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Exposure to occupational hazards and risk of sinonasal epithelial cancer: results from an extended Italian case–control study
  1. Angelo d’Errico1,
  2. Jana Zajacova2,
  3. Anna Cacciatore2,
  4. Santo Alfonzo2,
  5. Fabio Beatrice3,
  6. Fulvio Ricceri1,4,
  7. Guido Valente5
  1. 1Epidemiology, Local Health Unit ASL TO3, Piedmont Region, Grugliasco (TO), Italy
  2. 2Occupational Health and Safety Department, Local Health Unit CN1, Saluzzo, Cuneo, Italy
  3. 3Otolaryngology (ENT) Unit, San Giovanni Bosco Hospital, Turin, Italy
  4. 4Department of Clinical and Biological Sciences, Universita degli Studi di Torino, Orbassano, Torino, Italy
  5. 5University of Oriental Piedmont, Department of Translational Medicine, Novara, Italy
  1. Correspondence to Dr Fulvio Ricceri, Department of Clinical and Biological Sciences, Universita degli Studi di Torino, Orbassano, 10095 Torino, Italy; fulvio.ricceri{at}


Objectives There is sufficient evidence for a causal association of sinonasal epithelial cancers (SNEC) only for exposure to wood and leather dusts, nickel compounds and employment in isopropyl alcohol production. The aim of this study was to assess whether other occupational hazards are associated with the risk of SNEC for the main histologic types, namely adenocarcinoma (AD) and squamous cell carcinoma (SCC).

Methods The study population included 375 incident SNEC cases collected from 1996 to 2014 (79% of all diagnosed SNEC) throughout the Piedmont region by the regional Sinonasal Cancer Registry, and 408 hospital controls. Exposure to 17 occupational agents was assigned through expert assessment based on interviews to the subjects on jobs held throughout their working life. The relationship of SNEC with ever and cumulative exposure to the hazards was assessed through unconditional logistic regression models adjusted for age, sex, area of residence, smoking habit, year of enrolment and coexposures.

Results AD was associated with both ever and cumulative exposure to wood dust, leather dust and organic solvents, and with cumulative exposure to textiles dusts. SCC risk was significantly increased by ever exposure to nickel, chromium and welding fumes, as well as by cumulative exposure to welding fumes, arsenic and organic solvents. A mixed group of other histological types was associated with both ever and cumulative exposure to wood dust and textile dusts.

Conclusions The associations of SNEC with wood dust, leather dust and nickel were confirmed, while some new associations were observed for other hazards, which merit further investigation.

  • epidemiology
  • cancer
  • respiratory
  • retrospective exposure assessment
  • wood dust
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  • Contributors Ad and GV conceived the study. Ad, JZ and FR performed the statistical analysis. JZ, AC, SA and FB contributed in data collection and standardisation. Ad, FR and GV supervised the study. Ad wrote the first draft of the manuscript. All authors gave sostantial contribution in revising the final version of the manuscript.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval The study received approval by the Joint Ethical Committee of the Local Health Units CN1, CN2, AT, located at 'S. Croce e Carle' hospital, Cuneo, Italy.

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

  • Data availability statement No data are available. For ethical reasons, our ethical committee does not allow open/public sharing of individual data. Aggregated data are available to other researchers, on request. Requests may be sent to the corresponding author.

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