A case-control study on occupational risk factors for sino-nasal cancer.
OBJECTIVE
Sino-nasal cancer has been consistently associated with exposure to wood dust, leather dust, nickel and chromium compounds; for other occupational hazards, the findings are somewhat mixed. The aim of this study was to investigate the risk of sino-nasal epithelial cancer (SNEC) by histological type with prior exposure to suspected occupational risk factors and, in particular, those in metalworking.


METHODS
Between 1996 and 2000, incident cases were collected on a monthly basis from hospitals throughout the Piedmont region of Italy by the regional Sino-nasal Cancer Registry. A questionnaire on occupational history, completed by 113 cases and 336 hospital controls, was used to assign exposure to occupational hazards. The relationship between SNEC and cumulative exposure to these hazards was explored using unconditional logistic regression to statistically adjust for age, sex, smoking and co-exposures, allowing for a 10-year latency period.


RESULTS
The risk of adenocarcinoma was significantly increased with ever-exposure to wood dust (odds ratio; OR = 58.6), and to leather dust (OR = 32.8) and organic solvents (OR = 4.3) after controlling for wood dust, whereas ever-exposure to welding fumes (OR = 3.7) and arsenic (OR = 4.4) significantly increased the risk for squamous cell carcinoma. For each of these hazards, a significant increasing trend in risk across ordered cumulative exposure categories was found and, except for arsenic, a significantly increased risk with ever-exposure at low intensity. Treating cumulative exposure on a continuous scale, a significant effect of textile dusts was also observed for adenocarcinoma. For a mixed group of other histological types, a significant association was found with wood dust and organic solvents.


CONCLUSIONS
Some occupational risk factors for SNEC were confirmed, and dose-response relationships were observed for other hazards that merit further investigation. The high risk for adenocarcinoma with low-intensity exposure to wood dust lends support for a reduction in the occupational threshold value.
d'Errico
A
A
Local Health Unit ASL TO3, Epidemiology Department-Piedmont Region, Via Sabaudia 164, Grugliasco (TO) 10095, Italy. angelo.derrico@epi.piemonte.it
Pasian
S
S
Baratti
A
A
Zanelli
R
R
Alfonzo
S
S
Gilardi
L
L
Beatrice
F
F
Bena
A
A
Costa
G
G
D000230:Adenocarcinoma / Q000453:epidemiology / Q000209:etiology*; D000328:Adult; D017677:Age Distribution; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000453:epidemiology / Q000209:etiology*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D019570:Inhalation Exposure / Q000009:adverse effects / Q000032:analysis; D007558:Italy / Q000453:epidemiology; D008297:Male; D008669:Metallurgy; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects* / Q000032:analysis; D016017:Odds Ratio; D010255:Paranasal Sinus Neoplasms / Q000453:epidemiology / Q000209:etiology*; D012307:Risk Factors; D017678:Sex Distribution