Occupational exposure to formaldehyde and wood dust and nasopharyngeal carcinoma
Occupational exposure to formaldehyde and wood dust and nasopharyngeal carcinoma
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DOI：
10.1136/oem.57.6.376
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发表时间：
2000-06-01
影响因子：
4.9
通讯作者：
Berwick, M
中科院分区：
文献类型：
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作者：
Vaughan, TL;Stewart, PA;Berwick, M
目的 - 调查职业接触甲醛和木屑是否会增加患鼻咽癌 (NPC) 的风险。方法 - 在参与国家癌症研究所 SEER 计划的美国五个癌症登记处进行了一项多中心、基于人群的病例对照研究。 1987年至1993年间新诊断鼻咽癌的病例（n = 196）和同期通过随机数字拨号从普通人群中选出的对照组（n = 244）参加了结构化电话访谈，询问了该疾病的可疑危险因素，包括职业和化学品接触史。癌症的组织学类型是从登记的临床记录中提取的。由经验丰富的工业卫生员对甲醛和木屑的潜在暴露进行评估，他们对病例或对照状态不知情。结果-对于甲醛，在调整吸烟、种族和其他危险因素后，发现随着持续时间（p=0.014）和累积暴露（p=0.033）的增加，鳞状细胞癌和未特指的上皮癌风险增加，但最大暴露浓度则不然。与那些被认为未接触过的人相比，累积接触 >1.10 ppm 年的人的比值比 (OR) 为 3.0（95% 置信区间 (95% CI) 1.3 至 6.6）。在仅限于被认为绝对暴露的工作的分析中，这些趋势变得更加强烈。这种关联在吸烟者中最为明显。相比之下，潜在的甲醛暴露与未分化癌和非角化癌之间没有关联。几乎没有证据表明接触木尘会增加鼻咽癌的风险，因为在控制潜在的甲醛暴露后，适度的粗关联基本上消失了。结论-这些结果支持这样的假设，即职业接触甲醛而不是木尘会增加鼻咽癌的风险。这种关联似乎是鳞状细胞癌特有的。应继续监测暴露于甲醛和木屑的工人群体中是否存在鼻咽癌和其他呼吸道癌症。鼻咽癌的未来研究应在评估环境和宿主因素的风险时考虑组织学类型。
Objectives-To investigate whether occupational exposures to formaldehyde and wood dust increase the risk of nasopharyngeal cancer (NPC).Methods-A multicentred, population based case-control study was carried out at five cancer registries in the United States participating in the National Cancer Institute's SEER program. Cases (n=196) with a newly diagnosed NPC between 1987 and 1993, and controls (n=244) selected over the same period from the general population through random digit dialing participated in structured telephone interviews which inquired about suspected risk factors for the disease, including a lifetime history of occupational and chemical exposure. Histological type of cancer was abstracted from clinical records of the registries. Potential exposure to formaldehyde and wood dust was assessed on a job by job basis by experienced industrial hygienists who were blinded as to case or control status.Results-For formaldehyde, after adjusting for cigarette use, race, and other risk factors, a trend of increasing risk of squamous and unspecified epithelial carcinomas was found for increasing duration (p=0.014) and cumulative exposure (p=0.033) but not for maximum exposure concentration. The odds ratio (OR) for people cumulatively exposed to >1.10 ppm-years was 3.0 (95% confidence interval (95% CI) 1.3 to 6.6) compared with those considered unexposed. In analyses limited to jobs considered definitely exposed, these trends became stronger. The associations were most evident among cigarette smokers. By contrast, there was no association between potential exposure to formaldehyde and undifferentiated and non-keratinising carcinomas. There was little evidence that exposure to wood dust increased risk of NPC, as modest crude associations essentially disappeared after control for potential exposure to formaldehyde.Conclusions-These results support the hypothesis that occupational exposure to formaldehyde, but not wood dust, increases risk of NPC. This association seems to be specific to squamous cell carcinomas. Established cohorts of workers exposed to formaldehyde and wood dust should continue to be monitored for NPC and other respiratory cancers. Future studies of NPC should take into account histological type in assessing risk from environmental and host factors.