ORIGINAL ARTICLES

Occupational risks for adenocarcinoma of the nasal cavity and paranasal sinuses in the German wood industry

B Pesch¹, C B Pierl¹, M Gebel¹, I Gross¹, D Becker¹, G Johnen¹, H-P Rihs¹, K Donhuijsen², V Lepentsiotis³, M Meier³, J Schulze³, T Brüning¹

¹ BGFA-Forschungsinstitut für Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Bochum, Germany
² Institut für Pathologie, Städtisches Klinikum Braunschweig, Germany
³ Holz-Berufsgenossenschaft, München, Germany

Dr B Pesch, BGFA-Forschungsinstitut für Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany; pesch{at}bgfa.de

Objectives: To examine the risk of wood dust and chemical exposures for adenocarcinoma of the nasal cavity and paranasal sinuses (ADCN) among German wood workers.

Methods: An industry-based case-control study with 86 male ADCN cases and 204 controls was conducted in the German wood-working industries. Cumulative and average wood-dust exposure was quantified with a job-exposure matrix based on wood-dust measurements at recent and historical workplaces. Probabilities of exposure to wood preservatives, stains, varnishes, and formaldehyde were semi-quantitatively rated. Odds ratios and 95% confidence intervals were calculated with logistic regression analysis conditional on age and adjusted for smoking and other factors. For estimating the risks of either wood dust or chemical additives, the authors additionally adjusted for the corresponding co-exposure.

Results: ADCN occurred relatively more frequently among wood workers that had ever worked as cabinet makers or joiners (OR 2.96, 95% CI 1.46 to 6.01) than as saw millers (OR 0.15, 95% CI 0.03 to 0.68). Average exposure to inhalable wood dust 5 mg/m³ was associated with a high risk (OR 48.47, 95% CI 13.30 to 176.63) compared to levels below 3.5 mg/m³. Assuming 40 years of exposure under these concentrations, the corresponding OR was 4.20 (95% CI 1.69 to 10.43). Exposure between 3.5 and 5 mg/m³ was also found to pose a risk (OR 10.54, 95% CI 3.34 to 33.27). Exposure to pigment stains before 1970 was associated with an increased risk (OR 3.03; 95% CI 1.11 to 8.26). No significant associations were estimated for wood preservatives, varnishes, and formaldehyde.

Conclusions: The authors found an elevated ADCN risk for exposure to inhalable wood dust above 3.5 mg/m³. The rareness of the disease does not allow the exclusion of risk below that concentration. For pigment stains, there is evidence for an association of historical exposure with the development of ADCN in German wood workers.

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