Abstract
Head and neck cancers account for an estimated 549,000 global cancer diagnoses each year. While tobacco use, alcohol consumption, and HPV16 infection are considered to be the major risk factors for this disease, occupational risk factors, including exposure to asbestos, have also been described, although dust exposures other than asbestos have been historically understudied. We have investigated the relationship between occupational exposures to five types of dusts, including sawdust, concrete dust, leather dust, metal dust, and chimney soot, and head and neck squamous cell carcinomas (HNSCC) in the greater Boston area. We report findings from a population-based case–control study involving 951 incident HNSCC cases and 1193 controls, frequency matched on age (±3 years), sex, and town/neighborhood of residence. Multivariable logistic regression was used to assess the association between occupational exposure to each type of dust and HNSCC, overall and by primary tumor site. After adjusting for age, sex, race, smoking, alcohol consumption, education, and HPV16 serology, laryngeal carcinoma risk increased for each decade of occupational exposure to sawdust (OR = 1.2, 95% CI: 1.0, 1.3) and metal dust (OR = 1.2, 95% CI: 1.0, 1.4); and HNSCC risk increased for each decade of occupational leather dust exposure (OR = 1.5, 95% CI: 1.2, 1.9). We have provided evidence for an association between occupational sawdust and metal dust and laryngeal squamous cell carcinoma, and leather dust and HNSCC, with increasing risk with longer duration at the exposed occupation.
Highlights
Head and neck cancer accounts for an estimated 549,000 global cancer diagnoses each year [1], making it the 7th most common cancer worldwide (6th among men)
As a number of different exposures may be common to an occupation, we constructed a correlation matrix to explore the relationship between dust exposures and other select occupational exposures that could potentially influence head and neck squamous cell carcinomas (HNSCC) risk (Table 2)
While International Agency for Cancer Research (IARC) considers both wood dust and leather dust to be causal for sinonasal cancers [8], the literature remains sparse for other cancers of the upper aerodigestive tract, especially for oral and pharyngeal cancers
Summary
Head and neck cancer (excluding cancers of the nasopharynx) accounts for an estimated 549,000 global cancer diagnoses each year [1], making it the 7th most common cancer worldwide (6th among men). Smoking (and to a somewhat lesser extent, smokeless tobacco or betel quid mixtures), alcohol consumption, and HPV16 infection are widely recognized as the primary risk factors for this disease [3]. While those risk factors have garnered the majority of attention in etiologic research for HNSCC, and deservingly so, as they are attributed to the vast majority of these tumors, there is evidence that other factors may contribute to this disease, including occupational exposures [4, 5]. As manufacturing becomes progressively more globalized, the elucidation of occupational risk factors becomes increasingly critical for the formulation and implementation of adequate safety policy and procedures.
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