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A Case-control Study on Occupational Risk Factors for Sino-nasal Cancer
  1. Angelo d'Errico (angelo.derrico{at}epi.piemonte.it)
  1. Epidemiology Unit, Piedmont Region, ASL TO3, Grugliasco (TO), Italy
    1. Sherri Pasian (smpasian{at}yahoo.ca)
    1. Epidemiology Unit, Piedmont Region, ASL TO3, Grugliasco (TO), Italy
      1. Alberto Baratti (alberto.baratti{at}asl17.it)
      1. Occupational Medicine Department, ASL CN1, Savigliano, Italy
        1. Roberto Zanelli (rzanelli{at}asl19.asti.it)
        1. Occupational Health and Safety Department, ASL AT, Asti, Italy
          1. Santo Alfonzo (santo.alfonzo{at}asl17.it)
          1. Occupational Health and Safety Department, ASL CN1, Saluzzo, Italy
            1. Luisella Gilardi (luisella.gilardi{at}dors.it)
            1. Documentation Center for Health Promotion, ASL TO3, Grugliasco, Italy
              1. Fabio Beatrice (fabio.beatrice{at}tin.it)
              1. Otolaryngology (ENT) Unit, Giovanni Bosco Hospital, Turin, Italy
                1. Antonella Bena (antonella.bena{at}epi.piemonte.it)
                1. Epidemiology Unit, Piedmont Region, ASL TO3, Grugliasco (TO), Italy
                  1. Giuseppe Costa (giuseppe.costa{at}unito.it)
                  1. University of Turin, Department of Public Health, Turin, Italy

                    Abstract

                    Objectives: 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 malignancies (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 (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.

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