Assessing Lung Cancer Risks for Food Delivery Workers: Key Considerations

Regarding the job of food delivery and lung cancer?

Hello, Doctor! I would like to ask: 1.
Due to financial reasons, I have to spend a lot of time riding a motorcycle for food delivery (Foodpanda).
If I continue doing this for 20 years, will my risk of developing lung cancer be significantly high? What if I wear a mask? 2.
a.
What type of mask is the best to wear? b.
If using a standard surgical mask, should I wear two layers? c.
Do you think I need to purchase a specific type or model of mask? I'm willing to spend money on it.
3.
I would like to ask you, based on the following three points: 1- I previously did food delivery for a while without wearing a mask.
2- Compared to those who do not do food delivery, we are exposed to vehicle exhaust for long periods.
3- My family lives next to a busy road, with our living room window facing that road, and we have lived there for about 16 years.
Given these three factors, do you think I should consider paying for an LDCT scan for lung cancer, even though I may not qualify for assistance (I have never smoked and have no family history)? Thank you very much, Doctor.

Nìmíng, 30~39 year old female. Ask Date: 2024/04/27

Dr. Li Zhenggang reply Family Medicine

1.
According to a report by the WHO, one of the risk factors for lung cancer is air pollution.
Therefore, the longer the exposure to air pollution, the higher the risk compared to individuals who are not exposed to it.
As for whether the risk is "very high," that depends on each person's definition of "very high." For reference, the incidence rate of lung cancer in Taiwan in 2019 was 36 cases per 100,000 people.
2a.
Regarding masks, it is important to consider both filtration efficiency and comfort.
I am not an expert on this, so you may refer to the recommendations from the National Health Service.
2b.
Generally speaking, surgical masks are a good choice, and using two layers is actually unnecessary.
2c.
Special models are primarily used in specific situations, so I suggest considering them only if you encounter such circumstances.
3.
It is indeed worth considering self-paying for a low-dose computed tomography (CT) scan.

Reply Date: 2024/04/27

More Info

Assessing the lung cancer risks for food delivery workers involves several key considerations, especially given the unique exposure to environmental pollutants and the potential impact of prolonged exposure to vehicle emissions. Here’s a comprehensive overview based on your concerns:

1. Long-Term Exposure and Lung Cancer Risk
Working as a food delivery rider for an extended period, such as 20 years, does raise concerns about lung health, particularly due to exposure to air pollution. Studies have shown that long-term exposure to particulate matter (PM2.5) and other pollutants from vehicle emissions can increase the risk of respiratory diseases, including lung cancer. The International Agency for Research on Cancer (IARC) classifies air pollution, particularly PM2.5, as a Group 1 carcinogen, meaning there is sufficient evidence to suggest it can cause cancer in humans.

While wearing a mask can provide some level of protection, it is essential to understand the type of mask and its effectiveness against fine particulate matter.

2. Mask Recommendations
#
a. Best Type of Mask
For optimal protection against airborne pollutants, an N95 respirator is recommended. These masks are designed to filter out at least 95% of airborne particles, including PM2.5. However, they can be uncomfortable for long periods, especially during physical activity.

#
b. Surgical Masks
If you are using a surgical mask, wearing two layers may improve filtration but can also make breathing more difficult. The effectiveness of a surgical mask against fine particulate matter is significantly lower than that of an N95 mask.

#
c. Special Mask Types
If you are concerned about prolonged exposure to pollutants, investing in a high-quality mask, such as an N95 or a similar respirator, is advisable. These masks are more effective in filtering out harmful particles compared to standard surgical masks.

3. Need for LDCT Screening
Given your specific circumstances, including previous periods of not wearing a mask, long-term exposure to vehicle emissions, and living near a busy road, it is reasonable to consider lung cancer screening. While you may not fit the typical criteria for high-risk individuals (such as smokers or those with a family history of lung cancer), your unique exposure profile could warrant further investigation.

Low-Dose Computed Tomography (LDCT) is a sensitive screening tool for lung cancer and is particularly beneficial for individuals at risk due to environmental exposures. Although the standard recommendations focus on smokers and those with a family history, your prolonged exposure to pollutants could justify a discussion with your healthcare provider about the potential benefits of LDCT screening.

Conclusion
In summary, your role as a food delivery worker does expose you to increased risks for lung health, particularly if you are in areas with high traffic pollution. Wearing an appropriate mask, such as an N95, can help mitigate some risks, but it is not a complete solution. Given your exposure history, discussing the possibility of LDCT screening with your healthcare provider may be a prudent step.
Additionally, consider other lifestyle modifications to improve your lung health, such as ensuring good indoor air quality at home, using air purifiers, and minimizing exposure to other pollutants. Regular check-ups and being proactive about your health can help address any concerns you may have regarding lung cancer risks.

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