title: Occupational exposures to asbestos, polycyclic aromatic hydrocarbons and solvents, and cancers of the oral cavity and pharynx: a quantitative literature review.
abstract: OBJECTIVE
  The role of occupational risk factors in oral and pharyngeal cancer is not well known and is possibly underestimated. This quantitative review summarizes epidemiological findings on exposure to asbestos, polycyclic aromatic hydrocarbons and solvents, and cancers of the oral cavity and pharynx.
  
  
  METHODS
  A systematic literature search was performed. We analyzed 63 publications: 8 from case-control studies and 55 from cohort studies. For agents with at least five available studies with homogenous exposure, a series of meta-analyses was conducted to provide quantitative pooled estimates of risks, using random effect models.
  
  
  RESULTS
  Exposure to asbestos (meta-RR 1.25; 95% CI 1.10-1.42) and to polycyclic aromatic hydrocarbons (meta-RR 1.14; 95% CI 1.02-1.28) was found to be associated with oral and pharyngeal cancer risk. On the other hand, no association was found with exposure to solvents in general (meta-RR 0.98; 95% CI 0.77-1.23) but the strong heterogeneity between studies suggested differences in exposures. The small number of studies with homogeneous exposure did not allow meta-analyses for specific solvents.
  
  
  CONCLUSIONS
  Future investigations should overcome common weaknesses of past studies, in terms of sample size, characterization of exposure, and classification of cancer sites.
authors.affiliation: Inserm UMRS 1018, CESP, Epidemiology of Occupational and Social Determinants of Health, Centre for Research in Epidemiology and Population Health, 15/16, avenue Paul Vaillant Couturier, 94807, Villejuif, France.
authors.forename: Sophie
authors.initials: S
authors.lastname: Paget-Bailly
authors.forename: Diane
authors.initials: D
authors.lastname: Cyr
authors.forename: Danièle
authors.initials: D
authors.lastname: Luce
mesh_terms: D001194:Asbestos / Q000009:adverse effects*; D006801:Humans; D009062:Mouth Neoplasms / Q000139:chemically induced*; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects*; D010610:Pharyngeal Neoplasms / Q000139:chemically induced*; D011084:Polycyclic Aromatic Hydrocarbons / Q000009:adverse effects*; D012997:Solvents / Q000009:adverse effects*
chemical_list: D011084:Polycyclic Aromatic Hydrocarbons; D012997:Solvents; D001194:Asbestos