title: Occupational exposure and laryngeal and hypopharyngeal cancer risk in central and eastern Europe.
abstract: A multicenter case-control study was conducted during 1999-2002 in four European countries (Poland, Romania, Russia, and Slovakia) to evaluate the role of occupational exposures in risk of laryngeal/hypopharyngeal cancer. Male cancer cases (34 hypopharyngeal, 316 laryngeal) with full data on occupational history and nonoccupational factors were compared with 728 hospital controls for occupational exposure to 73 suspected carcinogens. Occupational history was evaluated by industrial hygienists blinded to case/control status. Elevated risks for ever exposure to coal dust were found for both hypopharyngeal (odds ratio (OR) = 4.19, 95% confidence interval (CI): 1.18, 14.89) and laryngeal (OR = 1.81, 95% CI: 0.94, 3.47) cancer, with clear dose-response patterns. Inclusion of a 20-year lag in the analysis strengthened these associations. Hypopharyngeal cancer risk was also significantly associated with exposure to mild steel dust (OR = 3.04, 95% CI: 1.39, 6.64) and iron compounds and fumes (OR = 2.74, 95% CI: 1.29, 5.84), without clear dose-response relations. Laryngeal cancer was significantly associated with exposure to hard-alloys dust (OR = 2.23, 95% CI: 1.08, 4.57) and chlorinated solvents (OR = 2.18, 95% CI: 1.03, 4.61), without dose-response relations. A possible link between high formaldehyde exposure and laryngeal cancer was suggested. No association was found for exposure to asbestos or inorganic acid mists. These data indicate that occupational exposure to coal dust may play a role in laryngeal and hypopharyngeal cancer. Other possible relations need further evaluation.
authors.affiliation: Cancer Research Centre, Moscow, Russia.
authors.forename: Oxana
authors.initials: O
authors.lastname: Shangina
authors.forename: Paul
authors.initials: P
authors.lastname: Brennan
authors.forename: Neonila
authors.initials: N
authors.lastname: Szeszenia-Dabrowska
authors.forename: Dana
authors.initials: D
authors.lastname: Mates
authors.forename: Eleonóra
authors.initials: E
authors.lastname: Fabiánová
authors.forename: Tony
authors.initials: T
authors.lastname: Fletcher
authors.forename: Andrea
authors.initials: A
authors.lastname: t'Mannetje
authors.forename: Paolo
authors.initials: P
authors.lastname: Boffetta
authors.forename: David
authors.initials: D
authors.lastname: Zaridze
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005061:Europe, Eastern / Q000453:epidemiology; D006801:Humans; D007012:Hypopharyngeal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*