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A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking

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 hav...

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Autores principales: Emanuelli, Enzo, Alexandre, Enrico, Cazzador, Diego, Comiati, Vera, Volo, Tiziana, Zanon, Alessia, Scapellato, Maria Luisa, Carrieri, Mariella, Martini, Alessandro, Mastrangelo, Giuseppe
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2016
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957368/
https://www.ncbi.nlm.nih.gov/pubmed/27453718
http://dx.doi.org/10.1186/s12995-016-0124-7
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author Emanuelli, Enzo
Alexandre, Enrico
Cazzador, Diego
Comiati, Vera
Volo, Tiziana
Zanon, Alessia
Scapellato, Maria Luisa
Carrieri, Mariella
Martini, Alessandro
Mastrangelo, Giuseppe
author_facet Emanuelli, Enzo
Alexandre, Enrico
Cazzador, Diego
Comiati, Vera
Volo, Tiziana
Zanon, Alessia
Scapellato, Maria Luisa
Carrieri, Mariella
Martini, Alessandro
Mastrangelo, Giuseppe
author_sort Emanuelli, Enzo
collection PubMed
description 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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spelling pubmed-49573682016-07-23 A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking Emanuelli, Enzo Alexandre, Enrico Cazzador, Diego Comiati, Vera Volo, Tiziana Zanon, Alessia Scapellato, Maria Luisa Carrieri, Mariella Martini, Alessandro Mastrangelo, Giuseppe J Occup Med Toxicol Research 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. BioMed Central 2016-07-21 /pmc/articles/PMC4957368/ /pubmed/27453718 http://dx.doi.org/10.1186/s12995-016-0124-7 Text en © The Author(s). 2016 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research
Emanuelli, Enzo
Alexandre, Enrico
Cazzador, Diego
Comiati, Vera
Volo, Tiziana
Zanon, Alessia
Scapellato, Maria Luisa
Carrieri, Mariella
Martini, Alessandro
Mastrangelo, Giuseppe
A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking
title A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking
title_full A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking
title_fullStr A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking
title_full_unstemmed A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking
title_short A case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking
title_sort case-case study on sinonasal cancer prevention: effect from dust reduction in woodworking and risk of mastic/solvents in shoemaking
topic Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4957368/
https://www.ncbi.nlm.nih.gov/pubmed/27453718
http://dx.doi.org/10.1186/s12995-016-0124-7
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