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 cancer (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 (odds ratio; 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 everexposure 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.

The objective of this study was to investigate the relationship between cancer incidence and socioeconomic status, and to examine the temporal trends in social inequalities in cancer risk. Educational differentials in the incidence of cancer (25 sites) among adult residents of Turin (Italy) were examined using data from the Turin Longitudinal Study and the Piedmont Cancer Registry. The relationship between cancer incidence and educational level was evaluated over three 5-year periods between 1985 and 1999 using Poisson models. An estimated 17% of malignancies among men in the low-educational group were attributable to education, whereas women with a low educational level were slightly protected. Less-educated men had higher risks of upper aero-digestive tract, stomach, lung, liver, rectal, bladder, central nervous system and ill-defined cancers, and lower risks of melanoma, kidney and prostate cancers. Women with lower educational levels were at higher risk of stomach, liver and cervical cancers, whereas they were less likely to be diagnosed with melanoma, ovarian and breast cancers. For most sites, the educational gradient in risk did not vary substantially over time. The educational inequalities in cancer incidence observed in this cohort appear similar in magnitude and direction to socioeconomic inequalities found in other Western countries; for some cancer sites results partly differ from the results of other studies, and require further investigation. A thorough understanding of the relative burden of well-documented causes of social inequalities in cancer risk is essential to address preventive measures and to direct future research on unexplained social differences.

The direct association observed elsewhere among blue collars between depressive symptoms and demand was confirmed, but not for job control or job strain. It cannot be ruled out that the association with demand was at least in part determined by reverse causation, due to exposure over-reporting among subjects with subclinical depressive symptoms at baseline. The protective effect of demand among white collars is not consistent with the literature and may be attributable to the particular characteristics of this sample, which included mainly workers employed in public administrative positions.