[Adenocarcinomas of the ethmoid sinuses. Epidemiological data]

Abstract

Objective: The relationship between adenocarcinomas of the ethmoid (ADKE) and wood-dust exposure has been well established. Sino-nasal cancer in wood-workers has been added to the list of occupational disorders in France, as prescribed disease number 47-Bq.

Patients and methods: Our data set consisted of 207 cases with sino-nasal cancer (from January 1985 to January 2001). Among these cases, 67.1% were adenocarcinoma. A wood dust exposure has been reported in 96.4% cases. The mean duration of wood dust exposure was 30 years. The mean latency between the end of the exposure and the diagnostic was 10.6 years.

Results: Our epidemiological data confirmed those from the biomedical literature. The occupations at greatest risk are furniture workers, sawmill workers, carpentry workers, and other wood product workers. Two components of exposure - duration and average level - contributed independently to the overall elevated risk. The risk is greater among men who were employed in jobs with the highest wood dust exposure and increases with the duration of exposure.

Conclusions: The preinvasive stages of ADKE (mucostasis/cuboïd metaplasia/dysplasia) are still an unverified hypothesis. ADKE were observed in workers who use "hard" woods. The chemical nature of the carcinogenic factor(s) in wood dust is not known. The factors responsible for induction of ADKE in hard wood-workers probably exist in the wood-dust itself. Tannins were suggested as possible contributing agents to induction of ADKE. In addition to wood dust, exposures may include formaldehyde. Given these facts, it should be possible to define preventive measures, so that incidence of ADKE in professional wood and leather workers should decrease.