Gastric cancer in coal miners: an hypothesis of coal mine dust causation.

An hypothesis is proposed to explain the elevated incidence of gastric cancer among coal miners. Inhaled coal mine dust, especially the larger particles, is cleared from the lung and tracheobronchial tree by mucociliary function, swallowed, and introduced into the stomach. Organic and/or inorganic materials in the dust can undergo intra-gastric nitrosation and/or interaction with exogenous chemicals to form carcinogenic compounds which in turn may lead to precancerous lesions, which may subsequently develop into gastric cancer. This sequence of events, however, depends upon occupational exposures as well as life-style features and individual genetic predisposition.