinoma developing in printing company workers: new occupational disease

Abstract

An outbreak of cholangiocarcinoma occurred among young adult workers in the offset color proof-printing department at a printing company in Japan. They were exposed to chemicals, including dichloromethane and 1,2-dichloropropane. The measurement of liver function tests and tumor markers, and ultrasonography was useful to detect the cholangiocarcinoma in a regular health examination. Dilated intrahepatic bile ducts without tumor-induced obstruction as well as a space-occupying lesion, bile duct stenosis, and dilatation of bile duct due to main tumor were observed in diagnostic imaging. The cholangiocarcinomas arose from the large bile ducts. The precancerous or early cancerous lesions, such as biliary intraepithelial neoplasia and intraductal papillary neoplasm of the bile ducts, as well as non-specific bile duct injuries, such as fibrosis, were observed in various sites of the bile ducts. The cholangiocarcinoma are now recognized as a new occupational disease.