title: Laryngeal and hypopharyngeal cancer and occupational exposure to asbestos and man-made vitreous fibers: results of a case-control study.
abstract: BACKGROUND
  The data from a case-control study performed in France between 1989 and 1991 were used to test whether exposure to either asbestos or to man-made vitreous fibers (MMVF) is a risk factor for cancer of the larynx or the hypopharynx.
  
  
  METHODS
  This study involved 315 incident cases of laryngeal cancer, 206 cases of hypopharyngeal cancer, and 305 hospital-based controls with other types of cancer, all recruited in 15 hospitals in six French cities. The subjects' past occupational exposure to asbestos and to four types of MMVF (mineral wool, refractory ceramic fibers, glass filaments, and microfibers) was evaluated based on their job history, with the aid of a job-exposure matrix. Odds ratios were calculated with unconditional logistic regression, with adjustment for smoking and drinking levels.
  
  
  RESULTS
  Exposure to asbestos resulted in a significant increase in the risk of hypopharyngeal cancer (OR = 1.80, 95% CI: 1.08-2.99) and a nonsignificant increase in the risk of laryngeal cancer (OR = 1.24, 95% CI: 0.83-1.90). Risk was highest for the epilarynx (highest cumulative level of exposure: OR = 2.22, 95% CI: 1.05-4.71). Exposure to mineral wools was of borderline significance for the risk of hypopharyngeal cancer (OR = 1.55, 95% CI: 0.99-2.41), and nonsignificantly associated with the risk of laryngeal cancer (OR-1.33, 95% CI: 0.91-1.95). The risk was again highest for the epilarynx (OR = 1.85, 95% CI: 1.08-3.17). No significant results were observed for the other MMVF.
  
  
  CONCLUSIONS
  These results suggest that asbestos exposure increases the risk of epilaryngeal and hypopharyngeal cancers. It is difficult to reach a conclusion about the effects of mineral wools, because nearly all the exposed subjects were also exposed to asbestos. The possible effects of other MMVF were difficult to assess in this study, because of the paucity of exposed subjects.
authors.affiliation: Institut National de la Santé et de la Recherche Médicale (INSERM), Unité 88, St-Maurice, France.
authors.forename: J L
authors.initials: JL
authors.lastname: Marchand
authors.forename: D
authors.initials: D
authors.lastname: Luce
authors.forename: A
authors.initials: A
authors.lastname: Leclerc
authors.forename: P
authors.initials: P
authors.lastname: Goldberg
authors.forename: E
authors.initials: E
authors.lastname: Orlowski
authors.forename: I
authors.initials: I
authors.lastname: Bugel
authors.forename: J
authors.initials: J
authors.lastname: Brugère
mesh_terms: D000328:Adult; D000368:Aged; D001195:Asbestosis / Q000209:etiology*; D017610:Calcium Compounds / Q000009:adverse effects*; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D016022:Case-Control Studies; D003043:Cocarcinogenesis; D005602:France; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000209:etiology*; D007822:Laryngeal Neoplasms / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D012307:Risk Factors; D017640:Silicates / Q000009:adverse effects*; D012907:Smoking / Q000009:adverse effects
chemical_list: D017610:Calcium Compounds; D017640:Silicates; C031293:calcium silicate