Occupational exposures and head and neck cancers among Swedish construction workers.
OBJECTIVE
Occupational exposures in the construction industry may increase the risk of head and neck cancers, although the epidemiologic evidence is limited by problems of low study power and inadequate adjustment for tobacco use. In an attempt to address this issue, the relationship between selected occupational exposures and head and neck cancer risk was investigated using data from a large cohort of Swedish construction workers.


METHODS
Altogether 510 squamous cell carcinomas of the head and neck (171 in the oral cavity, 112 in the pharynx, 227 in the larynx) were identified during 1971-2001 among 307 799 male workers in the Swedish construction industry. Exposure to diesel exhaust, asbestos, organic solvents, metal dust, asphalt, wood dust, stone dust, mineral wool, and cement dust was assessed using a semi-quantitative job-exposure matrix. Rate ratios (RR) and 95% confidence intervals (95% CI) were calculated for head and neck cancers in relation to occupational exposure, using Poisson regression with adjustment for age and smoking status.


RESULTS
Asbestos exposure was related to an increased laryngeal cancer incidence (RR 1.9, 95% CI 1.2-3.1). Excesses of pharyngeal cancer were observed among workers exposed to cement dust (RR 1.9, 95% CI 1.2-3.1). No occupational exposures were associated with oral cavity cancer. These findings did not materially change upon additional adjustment for cigarette pack-years.


CONCLUSIONS
These findings offer further evidence that asbestos increases the risk of laryngeal cancer. The observation of a positive association between cement dust exposure and pharyngeal cancer warrants further investigation.
Purdue
Mark P
MP
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 6120 Executive Blvd, EPS 8111, Rockville, MD 20852, USA. purduem@mail.nih.gov
Järvholm
Bengt
B
Bergdahl
Ingvar A
IA
Hayes
Richard B
RB
Baris
Dalsu
D
D000328:Adult; D000368:Aged; D001194:Asbestos / Q000009:adverse effects; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology*; D015331:Cohort Studies; D003252:Construction Materials / Q000009:adverse effects*; D004391:Dust; D006258:Head and Neck Neoplasms / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D007822:Laryngeal Neoplasms / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D010610:Pharyngeal Neoplasms / Q000209:etiology; D012907:Smoking / Q000009:adverse effects; D013548:Sweden / Q000453:epidemiology
D004391:Dust; D001194:Asbestos