Abstract
BackgroundFew epidemiological studies have investigated the link between occupational exposure to solvents and head and neck cancer risk, and available findings are sparse and inconsistent. The objective of this study was to examine the association between occupational exposure to chlorinated solvents and head and neck cancer risk.MethodsWe analyzed data from 4637 men (1857 cases and 2780 controls) included in a population-based case-control study, ICARE (France). Occupational exposure to five chlorinated solvents (perchloroethylene [PCE], trichloroethylene [TCE], methylene chloride [MC], chloroform [CF], and carbon tetrachloride [CT]) was assessed through job-exposure matrices. Odds ratios (ORs) and confidence intervals (95% CI) were estimated by unconditional logistic regression, adjusted for age, tobacco smoking, alcohol consumption, asbestos exposure, and other potential confounders.ResultsWe observed no association between chlorinated solvent exposure and head and neck cancer risk, despite a non-significant increase in risk among subjects who had the highest cumulative level of exposure to PCE, (OR = 1.81; 95% CI = 0.68 to 4.82). In subsite analysis, the risk of laryngeal cancer increased with cumulative exposure to PCE (p for trend = 0.04). The OR was 3.86 (95% CI = 1.30 to 11.48) for those exposed to the highest levels of PCE. A non-significant elevated risk of hypopharyngeal cancer was also observed in subjects exposed to the highest levels of MC (OR = 2.36; 95% CI = 0.98 to 5.85).ConclusionOur findings provide evidence that high exposure to PCE increases the risk of laryngeal cancer, and suggest an association between exposure to MC and hypopharyngeal cancer. Exposure to other chlorinated solvents was not associated with the risk of head and neck cancer.
Highlights
Few epidemiological studies have investigated the link between occupational exposure to solvents and head and neck cancer risk, and available findings are sparse and inconsistent
We fitted models with and without cumulative asbestos exposure in four categories.As the inclusion of asbestos exposure resulted in changes in Odds ratios (ORs) for most solvents and no change in OR point estimate without loss of precision for the others, we present below the models adjusted for asbestos exposure
Concerning lifetime exposure to chlorinated solvents, the most prevalent exposure was to TCE with 8.76% of cases and 7.53% of controls exposed followed by methylene chloride (MC) with 1.43% of cases and 1.14% of controls exposed
Summary
Few epidemiological studies have investigated the link between occupational exposure to solvents and head and neck cancer risk, and available findings are sparse and inconsistent. The objective of this study was to examine the association between occupational exposure to chlorinated solvents and head and neck cancer risk. Until recently, chlorinated solvents have been widely used in practically all branches of modern industry. Their use has since decreased in response to various factors, including increasing knowledge pertaining to their toxicity and. Few epidemiological studies have examined the link between occupational exposure to chlorinated solvents and head and neck cancer risk, and available findings are sparse and inconsistent. Shangina et al found a significantly increased risk of laryngeal cancer associated with chlorinated solvent exposure [13] and Vaughan et al found a non-significant increased risk of oral, pharyngeal, and laryngeal cancer among subjects exposed to PCE [14]
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