Jansing Paul J, Chanda Robin, Gore Claudia, Küpper Thomas
State Institute for Occupational Health and Safety of North Rhine-Westphalia Düsseldorf, Germany.
Int J Occup Med Environ Health. 2003;16(4):329-35.
Regulations to certify nasal carcinoma as occupational disease induced by wood dust vary in the European countries. In Germany, it must be adenocarcinoma and the dust originating from beech or oak trees. In other countries, the disease is reconized as induced by occupation independent of the kind of wood dust or the type of carcinoma. With regard to the harmonization of regulations necessary in Europe we investigate whether these differences are acceptable from the scientific viewpoint.
In a retrospective analysis of a group of 28 patients with wood dust-induced nasal carcinoma in North Rhine-Westphalia, Germany, we studied whether significant differences in exposure, personal risks (smoking) and histological tumor type could justify the current German, Austrian and Luxembourg pattern of occupational disease certification. To quantify cumulative time of exposure we developed a new semiquantitative formula for the calculation of wood dust years (WDY).
Our results indicate that there are no significant differences between the subgroups, i.e., exposure to hard wood (n = 13) or other woods (n = 15), WDY (13.1 +/- 11.3), smoking (n = 17) or nonsmoking, type of work and the diagnosis of nasal squamous cell carcinoma (n = 8) versus nasal adenocarcinoma (n = 20). The review of literature suggests systematic errors in the studies that led to the current German regulations.
We recommend to amend the German, Austrian and Luxembourg regulations and to recognise nasal carcinomas as occupational disease, regardless of the type of wood dust exposure, and regardless of the tumor histology as also recommended by the International Agency for Research on Cancer (IARC).
欧洲各国关于将鼻腔癌认定为由木尘诱发的职业病的规定各不相同。在德国，必须是腺癌且木尘源自山毛榉或橡树。在其他国家，无论木尘种类或癌症类型如何，该病都被认定为职业诱发疾病。考虑到欧洲必要的法规协调，我们研究了从科学角度来看这些差异是否可以接受。
在对德国北莱茵 - 威斯特法伦州一组28例由木尘诱发的鼻腔癌患者进行回顾性分析时，我们研究了暴露、个人风险（吸烟）和组织学肿瘤类型方面的显著差异是否能够证明德国、奥地利和卢森堡目前的职业病认证模式合理。为了量化累积暴露时间，我们开发了一种新的半定量公式来计算木尘年（WDY）。
我们的结果表明，各亚组之间没有显著差异，即暴露于硬木（n = 13）或其他木材（n = 15）、WDY（13.1 +/- 11.3）、吸烟（n = 17）或不吸烟、工作类型以及鼻腔鳞状细胞癌（n = 8）与鼻腔腺癌（n = 20）的诊断之间。文献综述表明导致当前德国法规的研究存在系统误差。
我们建议修订德国、奥地利和卢森堡的法规，将鼻腔癌认定为职业病，无论木尘暴露类型如何，也无论肿瘤组织学类型如何，正如国际癌症研究机构（IARC）所建议的那样。
