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Workplace
Short report
Sinonasal adenocarcinoma following styrene exposure in the reinforced plastics industry
  1. Mette Schou Nissen1,
  2. Zara Ann Stokholm1,
  3. Mette Skovgaard Christensen1,
  4. Vivi Schlünssen2,3,
  5. Jesper Medom Vestergaard1,
  6. Inge Brosbøl Iversen1,
  7. Henrik Albert Kolstad1
  1. 1Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus, Denmark
  2. 2Department of Public Health, Danish Ramazzini Centre, Aarhus University, Aarhus, Denmark
  3. 3National Research Centre for the Working Environment, Copenhagen, Denmark
  1. Correspondence to Dr Henrik Albert Kolstad, Department of Occupational Medicine, Danish Ramazzini Centre, Aarhus University Hospital, Aarhus 8000, Denmark; henkol{at}rm.dk

Abstract

Background Sinonasal adenocarcinoma is a rare disease expected to have rare causes and potential for strong risk factors as reflected by the strong association with occupational wood dust exposure. High level styrene exposure is a rare and suspected carcinogen, and this study examines the exposure–response relation between occupational styrene exposure, sinonasal adenocarcinoma and other subtypes.

Methods We followed 73 092 styrene-exposed workers from 1968 to 2011 and identified sinonasal cancers in the Danish Cancer Registry. We modelled cumulative styrene exposure and estimated incidence rates and age, sex and wood-industry adjusted ORs.

Results During 1 585 772 person-years, we observed nine cases of adenocarcinoma, corresponding to a fivefold non-significantly increased OR for estimates of high versus low cumulative styrene exposure (OR 5.11, 95% CI 0.58 to 45.12). The increased risk was confined to exposure received during the recent 15 years. The other histological subtypes showed no increased risk.

Conclusion This study suggests increased risk of sinonasal adenocarcinoma following styrene exposure. The observations are, however, few, confounding from wood dust exposure cannot be ruled out, and additional studies are needed before firm conclusions can be drawn.

  • sinonasal cancer
  • cohort study
  • epidemiology
  • styrene
  • occupational exposure

This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/

https://doi.org/10.1136/oemed-2017-104974

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    Footnotes

    • Contributors MSN conducted analysis and interpretation of data and drafted the work. All authors designed the work, interpreted data, revised it for intellectual content and provided final approval for the work to be published and agreed to be accountable for all aspects of the work.

    • Funding The study is funded by the Danish Council for Independent Research (grant no. 6110-00197) and the Danish Working Environment Research Fund (grant no. 32-2011-09).

    • Competing interests None declared.

    • Patient consent Not required.

    • Ethics approval The Danish Data Protection Agency approved the study (j.no: 1-16-02-01-07). In Denmark, register studies and individual surveys, where biological materials are not included, do not need approval from the Committee System on Biomedical Research Ethics. Participants in the survey were informed of the possibility to withdraw their consent of participation at any point in time.

    • Provenance and peer review Not commissioned; externally peer reviewed.