Sinonasal cancer and occupational exposures: a pooled analysis of 12 case-control studies.
OBJECTIVE
In order to examine the associations between sinonasal cancer and occupational exposures other than wood dust and leather dust, the data from 12 case-control studies conducted in seven countries were pooled and reanalyzed.


METHODS
The pooled data set included 195 adenocarcinoma cases (169 men and 26 women), 432 squamous cell carcinomas (330 men and 102 women), and 3136 controls (2349 men and 787 women). Occupational exposures to formaldehyde, silica dust, textile dust, coal dust, flour dust, asbestos, and man-made vitreous fibers were assessed with a job-exposure matrix. Odds ratios (ORs) were adjusted for age, study, wood dust, and leather dust, or other occupational exposures when relevant. 95% confidence intervals (CIs) were estimated by unconditional logistic regression.


RESULTS
A significantly increased risk of adenocarcinoma was associated with exposure to formaldehyde. The ORs for the highest level of exposure were 3.0 (Cl = 1.5-5.7) among men and 6.2 (CI=2.0-19.7) among women. An elevated risk of squamous cell carcinoma was observed among men (OR=2.5, CI=0.6-10.1) and women (OR = 3.5, CI = 1.2-10.5) with a high probability of exposure to formaldehyde. Exposure to textile dust was associated with non-significantly elevated risk of adenocarcinoma, among women only: the OR for the high level of cumulative exposure was 2.5 (CI = 0.7-9.0). High level of asbestos exposure was associated with a significantly increased risk of squamous cell carcinoma among men (OR = 1.6, CI = 1.1-2.3).


CONCLUSIONS
The results of this pooled analysis support the hypothesis that occupational exposure to formaldehyde increases the risk of sinonasal cancer, particularly of adenocarcinoma. They also indicate an elevated risk of adenocarcinoma among women exposed to textile dust, and suggest that exposure to asbestos may increase the risk of squamous cell carcinoma.
Luce
Danièle
D
Inserm Unité 88, Hopital, National de Saint-Maurice, Saint-Maurice, France. d.luce@st-maurice.inserm.fr
Leclerc
Annette
A
Bégin
Denis
D
Demers
Paul A
PA
Gérin
Michel
M
Orlowski
Ewa
E
Kogevinas
Manolis
M
Belli
Stefano
S
Bugel
Isabelle
I
Bolm-Audorff
Ulrich
U
Brinton
Louise A
LA
Comba
Pietro
P
Hardell
Lennart
L
Hayes
Richard B
RB
Magnani
Corrado
C
Merler
Enzo
E
Preston-Martin
Susan
S
Vaughan
Thomas L
TL
Zheng
Wei
W
Boffetta
Paolo
P
D000230:Adenocarcinoma / Q000209:etiology*; D000328:Adult; D001194:Asbestos / Q000009:adverse effects; D002273:Carcinogens / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D016022:Case-Control Studies; D003031:Coal; D004202:Disinfectants / Q000009:adverse effects*; D004391:Dust; D005260:Female; D005557:Formaldehyde / Q000009:adverse effects*; D006801:Humans; D008297:Male; D019016:Mineral Fibers / Q000009:adverse effects; D016273:Occupational Exposure; D010255:Paranasal Sinus Neoplasms / Q000209:etiology*; D012307:Risk Factors
D002273:Carcinogens; D003031:Coal; D004202:Disinfectants; D004391:Dust; D019016:Mineral Fibers; D001194:Asbestos; D005557:Formaldehyde