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Consonni D, Stoppa G, Binazzi A, Dallari B, Stella S, Rugarli S, Trobbiani C, Biggeri A, Catelan D, Mensi C. Sinonasal cancer incidence in Lombardy, Italy, 2008-20. Occup Med (Lond) 2024; 74:304-312. [PMID: 38754984 PMCID: PMC11165369 DOI: 10.1093/occmed/kqae034] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/18/2024] Open
Abstract
BACKGROUND Epithelial sinonasal cancers (SNC) are rare tumours with recognized associations with known/suspected occupational carcinogens (wood/leather dust, nickel/chromium compounds and formaldehyde). In Italy, a national SNC registry organized as a network of regional registries was established by law in 2008. AIMS To describe SNC time trends, occupational exposures and geographical distribution in Lombardy, North-West Italy, based on population registry data (2008-20). METHODS The Lombardy SNC Registry records epithelial SNCs using various sources. Interviews to collect occupational history are performed using a standardized questionnaire. Using several standard populations, we calculated yearly crude and age-standardized rates (ASRs per 100,000 person-years). Standardized incidence ratios (SIR) at municipality level were calculated, and Bayesian models were fitted to produce smoothed SIR maps. RESULTS We recorded 827 cases (553 men, 274 women). Crude (world standardized) ASRs were 0.9 (0.4) in men and 0.4 (0.2) in women, with no time trends. Interviews were obtained for 485 (88%) men and 223 (81%) women. Among men, 217 (45%) had been exposed to occupational carcinogens (wood/leather dust: 150/65 cases, 31%/13%), while only 36 women (16%) were exposed. Among 201 men with adenocarcinoma, exposure to wood/leather dust occurred in 103/50 cases (75%/50%). Areas with elevated SIRs associated with leather dust were found in the Western areas. Exposure to wood dust was more widespread. CONCLUSIONS This study found a high frequency of occupational exposures (wood and leather dust), particularly in men with SNC. Employment in shoe industries clustered in the Western part, while work in furniture industries was less spatially structured.
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Affiliation(s)
- D Consonni
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
| | - G Stoppa
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, Padua 35131, Italy
| | - A Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology and Hygiene, National Institute for Insurance against Accidents at Work (INAIL), Rome 00143, Italy
| | - B Dallari
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
| | - S Stella
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
| | - S Rugarli
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
| | - C Trobbiani
- School of Occupational Health, University of Milan, Milan 20122, Italy
| | - A Biggeri
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, Padua 35131, Italy
| | - D Catelan
- Unit of Biostatistics, Epidemiology and Public Health, DCTVPH, University of Padova, Padua 35131, Italy
| | - C Mensi
- Occupational Health Unit, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milan 20122, Italy
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Binazzi A, di Marzio D, Mensi C, Consonni D, Miligi L, Piro S, Zajacovà J, Sorasio D, Galli P, Camagni A, Calisti R, Massacesi S, Cozzi I, Balestri A, Murano S, Fedeli U, Comiati V, Eccher S, Lattanzio S, Marinaccio A. Gender Differences in Sinonasal Cancer Incidence: Data from the Italian Registry. Cancers (Basel) 2024; 16:2053. [PMID: 38893172 PMCID: PMC11171114 DOI: 10.3390/cancers16112053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2024] [Revised: 05/24/2024] [Accepted: 05/24/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Although rare, sinonasal cancers (SNCs) have a high occupational attributable fraction. METHODS We applied gender-based approaches to descriptive analyses, incidence, and patterns of exposures using the Italian National Sinonasal Cancer Registry (ReNaTuNS: Registro Nazionale Tumori Naso-Sinusali). RESULTS The study included 2851 SNC patients. SNC was diagnosed more often in men (73%) than in women (27%). The most frequent morphology in men was intestinal-type adenocarcinoma (33%), whereas in women, it was squamous cell carcinoma (49%). Nasal cavities were predominant in both genders (50%), ethmoidal sinus in men (24%), and maxillary in women (24%). Incidence rates were 0.76 (per 100,000 person-years) in men and 0.24 in women and increased by age, more evidently in men, peaking over 75 years in both. Occupational exposures to wood and leather dusts were the most frequent (41% for men, 33% for women). Few exposures were extra-occupational or domestic. Unlikely exposure was relevant in women (57%). CONCLUSIONS The surveillance of SNC cases through a registry that allows for the identification of and compensation for this occupational disease is important in Italy, where numerous workers are exposed to carcinogens for SNC, without even being aware. Considering the rarity of the disease, particularly among women, the ReNaTuNS can provide a method to analyze gender differences.
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Affiliation(s)
- Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene, National Institute for Insurance against Accidents at Work (INAIL), 00100 Roma, Italy; (D.d.M.); (A.M.)
| | - Davide di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene, National Institute for Insurance against Accidents at Work (INAIL), 00100 Roma, Italy; (D.d.M.); (A.M.)
| | - Carolina Mensi
- Sinonasal Cancer Registry of Lombardy, Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy; (C.M.); (D.C.)
| | - Dario Consonni
- Sinonasal Cancer Registry of Lombardy, Epidemiology Unit, Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico, 20100 Milano, Italy; (C.M.); (D.C.)
| | - Lucia Miligi
- Institute for Cancer Research, Prevention and Clinical Network (ISPRO) Foundation, 50139 Firenze, Italy;
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, (ISPRO), 50139 Firenze, Italy;
| | - Sara Piro
- Sinonasal Cancer Registry of Tuscany, Occupational and Environmental Epidemiology Unit, (ISPRO), 50139 Firenze, Italy;
| | - Jana Zajacovà
- Sinonasal Cancer Registry of Piedmont, Occupational Health and Safety Department, CN1 Local Health Authority, 12037 Saluzzo, Italy; (J.Z.); (D.S.)
| | - Denise Sorasio
- Sinonasal Cancer Registry of Piedmont, Occupational Health and Safety Department, CN1 Local Health Authority, 12037 Saluzzo, Italy; (J.Z.); (D.S.)
| | - Paolo Galli
- Sinonasal Cancer Registry of Emilia Romagna, Occupational Safety and Prevention Unit, Public Health Department, Bologna Local Health Authority, 40121 Bologna, Italy; (P.G.); (A.C.)
| | - Angela Camagni
- Sinonasal Cancer Registry of Emilia Romagna, Occupational Safety and Prevention Unit, Public Health Department, Bologna Local Health Authority, 40121 Bologna, Italy; (P.G.); (A.C.)
| | - Roberto Calisti
- Sinonasal Cancer Registry of Marche, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Department of Prevention, Macerata Health Authority, 62012 Civitanova Marche, Italy; (R.C.); (S.M.)
| | - Stefania Massacesi
- Sinonasal Cancer Registry of Marche, Unit of Workplace Prevention and Safety and of Occupational Epidemiology (SPreSAL Epi Occ), Department of Prevention, Macerata Health Authority, 62012 Civitanova Marche, Italy; (R.C.); (S.M.)
| | - Ilaria Cozzi
- Sinonasal Cancer Registry of Lazio, Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Roma, Italy; (I.C.); (A.B.)
- Laboratory of Industrial Hygiene, Department of Prevention, CRRA ASL Lazio, 01100 Viterbo, Italy
| | - Anna Balestri
- Sinonasal Cancer Registry of Lazio, Department of Epidemiology, Lazio Regional Health Service, ASL Roma 1, 00147 Roma, Italy; (I.C.); (A.B.)
- Laboratory of Industrial Hygiene, Department of Prevention, CRRA ASL Lazio, 01100 Viterbo, Italy
| | - Stefano Murano
- Sinonasal Cancer Registry of Autonomous Province of Bolzano, Alto Adige Health Authority, Occupational Medicine Unit, 39100 Bolzano, Italy;
| | - Ugo Fedeli
- Azienda Zero, Epidemiological Department, Veneto Region, 35131 Padova, Italy; (U.F.); (V.C.)
| | - Vera Comiati
- Azienda Zero, Epidemiological Department, Veneto Region, 35131 Padova, Italy; (U.F.); (V.C.)
| | - Silvia Eccher
- Sinonasal Cancer Registry of Autonomous Province of Trento, Hygiene and Occupational Medicine, Provincial Unit of Health, 38123 Trento, Italy; (S.E.); (S.L.)
| | - Sara Lattanzio
- Sinonasal Cancer Registry of Autonomous Province of Trento, Hygiene and Occupational Medicine, Provincial Unit of Health, 38123 Trento, Italy; (S.E.); (S.L.)
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene, National Institute for Insurance against Accidents at Work (INAIL), 00100 Roma, Italy; (D.d.M.); (A.M.)
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Chabrillac E, Talawdekar A, Garikipati S, Varley I, Sionis S, Beasley N, Jackson R. A single centre's experience of 23 cases of total rhinectomy for the treatment of squamous cell carcinoma involving the nasal vestibule. Eur Arch Otorhinolaryngol 2021; 279:2069-2075. [PMID: 34223976 DOI: 10.1007/s00405-021-06972-6] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2021] [Accepted: 06/27/2021] [Indexed: 11/25/2022]
Abstract
PURPOSE This study aims to analyse the oncological outcomes of total rhinectomy (TR) for squamous cell carcinomas (SCCs) involving the nasal vestibule, and to identify prognostic factors for disease recurrence. METHODS A retrospective single-centre study was conducted between September 2003 and February 2021 including all patients who underwent a TR for a SCC involving the nasal vestibule. RESULTS 23 patients were included in the study. Tumours originated from the anterior septum (n = 12), vestibule (n = 8) or skin (n = 3). Six TRs (26.1%) were salvage procedures, after primary radiotherapy or partial rhinectomy. Seven patients had a concurrent neck dissection and 17 patients (73.9%) received adjuvant treatment (14 patients had radiotherapy and 3 had chemoradiotherapy). After a median follow-up of 32 months, six patients (26.1%) presented with tumour recurrence. Three patients (13%) had nodal-only recurrence. The estimated 5-year overall survival, disease-free survival and disease-specific survival were 67.5%, 66.3% and 80.7%, respectively. Positive excision margins were a predictive factor for tumour recurrence (p = 0.0401). CONCLUSION For SCCs involving the nasal vestibule that are not amenable to limited surgical resection, TR along with adjuvant radiotherapy provide good oncological outcomes and should be considered the main treatment option.
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Affiliation(s)
- Emilien Chabrillac
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK. .,Department of Surgery, University Cancer Institute Toulouse-Oncopole, Toulouse, France.
| | - Ashish Talawdekar
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
| | | | - Iain Varley
- Department of Oral and Maxillo-Facial Surgery, Sheffield Teaching Hospitals Foundation Trust, Sheffield, UK
| | - Sara Sionis
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
| | - Nigel Beasley
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
| | - Richard Jackson
- Department of Ear, Nose and Throat Surgery, Sheffield Teaching Hospitals Foundation Trust, Royal Hallamshire Hospital, Glossop Rd, Broomhall, Sheffield, S10 2JF, UK
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Leonel AC, Bonan RF, Pinto MB, Kowalski LP, Perez DE. The pesticides use and the risk for head and neck cancer: A review of case-control studies. Med Oral Patol Oral Cir Bucal 2021; 26:e56-e63. [PMID: 32701932 PMCID: PMC7806356 DOI: 10.4317/medoral.23962] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Accepted: 05/26/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Tobacco, alcohol consumption, and HPV infection are the most common risk factors for head and neck cancer (HNC). Despite of this, recent evidences are growing on the association between long-term exposure to pesticides and the risk of chronic diseases, including different types of cancer. The present review evaluated in current literature evidence of an association between exposure to pesticides and the occurrence of HNCs. MATERIAL AND METHODS A literature search of the case-control studies was conducted in the PubMed, Web of science and Cochrane databases. Methodological quality of each study was rated with the Scottish Intercollegiate Guidelines Network (SIGN 50) checklist. RESULTS One thousand and thirty-five studies were identified and twelve met all criteria and, therefore, considered for quality assessment and data extraction. According to SIGN 50 criteria, six studies received an overall high-quality. All the studies considered of high quality found a positive association between exposure to pesticides and different HNC sites, including larynx, pharynx and nasal cavity. In addition, the increased risk was associated with the frequency of exposure. CONCLUSIONS Finally, improving pesticide users' awareness of their risks and proper handling, as well as adopting protective measures such as the use of personal protective equipment, appear to be effective in reducing human health damage.
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Affiliation(s)
- A-C Leonel
- Universidade Federal de Pernambuco, School of Dentistry Department of Clinical and Preventive Dentistry, Oral Pathology Section 4ª Travessa Professor Artur de Sá, s/n. Cidade Universitária 50740-521. Recife, Pernambuco, Brazil
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d'Errico A, Zajacova J, Cacciatore A, Alfonzo S, Beatrice F, Ricceri F, Valente G. Exposure to occupational hazards and risk of sinonasal epithelial cancer: results from an extended Italian case-control study. Occup Environ Med 2020; 78:oemed-2020-106738. [PMID: 33115924 DOI: 10.1136/oemed-2020-106738] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2020] [Revised: 09/23/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022]
Abstract
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.
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Affiliation(s)
- Angelo d'Errico
- Epidemiology, Local Health Unit ASL TO3, Piedmont Region, Grugliasco (TO), Italy
| | - Jana Zajacova
- Occupational Health and Safety Department, Local Health Unit CN1, Saluzzo, Cuneo, Italy
| | - Anna Cacciatore
- Occupational Health and Safety Department, Local Health Unit CN1, Saluzzo, Cuneo, Italy
| | - Santo Alfonzo
- Occupational Health and Safety Department, Local Health Unit CN1, Saluzzo, Cuneo, Italy
| | - Fabio Beatrice
- Otolaryngology (ENT) Unit, San Giovanni Bosco Hospital, Turin, Italy
| | - Fulvio Ricceri
- Epidemiology, Local Health Unit ASL TO3, Piedmont Region, Grugliasco (TO), Italy
- Department of Clinical and Biological Sciences, Universita degli Studi di Torino, Orbassano, Torino, Italy
| | - Guido Valente
- University of Oriental Piedmont, Department of Translational Medicine, Novara, Italy
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Lin YL. Proton beam therapy of periorbital sinonasal squamous cell carcinoma: Two case reports and review of literature. World J Clin Oncol 2020; 11:655-672. [PMID: 32879851 PMCID: PMC7443830 DOI: 10.5306/wjco.v11.i8.655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2020] [Revised: 06/11/2020] [Accepted: 07/18/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Sinonasal malignancies are rare but demanding due to complex anatomy, usually late diagnosis, and inconsistent therapy strategy based on multimodality approaches. Squamous cell carcinoma (SCC) is the most common histology, with poorer prognosis. In the setting of orbital invasion, an orbital exenteration may be required. However, in case of primary rejection of disfiguring surgery or unresectable disease, proton beam therapy (PBT) should be largely considered, allowing for better sparing of neighboring critical structures and improved outcomes by dose escalation. CASE SUMMARY A 62-year-old male presented with a recurrent SCC in the nasal septum abutting frontal skull base and bilateral orbits at 7 mo after primary partial nasal amputation. Because of refusal of face-deforming surgery and considerable adverse effects of conventional radiotherapy, the patient underwent a PBT by hyperfractionated accelerated scheme, resulting in complete response and moderate toxicities. After 2 years, a nasal reconstruction was implemented with satisfactory appearance and recurrence-freedom to date. Another patient with an initially extended sinonasal SCC, invading right orbit and facial soft tissue, declined an orbital exenteration and was treated with a normofractionated PBT to the gross tumor and elective cervical lymphatics. The follow-up showed a continuous tumor remission with reasonable late toxicities, such as cataract and telangiectasia on the right. Despite T4a stage and disapproval of concurrent chemotherapy owing to individual choice, both patients still achieved outstanding treatment outcomes with PBT alone. CONCLUSION PBT enabled orbit preservation and excellent tumor control without severe adverse effects on both presented patients with locally advanced sinonasal SCC.
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Affiliation(s)
- Yi-Lan Lin
- Department of Radiation Oncology, Rinecker Proton Therapy Center, Munich 81371, Germany
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Mantsopoulos K, Taha L, Agaimy A, Iro H. Postlaryngectomy sinonasal squamous cell carcinoma: Case report and review of the literature. Clin Case Rep 2020; 8:630-634. [PMID: 32274024 PMCID: PMC7141728 DOI: 10.1002/ccr3.2657] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 11/19/2019] [Accepted: 12/14/2019] [Indexed: 11/22/2022] Open
Abstract
Postlaryngectomy sinonasal squamous cell carcinoma, being theoretically associated with exposure to the same risk factors or development of precancerous lesions due to altered nasal physiology, should warrant a thorough head and neck examination.
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Affiliation(s)
- Konstantinos Mantsopoulos
- Department of Otolaryngology, Head and neck surgery Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) Erlangen Germany
| | - Lava Taha
- Department of Otolaryngology, Head and neck surgery Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) Erlangen Germany
| | - Abbas Agaimy
- Institute of Pathology Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) Erlangen Germany
| | - Heinrich Iro
- Department of Otolaryngology, Head and neck surgery Friedrich-Alexander-Universität Erlangen-Nürnberg (FAU) Erlangen Germany
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Akkoca Ö, Unlu CE, Tatar I, Sargon MF, Zeybek D, Oguztuzun S. Protective Effect of Aerobic Exercise on the Nasal Mucosa of Rats Against the Histopathologic Changes in Cigarette Smoke Exposure. EAR, NOSE & THROAT JOURNAL 2020; 99:453-459. [PMID: 31996045 DOI: 10.1177/0145561319900758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
INTRODUCTION Smoking is a public health problem that has been proven to have adverse effects on human health. Aerobic exercise has positive effects on the human body, especially on the respiratory system. OBJECTIVE The aim of this experimental animal model study was to determine whether regular aerobic exercise has a protective effect against the harmful effects of cigarette smoke on the nasal mucosa of rats. METHODS A total of 24 male Wistar albino rats were randomly separated into 3 groups of 8: group 1 (cigarette smoking), group 2 (cigarette smoking and exercise), and group 3 (control group). At the end of the experiment period, histopathological (light and electron microscopy) and immunohistochemical (GSTA 1, CYP1A1, and CYP2E1) evaluations were made of the nasal mucosa of the animals. RESULTS Goblet cell loss and basal membrane thickening were significantly lower in group 2 and group 3 compared to group 1. In the electron microscope evaluation, the inflammatory expressions of the goblet cells were observed in a very small area in group 2. In group 1, these were distributed over large areas between the mucosal cells. There was seen to be significant swelling of the mitochondria in group 1 compared to the other groups. No statistically significant difference was determined between the groups with respect to GSTA1, CYP2E1, and CYP1A1 scores (P > .05). CONCLUSION The results of this study showed that regular aerobic exercise has a protective effect against the harmful effects of smoking on the nasal mucosa of rats.
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Affiliation(s)
- Özlem Akkoca
- University of Health Sciences, Ankara Training and Research Hospital, Ankara, Turkey
| | - Ceren Ersoz Unlu
- University of Health Sciences, Gulhane Training and Research Hospital, Ankara, Turkey
| | - Ilkan Tatar
- Department of Anatomy, Hacettepe University School of Medicine, Ankara, Turkey
| | | | - Dilara Zeybek
- Department of Histology and Embryology, Hacettepe University School of Medicine, Ankara, Turkey
| | - Serpil Oguztuzun
- Department of Biology, Kirikkale University School of Medicine, Kirikkale, Turkey
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Bunk S, Übelacker L, Scherzad A, Hochstöger J, Poier N, Hackenberg S, Kleinsasser N. [In vitro exposure of human nasal mucous membrane cells and lymphocytes to snuff]. HNO 2020; 68:8-13. [PMID: 31511908 DOI: 10.1007/s00106-019-00749-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
BACKGROUND While an abundant number of studies concerning tobacco smoke and chewing tobacco show carcinogenic potential, there is little data on the consequences of snuff, especially on the cellular level. Therefore, the mutagenic effect of snuff is difficult to estimate and the WHO assessment of snuff being not carcinogenic is based on very limited data. OBJECTIVES This paper investigates the potential cytotoxic and genotoxic effects of snuff on human lymphocytes and nasal mucosa cells. MATERIALS AND METHODS Two types of snuff were used: one without menthol and one with a high degree of menthol. The necessary nasal mucosa cells and lymphocytes were collected from 10 subjects undergoing nasal obstruction surgery and incubated for one hour with a snuff-DMSO mixture (range 0.01-2000 µg/ml). Methods included the trypan blue test, the comet assay, and the micronucleus test. RESULTS The trypan blue test showed no decrease in cell viability for either cell type. The comet assay revealed a significant increase in the Olive Tail Moment for lymphocytes starting at 100 µg/ml and at 1000 µg/ml for nasal mucosa cells. There was no significant increase in micronuclei according to the micronucleus test. No differences between these two types of tobacco were observed. CONCLUSION The present study demonstrated genotoxic damage, such as DNA strand breaks, which may be repaired, but no non-repairable elevated micronuclei. The present findings cast doubts on the WHO assessment that snuff is not carcinogenic. However, for a sound assessment of the risk potential of snuff, further research on various genotoxic endpoints in human cells is warranted.
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Affiliation(s)
- S Bunk
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - L Übelacker
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - A Scherzad
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - J Hochstöger
- Hals-Nasen-Ohrenklinik, Kepler Universitätsklinikum Linz, Krankenhausstraße 9, 4021, Linz, Österreich
| | - N Poier
- Hals-Nasen-Ohrenklinik, Kepler Universitätsklinikum Linz, Krankenhausstraße 9, 4021, Linz, Österreich
| | - S Hackenberg
- Klinik und Poliklinik für Hals‑, Nasen- und Ohrenheilkunde, plastische und ästhetische Operationen, Universitätsklinikum Würzburg, Würzburg, Deutschland
| | - N Kleinsasser
- Hals-Nasen-Ohrenklinik, Kepler Universitätsklinikum Linz, Krankenhausstraße 9, 4021, Linz, Österreich.
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Impairment of nasal mucociliary clearance time in wood industry workers. Eur Arch Otorhinolaryngol 2019; 277:493-496. [PMID: 31758307 DOI: 10.1007/s00405-019-05729-6] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2019] [Accepted: 11/07/2019] [Indexed: 01/27/2023]
Abstract
PURPOSE The aim of this study is to investigate the effect of wood dust on nasal mucociliary clearance time in wood industry workers. Moreover, the correlation between duration of exposure to wood dust and nasal mucociliary clearance time will be evaluated. METHODS A total of 50 male subjects were included in the study. All of the subjects were non-smokers. Nasal mucociliary clearance time of 25 wood industry workers was measured with saccharine method and compared with the results of 25 age-matched control group. Also, the correlation between nasal mucociliary clearance time and duration of exposure to wood dust in woodworkers was evaluated. RESULTS The mean mucociliary clearance time in control group and wood industry workers was 12.28 ± 1.98 and 16.72 ± 2.71, respectively. The mean mucociliary clearance time in wood industry workers was significantly longer than control group (p < 0.0001). Also,there was positive correlation between duration of exposure to wood dust and nasal mucociliary clearance time in wood industry workers (r = 0.879, p < 0.0001). CONCLUSION The clinicians must remember that mucociliary clearance time in wood industry workers is prolonged. So the wood industry workers must be followed up more closely for sinonasal infections and respiratory tract diseases.
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Kuijpens JHLP, Louwman MWJ, Takes R, Slootweg PJ, Burdorf A, van Dijk BAC. Sinonasal cancer in The Netherlands: Follow-up of a population-based study 1989-2014 and incidence of occupation-related adenocarcinoma. Head Neck 2018; 40:2462-2468. [DOI: 10.1002/hed.25374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2017] [Revised: 03/09/2018] [Accepted: 05/22/2018] [Indexed: 01/09/2023] Open
Affiliation(s)
| | - Marieke W. J. Louwman
- Comprehensive Cancer Centre The Netherlands (IKNL), Department of Research; Utrecht The Netherlands
| | - Robert Takes
- Department of Oto-Rhino-Laryngology and Head and Neck Surgery; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Piet J. Slootweg
- Department of Pathology; Radboud University Medical Centre; Nijmegen The Netherlands
| | - Alex Burdorf
- Department of Public Health; Erasmus Medical Centre; Rotterdam The Netherlands
| | - Boukje A. C. van Dijk
- Comprehensive Cancer Centre The Netherlands (IKNL), Department of Research; Utrecht The Netherlands
- University of Groningen, University Medical Center Groningen, Department of Epidemiology; Groningen The Netherlands
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12
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Zheng G, Yu H, Kanerva A, Försti A, Sundquist K, Hemminki K. Familial Ovarian Cancer Clusters with Other Cancers. Sci Rep 2018; 8:11561. [PMID: 30069056 PMCID: PMC6070489 DOI: 10.1038/s41598-018-29888-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2018] [Accepted: 07/12/2018] [Indexed: 12/20/2022] Open
Abstract
Familial risk of ovarian cancer is well-established but whether ovarian cancer clusters with other cancers and the clusters differ by histology remains uncertain. Using data from the Swedish Family-Cancer Database, we explored familial associations of ovarian cancer with other cancers with a novel approach; relative risk for (histology-specific) ovarian cancer was estimated in families with patients affected by other cancers, and conversely, risks for other cancers in families with (histology-specific) ovarian cancer patients. Eight discordant cancers were associated with ovarian cancer risk, of which family history of breast cancer showed a dose-response (P-trend <0.0001). Conversely, risks of eight types of cancer increased in families with ovarian cancer patients, and dose-responses were shown for risks of liver (P-trend = 0.0083) and breast cancers (P-trend <0.0001) and cancer of unknown primary (P-trend = 0.0157). Some cancers were only associated with histology-specific ovarian cancers, e.g. endometrial cancer was only associated with endometrioid type but with highest significance. Novel associations with virus-linked cancers of the nose and male and female genitals were found. The results suggest that ovarian cancer shares susceptibility with a number of other cancers. This might alert genetic counselors and challenge approaches for gene and gene-environment identification.
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Affiliation(s)
- Guoqiao Zheng
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany. .,Faculty of Medicine, University of Heidelberg, Heidelberg, Germany.
| | - Hongyao Yu
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Faculty of Medicine, University of Heidelberg, Heidelberg, Germany
| | - Anna Kanerva
- Cancer Gene Therapy Group, Faculty of Medicine, University of Helsinki, Helsinki, Finland.,Department of Obstetrics and Gynecology, Helsinki University Hospital, Helsinki, Finland
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden.,Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, USA.,Center for Community-based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Izumo, Japan
| | - Kari Hemminki
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.,Center for Primary Health Care Research, Lund University, 205 02, Malmö, Sweden
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13
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Binazzi A, Corfiati M, Di Marzio D, Cacciatore AM, Zajacovà J, Mensi C, Galli P, Miligi L, Calisti R, Romeo E, Franchi A, Marinaccio A. Sinonasal cancer in the Italian national surveillance system: Epidemiology, occupation, and public health implications. Am J Ind Med 2018; 61:239-250. [PMID: 29114957 DOI: 10.1002/ajim.22789] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/05/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Sinonasal cancer (SNC) is a rare tumor with predominant occupational etiology associated with exposures to specific carcinogens. The aim of this study is to describe SNC cases recorded in Italy in the period 2000-2016. METHODS Clinical information, occupational history, and lifestyle habits of SNC cases collected in the Italian Sinonasal Cancer Register were examined. Age-standardized rates were estimated. RESULTS Overall, 1529 cases were recorded. The age-standardized incidence rates per 100 000 person-years were 0.65 in men and 0.26 in women. Occupational exposures were predominant among the attributed exposure settings, primarily to wood and leather dusts. Other putative causal agents included chrome, solvents, tannins, formaldehyde, textile dusts, and pesticides. Many cases had unknown exposure. CONCLUSIONS Epidemiological surveillance of SNC cases and their occupational history is fundamental for monitoring the occurrence of the disease in exposed workers in industrial sectors generally not considered at risk of SNC as well as in non-occupational settings.
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Affiliation(s)
- Alessandra Binazzi
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene; National Institute for Insurance Against Accidents at Work (INAIL); Rome Italy
| | - Marisa Corfiati
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene; National Institute for Insurance Against Accidents at Work (INAIL); Rome Italy
| | - Davide Di Marzio
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene; National Institute for Insurance Against Accidents at Work (INAIL); Rome Italy
| | - Anna M. Cacciatore
- Sinonasal Cancer Registry of Piedmont; Occupational Health and Safety Department; ASL CN1; Cuneo Italy
| | - Jana Zajacovà
- Sinonasal Cancer Registry of Piedmont; Occupational Health and Safety Department; ASL CN1; Cuneo Italy
| | - Carolina Mensi
- Sinonasal Cancer Registry of Lombardy; Department of Preventive Medicine; Fondazione IRCCS Ca’ Granda-Ospedale Maggiore Policlinico; Milan Italy
| | - Paolo Galli
- Sinonasal Cancer Registry of Emilia-Romagna; Department of Public Health; Unit of Workplace Prevention and Safety; AUSL Imola Italy
| | - Lucia Miligi
- Sinonasal Cancer Registry of Tuscany; Cancer Prevention and Research Institute (ISPO); Environmental and Occupational Epidemiology Unit; Florence Italy
| | - Roberto Calisti
- Sinonasal Cancer Registry of Marche; Department of Prevention; SPreSAL; Civitanova Marche Italy
| | - Elisa Romeo
- Sinonasal Cancer Registry of Lazio; Department of Epidemiology; ASL RM1; Rome Italy
| | - Alessandro Franchi
- Department of Surgery and Translational Medicine; University of Florence; Florence Italy
| | - Alessandro Marinaccio
- Department of Occupational and Environmental Medicine, Epidemiology, Hygiene; National Institute for Insurance Against Accidents at Work (INAIL); Rome Italy
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14
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Carey RM, Parasher AK, Workman AD, Yan CH, Glicksman JT, Chen J, Palmer JN, Adappa ND, Newman JG, Brant JA. Disparities in sinonasal squamous cell carcinoma short- and long-term outcomes: Analysis from the national cancer database. Laryngoscope 2017; 128:560-567. [DOI: 10.1002/lary.26804] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2017] [Revised: 06/05/2017] [Accepted: 06/26/2017] [Indexed: 12/19/2022]
Affiliation(s)
- Ryan M. Carey
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Arjun K. Parasher
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
- Leonard Davis Institute of Health Economics; University of Pennsylvania; Philadelphia Pennsylvania U.S.A
| | - Alan D. Workman
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
- Perelman School of Medicine; Philadelphia Pennsylvania U.S.A
| | - Carol H. Yan
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jordan T. Glicksman
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jinbo Chen
- University of Pennsylvania and the Department of Biostatistics and Epidemiology; Philadelphia Pennsylvania U.S.A
| | - James N. Palmer
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Nithin D. Adappa
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jason G. Newman
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
| | - Jason A Brant
- Department of Otorhinolaryngology-Head and Neck Surgery; Philadelphia Pennsylvania U.S.A
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15
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Emanuelli E, Alexandre E, Cazzador D, Comiati V, Volo T, Zanon A, Scapellato ML, Carrieri M, Martini A, Mastrangelo G. A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking. J Occup Med Toxicol 2016; 11:35. [PMID: 27453718 PMCID: PMC4957368 DOI: 10.1186/s12995-016-0124-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 06/29/2016] [Indexed: 11/25/2022] Open
Abstract
Background and aims Sinonasal cancers (SNCs) are rare neoplasms, accounting for about 3 % of head and neck cancers, with squamous cell carcinoma (SCC) and adenocarcinoma (ADC) as the most common subtypes. ADCs present strong associations with occupational wood dust exposure. Preventive measures have progressively reduced wood dust concentrations in workplaces but no study has evaluated the effectiveness of such interventions. Few studies indicate associations between ADC and exposure to solvents, which is common in the shoe industry, but this hypothesis still needs confirmation. Methods In a case-case study, we contrasted 32 ADCs against 21 Non-Adenocarcinoma Epithelial Tumors (NAETs) – all recruited from the same clinical setting (Padua’s University Hospital; period 2004–2015) – using questionnaires and clinical records to collect information on potential predictors. Non-occupational factors were age, sex, smoking, allergy and chronic sinusitis. Occupational factors were intensity and frequency of wood dust exposure, protection from wood dust, type of wood (in woodworking); frequency of exposure to leather dust or mastic/solvent (in shoemaking). Odds-ratio (OR), 95 % confidence interval (95 % CI) and two-tail p-values were obtained through stepwise backward logistic regression for each industry, always using as reference patients never employed in either trade and adjusting for non-occupational risk factors. Results Adjusted OR was 22.5 (95 % CI = 3.50–144; p = 0.001) and 9.37 (95 % CI = 1.29–67.6; p = 0.026), respectively, in patients with low or high degree of protection against wood dust. In the shoe industry, adjusted OR was 1 and 18.8 (95 % CI = 1.29–174; p = 0.030), respectively, in patients with low or high exposure to only mastic/solvent; and 1 and 22.5 (95 % CI = 2.07–244; p = 0.011), respectively, in patients with low or high exposure to only leather dust. Discussion and conclusions The questionnaire used was able to estimate with simple algorithms past exposures in wood and footwear industries. The case-case design considerably increased the validity of this small study. Results in this study were always consistent with the extant literature; this could support reliability of novel findings. In woodworking, respiratory protective equipment and local exhaust ventilation reduced the risk of occupational SNC; in footwear manufacture, where preventive interventions were seldom adopted, SNC risk was significantly greater for high exposure from mastic/solvent and leather dust. Electronic supplementary material The online version of this article (doi:10.1186/s12995-016-0124-7) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Enzo Emanuelli
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Enrico Alexandre
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Diego Cazzador
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Vera Comiati
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Tiziana Volo
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Alessia Zanon
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Maria Luisa Scapellato
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Mariella Carrieri
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Alessandro Martini
- Department of Otolaryngology and Endoscopic Surgery of the Upper Airways, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
| | - Giuseppe Mastrangelo
- Department of Occupational Medicine, University Hospital of Padua, Via Giustiniani 2, 35100 Padua, Italy
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16
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Andersson M, Selin F, Järvholm B. Asbestos exposure and the risk of sinonasal cancer. Occup Med (Lond) 2016; 66:326-31. [PMID: 26940471 DOI: 10.1093/occmed/kqw018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND While the increased risk of lung cancer and mesothelioma is well established, the relationship between exposure to asbestos dust and sinonasal cancer is less clear. AIMS To study the risk of sinonasal cancer in relation to asbestos dust exposure. METHODS A retrospective cohort study of construction workers, linked to the Swedish Cancer Registry. Participants were classified into four exposure groups; heavy, medium, low or very low exposure to asbestos, according to the incidence of pleural mesothelioma in their occupational group. Standardized incidence ratios (SIRs) and relative risks (RRs) were analysed, adjusted for age and smoking habits. The risks of adenocarcinoma and squamous cell carcinoma were investigated separately. RESULTS Among the 280222 subjects, there was no increased risk of sinonasal cancer compared to the general population [SIR 0.85, 95% confidence interval (CI) 0.68-1.03], or any dose-response relationship with exposure to asbestos. The highest RR was found in the low exposure group (RR 1.25, 95% CI 0.69-2.28) and the lowest RR was found in the group with the highest exposure to asbestos (RR 0.71, 95% CI 0.33-1.53). No significantly increased risk or dose-response association could be found for adenocarcinoma or squamous cell carcinoma when analysed separately. CONCLUSIONS This study did not find an increased risk of developing sinonasal cancer after asbestos exposure.
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Affiliation(s)
- M Andersson
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90185 Umeå, Sweden.
| | - F Selin
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90185 Umeå, Sweden
| | - B Järvholm
- Department of Public Health and Clinical Medicine, Occupational and Environmental Medicine, Umeå University, S-90185 Umeå, Sweden
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Binazzi A, Ferrante P, Marinaccio A. Occupational exposure and sinonasal cancer: a systematic review and meta-analysis. BMC Cancer 2015; 15:49. [PMID: 25885319 PMCID: PMC4339645 DOI: 10.1186/s12885-015-1042-2] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2014] [Accepted: 01/24/2015] [Indexed: 02/07/2023] Open
Abstract
Background Sinonasal cancer (SNC) has been related to occupational exposures, but the relative risk associated to specific jobs and/or carcinogen exposures other than wood and leather dust is generally based on small or inadequate sample sizes and the range of observed estimates is large. This paper is aimed at investigating such relationship through a systematic review of the literature followed by a meta-analysis of studies meeting specific inclusion criteria. Methods Systematic search was made with PubMed, Google Scholar and Scopus engines using related keywords. Occupational exposures include wood and leather dust, formaldehyde, nickel and chromium compounds, textile industry, farming and construction. Meta-analysis of published studies after 1985 with a case-control or cohort design was performed, firstly using the fixed-effect model. Heterogeneity was assessed with the Q statistical test and quantified by the I2 index. When the heterogeneity hypothesis appeared relevant, the random-effect model was chosen. Sources of heterogeneity were explored using subgroup analyses. Results Out of 63 reviewed articles, 28 (11 cohort, 17 case-control) were used in the meta-analysis. Heterogeneity among studies was observed and random-effects models were used. Exposure to wood dust results associated with SNC (RRpooled = 5.91, 95% CI: 4.31-8.11 for the case-control studies and 1.61, 95% CI: 1.10-2.37 for the cohort studies), as well as to leather dust (11.89, 95% CI: 7.69-18.36). The strongest associations are with adenocarcinomas (29.43, 95% CI: 16.46-52.61 and 35.26, 95% CI: 20.62-60.28 respectively). An increased risk of SNC for exposures to formaldehyde (1.68, 95% CI: 1.37-2.06 for the case control and 1.09, 95% CI: 0.66-1.79 for the cohort studies), textile industry (2.03, 95% CI: 1.47-2.8), construction (1.62, 95% CI: 1.11-2.36) and nickel and chromium compounds (18.0, 95% CI: 14.55-22.27) was found. Subset analyses identified several sources of heterogeneity and an exposure-response relationship was suggested for wood dust (p = 0.001). Conclusions By confirming the strength of association between occupational exposure to causal carcinogens and SNC risk, our results may provide indications to the occupational etiology of SNC (not only wood and leather dusts). Future studies could be focused on specific occupational groups to confirm causative agents and to define appropriate preventive measures. Electronic supplementary material The online version of this article (doi:10.1186/s12885-015-1042-2) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Alessandra Binazzi
- Italian National Workers' Compensation Authority (INAIL) Department of Occupational and Environmental Medicine, Epidemiology and Hygiene - Unit of Occupational and Environmental Epidemiology, Via Stefano Gradi 55, 00143, Rome, Italy.
| | - Pierpaolo Ferrante
- Italian National Workers' Compensation Authority (INAIL) Department of Occupational and Environmental Medicine, Epidemiology and Hygiene - Unit of Occupational and Environmental Epidemiology, Via Stefano Gradi 55, 00143, Rome, Italy.
| | - Alessandro Marinaccio
- Italian National Workers' Compensation Authority (INAIL) Department of Occupational and Environmental Medicine, Epidemiology and Hygiene - Unit of Occupational and Environmental Epidemiology, Via Stefano Gradi 55, 00143, Rome, Italy.
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