Abstract
Purpose
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.
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References
Behrens T, Schill W, Ahrens W (2009) Elevated cancer mortality in a German cohort of bitumen workers: extended follow-up through 2004. J Occup Environ Hyg 6:555–561
Berrino F, Richiardi L, Boffetta P, Esteve J, Belletti I, Raymond L, Troschel L, Pisani P, Zubiri L, Ascunce N, Guberan E, Tuyns A, Terracini B, Merletti F (2003) Occupation and larynx and hypopharynx cancer: a job-exposure matrix approach in an international case-control study in France, Italy, Spain and Switzerland. Cancer Causes Control 14:213–223
Blair A, Hartge P, Stewart PA, McAdams M, Lubin J (1998) Mortality and cancer incidence of aircraft maintenance workers exposed to trichloroethylene and other organic solvents and chemicals: extended follow up. Occup Environ Med 55:161–171
Boffetta P, Burstyn I, Partanen T, Kromhout H, Svane O, Langard S, Jarvholm B, Frentzel-Beyme R, Kauppinen T, Stucker I, Shaham J, Heederik D, Ahrens W, Bergdahl IA, Cenee S, Ferro G, Heikkila P, Hooiveld M, Johansen C, Randem BG, Schill W (2003) Cancer mortality among European asphalt workers: an international epidemiological study. I. Results of the analysis based on job titles. Am J Ind Med 43:18–27
Boice JD Jr, Marano DE, Fryzek JP, Sadler CJ, McLaughlin JK (1999) Mortality among aircraft manufacturing workers. Occup Environ Med 56:581–597
Boice JD Jr, Marano DE, Cohen SS, Mumma MT, Blot WJ, Brill AB, Fryzek JP, Henderson BE, McLaughlin JK (2006) Mortality among Rocketdyne workers who tested rocket engines, 1948–1999. J Occup Environ Med 48:1070–1092
Bosetti C, Boffetta P, La VC (2007) Occupational exposures to polycyclic aromatic hydrocarbons, and respiratory and urinary tract cancers: a quantitative review to 2005. Ann Oncol 18:431–446
Chang YM, Tai CF, Yang SC, Lin RS, Sung FC, Shih TS, Liou SH (2005) Cancer incidence among workers potentially exposed to chlorinated solvents in an electronics factory. J Occup Health 47:171–180
Coble JB, Brown LM, Hayes RB, Huang WY, Winn DM, Gridley G, Bravo-Otero E, Fraumeni JF Jr (2003) Sugarcane farming, occupational solvent exposures, and the risk of oral cancer in Puerto Rico. J Occup Environ Med 45:869–874
Conway DI, McKinney PA, McMahon AD, Ahrens W, Schmeisser N, Benhamou S, Bouchardy C, Macfarlane GJ, Macfarlane TV, Lagiou P, Minaki P, Bencko V, Holcatova I, Merletti F, Richiardi L, Kjaerheim K, Agudo A, Castellsague X, Talamini R, Barzan L, Canova C, Simonato L, Lowry RJ, Znaor A, Healy CM, McCartan BE, Marron M, Hashibe M, Brennan P (2010) Socioeconomic factors associated with risk of upper aerodigestive tract cancer in Europe. Eur J Cancer 46:588–598
Dement J, Welch L, Haile E, Myers D (2009a) Mortality among sheet metal workers participating in a medical screening program. Am J Ind Med 52:603–613
Dement JM, Ringen K, Welch LS, Bingham E, Quinn P (2009b) Mortality of older construction and craft workers employed at Department of Energy (DOE) nuclear sites. Am J Ind Med 52:671–682
DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188
Donato F, Monarca S, Marchionna G, Rossi A, Cicioni C, Chiesa R, Colin D, Boffetta P (2000) Mortality from cancer and chronic respiratory diseases among workers who manufacture carbon electrodes. Occup Environ Med 57:484–487
D’Souza G, Kreimer AR, Viscidi R, Pawlita M, Fakhry C, Koch WM, Westra WH, Gillison ML (2007) Case-control study of human papillomavirus and oropharyngeal cancer. N Engl J Med 356:1944–1956
Egger M, Davey SG, Schneider M, Minder C (1997a) Bias in meta-analysis detected by a simple, graphical test. BMJ 315:629–634
Egger M, Zellweger-Zähner T, Schneider M, Junker C, Lengeler C, Antes G (1997b) Language bias in randomised controlled trials published in English and German. Lancet 350:326–329
Enterline PE, Hartley J, Henderson V (1987) Asbestos and cancer: a cohort followed up to death. Br J Ind Med 44:396–401
Evanoff BA, Gustavsson P, Hogstedt C (1993) Mortality and incidence of cancer in a cohort of Swedish chimney sweeps: an extended follow up study. Br J Ind Med 50:450–459
Ferlay J, Shin HR, Bray F, Forman D, Mathers C, Parkin DM (2010) Estimates of worldwide burden of cancer in 2008: GLOBOCAN 2008. Int J Cancer
Giaroli C, Beeli S, Bruno C, Candela S, Grignoli M, Minisci S, Poletti R, Ricco G, Vecchi G, Venturi G, Ziccardi A, Comba P (1994) Mortality study of asbestos cement workers. Int Arch Occup Environ Health 66:7–11
Gibbs GW, Sevigny M (2007) Mortality and cancer experience of Quebec aluminum reduction plant workers, part 4: cancer incidence. J Occup Environ Med 49:1351–1366
Goodman M, Morgan RW, Ray R, Malloy CD, Zhao K (1999) Cancer in asbestos-exposed occupational cohorts: a meta-analysis. Cancer Causes Control 10:453–465
Gustavsson P, Jakobsson R, Johansson H, Lewin F, Norell S, Rutkvist LE (1998) Occupational exposures and squamous cell carcinoma of the oral cavity, pharynx, larynx, and oesophagus: a case-control study in Sweden. Occup Environ Med 55:393–400
Hansen ES (1989) Cancer incidence in an occupational cohort exposed to bitumen fumes. Scand J Work Environ Health 15:101–105
Harding AH, Darnton A, Wegerdt J, McElvenny D (2009) Mortality among British asbestos workers undergoing regular medical examinations (1971–2005). Occup Environ Med 66:487–495
Hashibe M, Brennan P, Chuang SC, Boccia S, Castellsague X, Chen C, Curado MP, Dal ML, Daudt AW, Fabianova E, Fernandez L, Wunsch-Filho V, Franceschi S, Hayes RB, Herrero R, Kelsey K, Koifman S, La VC, Lazarus P, Levi F, Lence JJ, Mates D, Matos E, Menezes A, McClean MD, Muscat J, Eluf-Neto J, Olshan AF, Purdue M, Rudnai P, Schwartz SM, Smith E, Sturgis EM, Szeszenia-Dabrowska N, Talamini R, Wei Q, Winn DM, Shangina O, Pilarska A, Zhang ZF, Ferro G, Berthiller J, Boffetta P (2009) Interaction between tobacco and alcohol use and the risk of head and neck cancer: pooled analysis in the International Head and Neck Cancer Epidemiology Consortium. Cancer Epidemiol Biomarkers Prev 18:541–550
Hein MJ, Stayner LT, Lehman E, Dement JM (2007) Follow-up study of chrysotile textile workers: cohort mortality and exposure-response. Occup Environ Med 64:616–625
Higgins JP, Thompson SG, Deeks JJ, Altman DG (2003) Measuring inconsistency in meta-analyses. BMJ 327:557–560
Hoshuyama T, Pan G, Tanaka C, Feng Y, Yu L, Liu T, Liu L, Hanaoka T, Takahashi K (2006) Mortality of iron-steel workers in Anshan, China: a retrospective cohort study. Int J Occup Environ Health 12:193–202
Huebner WW, Schoenberg JB, Kelsey JL, Wilcox HB, McLaughlin JK, Greenberg RS, Preston-Martin S, Austin DF, Stemhagen A, Blot WJ (1992) Oral and pharyngeal cancer and occupation: a case-control study. Epidemiology 3:300–309
Hughes JM, Weill H, Hammad YY (1987) Mortality of workers employed in two asbestos cement manufacturing plants. Br J Ind Med 44:161–174
Hurley JF, Archibald RM, Collings PL, Fanning DM, Jacobsen M, Steele RC (1983) The mortality of coke workers in Britain. Am J Ind Med 4:691–704
Jones DR, Sutton AJ, Abrams KR, Fenty J, Warren F, Rushton L (2009) Systematic review and meta-analysis of mortality in crop protection product manufacturing workers. Occup Environ Med 66:7–15
Karlehagen S, Andersen A, Ohlson CG (1992) Cancer incidence among creosote-exposed workers. Scand J Work Environ Health 18:26–29
Krstev S, Stewart P, Rusiecki J, Blair A (2007) Mortality among shipyard Coast Guard workers: a retrospective cohort study. Occup Environ Med 64:651–658
Lehman EJ, Hein MJ (2006) Mortality of workers employed in shoe manufacturing: an update. Am J Ind Med 49:535–546
Levi F, Pasche C, La VC, Lucchini F, Franceschi S, Monnier P (1998) Food groups and risk of oral and pharyngeal cancer. Int J Cancer 77:705–709
Levin JL, McLarty JW, Hurst GA, Smith AN, Frank AL (1998) Tyler asbestos workers: mortality experience in a cohort exposed to amosite. Occup Environ Med 55:155–160
Lipworth L, La VC, Bosetti C, McLaughlin JK (2009) Occupational exposure to rock wool and glass wool and risk of cancers of the lung and the head and neck: a systematic review and meta-analysis. J Occup Environ Med 51:1075–1087
Loomis D, Dement JM, Wolf SH, Richardson DB (2009) Lung cancer mortality and fibre exposures among North Carolina asbestos textile workers. Occup Environ Med 66:535–542
Marchand JL, Luce D, Leclerc A, Goldberg P, Orlowski E, Bugel I, Brugere J (2000) Laryngeal and hypopharyngeal cancer and occupational exposure to asbestos and man-made vitreous fibers: results of a case-control study. Am J Ind Med 37:581–589
Menvielle G, Luce D, Goldberg P, Leclerc A (2004) Smoking, alcohol drinking, occupational exposures and social inequalities in hypopharyngeal and laryngeal cancer. Int J Epidemiol 33:799–806
Merletti F, Boffetta P, Ferro G, Pisani P, Terracini B (1991) Occupation and cancer of the oral cavity or oropharynx in Turin, Italy. Scand J Work Environ Health 17:248–254
Merlo DF, Garattini S, Gelatti U, Simonati C, Covolo L, Ceppi M, Donato F (2004) A mortality cohort study among workers in a graphite electrode production plant in Italy. Occup Environ Med 61:e9
Moulin JJ, Mur JM, Wild P, Demonchy A, Eloy E, Jeannot A (1988) Epidemiologic study of the mortality among the employees of a coal tar distillery. Rev Epidemiol Sante Publ 36:99–107
Moulin JJ, Clavel T, Buclez B, Laffitte-Rigaud G (2000a) A mortality study among workers in a French aluminium reduction plant. Int Arch Occup Environ Health 73:323–330
Moulin JJ, Clavel T, Roy D, Dananche B, Marquis N, Fevotte J, Fontana JM (2000b) Risk of lung cancer in workers producing stainless steel and metallic alloys. Int Arch Occup Environ Health 73:171–180
Mundt KA, Birk T, Burch MT (2003) Critical review of the epidemiological literature on occupational exposure to perchloroethylene and cancer. Int Arch Occup Environ Health 76:473–491
Nokso-Koivisto P, Pukkala E (1994) Past exposure to asbestos and combustion products and incidence of cancer among Finnish locomotive drivers. Occup Environ Med 51:330–334
Parnes SM (1990) Asbestos and cancer of the larynx: is there a relationship? Laryngoscope 100:254–261
Pira E, Pelucchi C, Piolatto PG, Negri E, Discalzi G, La VC (2007) First and subsequent asbestos exposures in relation to mesothelioma and lung cancer mortality. Br J Cancer 97:1300–1304
Pira E, Pelucchi C, Piolatto PG, Negri E, Bilei T, La VC (2009) Mortality from cancer and other causes in the Balangero cohort of chrysotile asbestos miners. Occup Environ Med 66:805–809
Pukkala E, Martinsen JI, Lynge E, Gunnarsdottir HK, Sparen P, Tryggvadottir L, Weiderpass E, Kjaerheim K (2009) Occupation and cancer—follow-up of 15 million people in five Nordic countries. Acta Oncol 48:646–790
Puntoni R, Merlo F, Borsa L, Reggiardo G, Garrone E, Ceppi M (2001) A historical cohort mortality study among shipyard workers in Genoa, Italy. Am J Ind Med 40:363–370
Purdue MP, Jarvholm B, Bergdahl IA, Hayes RB, Baris D (2006) Occupational exposures and head and neck cancers among Swedish construction workers. Scand J Work Environ Health 32:270–275
Raaschou-Nielsen O, Hansen J, McLaughlin JK, Kolstad H, Christensen JM, Tarone RE, Olsen JH (2003) Cancer risk among workers at Danish companies using trichloroethylene: a cohort study. Am J Epidemiol 158:1182–1192
Raffn E, Lynge E, Juel K, Korsgaard B (1989) Incidence of cancer and mortality among employees in the asbestos cement industry in Denmark. Br J Ind Med 46:90–96
Reid A, Ambrosini G, de Klerk N, Fritschi L, Musk B (2004) Aerodigestive and gastrointestinal tract cancers and exposure to crocidolite (blue asbestos): incidence and mortality among former crocidolite workers. Int J Cancer 111:757–761
Ruder AM, Ward EM, Dong M, Okun AH, vis-King K (2004) Mortality patterns among workers exposed to styrene in the reinforced plastic boatbuilding industry: an update. Am J Ind Med 45:165–176
Schildt EB, Eriksson M, Hardell L, Magnuson A (1999) Occupational exposures as risk factors for oral cancer evaluated in a Swedish case-control study. Oncol Rep 6:317–320
Shangina O, Brennan P, Szeszenia-Dabrowska N, Mates D, Fabianova E, Fletcher T, Mannetje A, Boffetta P, Zaridze D (2006) Occupational exposure and laryngeal and hypopharyngeal cancer risk in central and eastern Europe. Am J Epidemiol 164:367–375
Sherson D, Svane O, Lynge E (1991) Cancer incidence among foundry workers in Denmark. Arch Environ Health 46:75–81
Sim MR, Del MA, Hoving JL, Macfarlane E, McKenzie D, Benke G, de Klerk N, Fritschi L (2009) Mortality and cancer incidence in workers in two Australian prebake aluminium smelters. Occup Environ Med 66:464–470
Sluis-Cremer GK, Liddell FD, Logan WP, Bezuidenhout BN (1992) The mortality of amphibole miners in South Africa, 1946–80. Br J Ind Med 49:566–575
Sorahan T, Faux AM, Cooke MA (1994) Mortality among a cohort of United Kingdom steel foundry workers with special reference to cancers of the stomach and lung, 1946–1990. Occup Environ Med 51:316–322
Sorahan T, Hamilton L, van Tongeren M, Gardiner K, Harrington JM (2001) A cohort mortality study of U.K. carbon black workers, 1951–1996. Am J Ind Med 39:158–170
Spinelli JJ, Demers PA, Le ND, Friesen MD, Lorenzi MF, Fang R, Gallagher RP (2006) Cancer risk in aluminum reduction plant workers (Canada). Cancer Causes Control 17:939–948
Straif K, Baan R, Grosse Y, Secretan B, El GF, Cogliano V (2005) Carcinogenicity of polycyclic aromatic hydrocarbons. Lancet Oncol 6:931–932
Straif K, brahim-Tallaa L, Baan R, Grosse Y, Secretan B, El GF, Bouvard V, Guha N, Freeman C, Galichet L, Cogliano V (2009) A review of human carcinogens—part C: metals, arsenic, dusts, and fibres. Lancet Oncol 10:453–454
Strand LA, Martinsen JI, Koefoed VF, Sommerfelt-Pettersen J, Grimsrud TK (2010) Asbestos-related cancers among 28, 300 military servicemen in the Royal Norwegian Navy. Am J Ind Med 53:64–71
Swaen GM, Slangen JM (1997) Mortality in a group of tar distillery workers and roofers. Int Arch Occup Environ Health 70:133–137
Swaen GM, Slangen JJ, Volovics A, Hayes RB, Scheffers T, Sturmans F (1991) Mortality of coke plant workers in The Netherlands. Br J Ind Med 48:130–135
Tarvainen L, Kyyronen P, Kauppinen T, Pukkala E (2008) Cancer of the mouth and pharynx, occupation and exposure to chemical agents in Finland [in 1971–95]. Int J Cancer 123:653–659
Teta MJ, Ott MG, Schnatter AR (1987) Population based mortality surveillance in carbon products manufacturing plants. Br J Ind Med 44:344–350
Tsai SP, Ahmed FS, Wendt JK, Foster DE, Donnelly RP, Strawmyer TR (2007) A 56-year mortality follow-up of Texas petroleum refinery and chemical employees, 1948–2003. J Occup Environ Med 49:557–567
Ulvestad B, Kjaerheim K, Martinsen JI, Damberg G, Wannag A, Mowe G, Andersen A (2002) Cancer incidence among workers in the asbestos-cement producing industry in Norway. Scand J Work Environ Health 28:411–417
Ulvestad B, Kjaerheim K, Martinsen JI, Mowe G, Andersen A (2004) Cancer incidence among members of the Norwegian trade union of insulation workers. J Occup Environ Med 46:84–89
Ward EM, Ruder AM, Suruda A, Smith AB, Halperin W, Fessler CA, Zahm SH (1994) Cancer mortality patterns among female and male workers employed in a cable manufacturing plant during World War II. J Occup Med 36:860–866
Wartenberg D, Reyner D, Scott CS (2000) Trichloroethylene and cancer: epidemiologic evidence. Environ Health Perspect 108(Suppl 2):161–176
Wellmann J, Weiland SK, Neiteler G, Klein G, Straif K (2006) Cancer mortality in German carbon black workers 1976–1998. Occup Environ Med 63:513–521
Wong O, Harris F (2005) Retrospective cohort mortality study and nested case-control study of workers exposed to creosote at 11 wood-treating plants in the United States. J Occup Environ Med 47:683–697
Acknowledgments
Sophie Paget-Bailly received a funding from the Health, Environment, Toxicology program (SEnT) of the Ile-de France regional council (Conseil régional d'Ile de France).
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Paget-Bailly, S., Cyr, D. & Luce, D. Occupational exposures to asbestos, polycyclic aromatic hydrocarbons and solvents, and cancers of the oral cavity and pharynx: a quantitative literature review. Int Arch Occup Environ Health 85, 341–351 (2012). https://doi.org/10.1007/s00420-011-0683-y
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DOI: https://doi.org/10.1007/s00420-011-0683-y