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

Alessandra Binazzi,Stefano Murano,Roberto Calisti,Matteo Bonzini,Carolina Mensi,Davide Di Marzio,Paolo Galli,Stefania Massacesi,Angela Camagni,Angelo D’Errico,Denise Sorasio,Lucia Miligi,Alessandro Marinaccio,Jana Zajacova,Anna Balestri,Sara Piro

doi:10.3390/ijerph182312593

Abstract

The aim of this study is to highlight tasks and jobs not commonly considered at high risk for sinonasal cancer (SNC) identified by Regional Operating Centers currently active in the Italian National Sinonasal Cancer Registry (ReNaTuNS), which retrieve occupational histories through a standardized questionnaire. Data on exposures to IARC carcinogenic agents in work settings unknown to be associated with SNC risk were collected and analyzed. Out of 2,208 SNC cases recorded in the ReNaTuNS database, 216 cases and their worked exposure periods were analyzed. Unsuspected jobs with exposure to wood dust include construction-related tasks, production of resins, agriculture and livestock jobs (straw and sawdust), and heel factory work (cork dust). Other examples are hairdressers, bakers (formaldehyde), dressmakers, technical assistants, wool and artificial fiber spinners, and upholsterers (textile dusts). Moreover, settings with coexposure to different agents (e.g., wood with leather dusts and chromium–nickel compounds) were recognized. The study describes jobs where the existence of carcinogenic agents associated with SNC risk is unexpected or not resulting among primary materials employed. The systematic epidemiological surveillance of all epithelial SNC cases with a detailed collection of their work history, as performed by a dedicated population registry, is essential for detecting all potential occupational cases and should be considered in the context of forensic medicine and the compensation process.

Highlights

Cancers of the nasal cavity and paranasal sinuses are rare malignancies, accounting for 3% to 5% of all head and neck cancers and less than 1% of all cancers [1]
By using data on sinonasal cancer (SNC) cases collected by CORs, the purpose of this paper is to describe economic sectors and jobs not conventionally considered to be at high risk for SNC, but where a definite occupational exposure to International Agency for Research on Cancer (IARC) carcinogens for SNC has been assessed and recognized
We present an analysis of retrieved occupational exposures to IARC carcinogenic agents for the nasal cavity and paranasal sinuses in subjects employed in work settings not traditionally associated with SNC

Summary

Introduction

Cancers of the nasal cavity and paranasal sinuses are rare malignancies, accounting for 3% to 5% of all head and neck cancers and less than 1% of all cancers [1]. Epithelial tumors represent more than 80% of all sinonasal tumors, with “sinonasal squamous cell carcinoma” (mainly occurring in the maxillary sinus and nasal cavity) and “intestinaltype adenocarcinoma” (which principally arises in the ethmoid sinus) being the most common subtypes. Sinonasal malignancies have an estimated incidence rate ranging from 0.5 to 1 case per 100,000 people and a 5-year overall survival reported to be at 30% to 50% [2]. Exposure linked to occupational settings is a major risk factor for sinonasal cancer (SNC), which is occupational exposure. Despite the low absolute risk in the general population, SNC is associated with high relative risks for specific chemical exposures and workplaces. The occupation-attributable fraction is estimated to be in the range of 20–46% and is elevated for adenocarcinomas (77%) [3,4]

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