Occupation and larynx and hypopharynx cancer: a job-exposure matrix approach in an international case-control study in France, Italy, Spain and Switzerland.
OBJECTIVE
To investigate the effect of exposure to occupational agents on the risk of hypopharyngeal/laryngeal cancer.


METHODS
Case-control study conducted during 1979-1982 in six centres in South Europe. An occupational history and information on exposure to non-occupational factors were collected for 1010 male cases of hypopharyngeal/ laryngeal cancer as well as for 2176 population controls. The exposure to 10 occupational agents was assessed through a job-exposure matrix. As occupational histories had been collected since 1945 major analyses were restricted to subjects aged less than 55 years (315 cases and 819 controls).


RESULTS
Significant elevated risks adjusted for non-occupational variables (smoking, alcohol consumption and diet) and other occupational exposures were consistently found for organic solvents (odds ratio (OR) for ever-exposure: 1.7, 95% confidence interval: 1.1-2.5) and asbestos (OR: 1.6, 1.0-2.5). A significant positive trend for both probability of exposure and duration was found for exposure to solvents. A positive association between exposure to formaldehyde and laryngeal cancer was also suggested. No association was found for exposure to arsenic and compounds, chromium and compounds, and polycyclic aromatic hydrocarbons. Analyses restricted to subjects aged 55 or more did not show elevated risks, with the exception of wood dust (OR: 1.8, 1.3-2.7).


CONCLUSIONS
In our study occupational exposure to solvents was associated with an increased risk of hypopharyngeal/laryngeal cancer. Results also provide additional evidence of an excess of risk for exposure to asbestos.
Berrino
Franco
F
Epidemiology Unit, National Cancer Institute, Milan, Italy.
Richiardi
Lorenzo
L
Boffetta
Paolo
P
Estève
Jacques
J
Belletti
Isabella
I
Raymond
Luc
L
Troschel
Loredana
L
Pisani
Paola
P
Zubiri
Lourdes
L
Ascunce
Nieves
N
Gubéran
Etienne
E
Tuyns
Albert
A
Terracini
Benedetto
B
Merletti
Franco
F
D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects*; D016022:Case-Control Studies; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D007822:Laryngeal Neoplasms / Q000453:epidemiology* / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D009790:Occupations; D016017:Odds Ratio; D012307:Risk Factors; D012997:Solvents / Q000009:adverse effects*
D012997:Solvents; D001194:Asbestos