[Occupational exposure and cancer of the oral cavity and pharynx].
BACKGROUND
Occupational risk factors for the development of laryngeal cancer are well accepted, whereas the etiologic relationship between occupational exposure to various noxious influences and the development of cancer of the oral cavity and pharynx remain a matter of debate. Based on published data, occupational risk factors for cancer of the oral cavity and pharynx should be evaluated.


METHODS
Publications since 1990 listed in the National Library of Medicine, textbooks and data obtained from the German Employer's Liability Insurance Association were evaluated.


RESULTS
In several tobacco- and alcohol-adjusted case-control and cohort studies, an association with occupation in construction and metalworking industries, as painters, carpenters and machine operators was consistently found. The relative risks or standardized mortality rates ranged between 1.5 and 3. Some recent investigations found an association for workers in the paper and rubber industry. The results in regard to the textile and woodworking industry were inconclusive.


CONCLUSIONS
In cases with moderate isolated tobacco or moderate isolated alcohol consumption, the risk attributable to occupational factors and smoking or drinking are of similar magnitude. According to German jurisdiction, a partial compensation of the acquired disability is then justified. In pronounced combined tobacco and alcohol consumption, the non-occupational risk factors increase exponentially and occupational risks attain marginal weight.
Univ. HNO-Klinik Ulm, Germany. herbert.riechelmann@medizin.uni-ulm.de
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D000293:Adolescent; D000328:Adult; D000428:Alcohol Drinking / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000209:etiology*; D016022:Case-Control Studies; D015331:Cohort Studies; D004185:Disability Evaluation; D005260:Female; D005858:Germany; D006801:Humans; D007351:Insurance, Liability / Q000331:legislation & jurisprudence; D008297:Male; D009062:Mouth Neoplasms / Q000209:etiology*; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure; D009790:Occupations; D010610:Pharyngeal Neoplasms / Q000209:etiology*; D011379:Prognosis; D012306:Risk; D012307:Risk Factors; D012907:Smoking / Q000009:adverse effects; D016540:Smoking Cessation