Prevalence of occupational hazards in patients with different types of epithelial sinonasal cancers

Abstract

Background: Occupational exposure to carcinogens contributes greatly to the etiology of sinonasal cancer (SNC), but the role of different risk factors in determining different histological subtypes is disputed. Methodology: All consecutive surgical epithelial SNC cases (case-series study) underwent a systematic occupational medicine examination to determine previous exposure to a wide range of work-related chemical hazards. Results: We investigated 65 SNC cases including intestinal-type adenocarcinoma [ITAC] squamous-cell carcinoma [SCC], and others. Occupational exposure was recognized for 39 cases. Occupational exposures were sensibly more frequent among ITAC than among SCC or other histotypes. Occupational exposure in ITAC cases was to leather or wood dust only, while among non-ITAC cases, we recognised exposure to formaldehyde, solvents and metal fumes. A high proportion of SNC with occupational exposure originated in the ethmoidal epithelium. Conclusion: In our case-series of SNC, a very high frequency of previous occupational exposure to carcinogens was detected, suggesting that occupational hazards may be associated to the aetiopathogenesis, primarily for ITAC, but also for other histotypes. Besides leather or wood, other chemical agents must be recognized as occupational risk factors.

Exposures to IARC Carcinogenic Agents in Work Settings Not Traditionally Associated with Sinonasal Cancer Risk: The Experience of the Italian National Sinonasal Cancer Registry

“…In a CAREX project, workers exposed to bark are exposed to wood dust mainly on this chemical basis [ 16 ]. Suberosis is a recognized form of pneumoconiosis that affects cork workers, while only recently, SNC cases were observed (prevalently intestinal-type adenocarcinomas) among subjects occupationally exposed to cork dust [ 17 , 18 , 19 , 20 ].…”

Gender Differences in Sinonasal Cancer Incidence: Data from the Italian Registry

“…The results of our study confirm the correlation between ITACs and ethmoid sinus for occupational exposure to both wood and leather dusts in men. A high proportion of ITAC (87% of the enrolled cases) with occupational exposure to leather or hardwood dusts was shown by an Italian study [ 38 ]. However, a geographical variation exists in ITAC patients [ 39 ], which may be attributed to the presence of unidentified genetic susceptibility factors or exposure to different types of wood or other compounds.…”

International Consensus Statement on Allergy and Rhinology: Sinonasal Tumors

“…Efforts to limit exposure to wood dust and other potentially causal substances in the workplace appear to be impacting the incidence and mortality of SNM at the population level, with significantly decreasing rates evident over recent years, predominantly in developed countries 28 . Based on this evidence, in many European countries, ITAC is officially considered a professional disease 89 . Additionally, a significant dose–response relationship was found between adenocarcinoma risk and exposure period to leather dust: the risk increased among workers over 5 years’ exposure by almost 60‐fold as compared to those unexposed 55 …”