Abstract
Occupational exposure to wood dust is one cause of nasopharyngeal cancer (NPC); however, assessing this exposure remains problematic. Therefore, the objective of this study was to develop a semi-quantitative exposure assessment method and then utilize it to evaluate the association between occupational exposure to wood dust and the development of NPC. In addition, variations in risk by histology were examined. A case-control study was conducted with 327 newly diagnosed cases of NPC at the National Cancer Institute and regional cancer centers in Thailand with 1:1 controls matched for age, gender and geographical residence. Occupational information was obtained through personal interviews. The potential probability, frequency and intensity of exposure to wood dust were assessed on a job-by-job basis by experienced experts. Analysis was performed by conditional logistic regression and presented in odds ratio (ORs) estimates and 95% confidence intervals (CI). Overall, a non significant relationship between occupational wood dust exposure and NPC risk for all subjects was observed (ORs=1.61, 95%CI 0.99-2.59); however, the risk became significant when analyses focused on types 2 and 3 of NPC (ORs=1.62, 95%CI 1.03-2.74). The significant association was stronger for those exposed to wood dust for >10 year (ORs=2.26, 95%CI 1.10-4.63), for those with first-time exposure at age>25 year (ORs=2.07, 95%CI 1.08-3.94), and for those who had a high cumulative exposure (ORs=2.17, 95%CI 1.03-4.58) when compared with those considered unexposed. In conclusion, wood dust is likely to be associated with an increased risk of type 2 or 3 NPC in the Thai population. The results of this study show that semi-quantitative exposure assessment is suitable for occupational exposure assessment in a case control study and complements the information from self-reporting.
Highlights
Nasopharyngeal cancer (NPC) has a high incidence in some areas of the world, e.g. Southern China, Taiwan, South East Asia, North Africa and the Arctic (Parkin et al, 2002)
The significant association was stronger for those exposed to wood dust for ≥10 years (ORs=2.26, 95%confidence intervals (CI) 1.10-4.63)
Participants who were first exposed to wood dust at early age (< 25 years) show no significant association, but firsttime exposure at age 25 years or older showed a significant association with type 2 and 3 nasopharyngeal cancer (NPC) (ORs=2.07, 95% confidence intervals (95%CI) 1.08-3.94), as well as for all subjects (ORs=1.94, 95%CI 1.03-3.65)
Summary
Nasopharyngeal cancer (NPC) has a high incidence in some areas of the world, e.g. Southern China, Taiwan, South East Asia, North Africa and the Arctic (Parkin et al, 2002). Type 1 NPC is predominant in low incidence regions, and may have an etiology different from that of the other two histologic types (Vauhan et al.,1996). Numerous environmental and genetic factors have been shown to be associated with the development of NPC. The strongest risk factor for NPC know today is infection of the Epstein-Bar virus (EBV) (Raab-Traub, 2002; Zheng et al, 1994). In the weaning years(Ward et al, 2000), smoking tobacco (Chen et al, 1990), and drinking alcohol (Chen et al, 2009) were found associated with an increased risk of NPC. Other studies have inconsistently linked increased NPC risk with ENT Chronic diseases (Yuan et al, 2000; Zou et al, 2000)
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