Comba P, Belli S
Laboratorio di Igiene Ambientale, Istituto Superiore di Sanità, Roma.
Ann Ist Super Sanita. 1992;28(1):121-32.
Etiologically-oriented epidemiologic studies on cancer of the nasal cavities and paranasal sinuses have been carried out since the beginning of the century. These studies showed that several chemical agents (chromates, nickel compounds, isopropylic alcohol, and mustard gas), and two occupational exposures (wood dust in the furniture industry and exposure to leather in shoe factories) were causally associated with nasal cancer. An increased risk has also been associated with several occupations (i.e. metalworker, textile worker, construction worker, and farmer) even in the apparent absence of causal agents. The first reports of an increased risk of nasal cancer in woodworkers and leather workers in Italy date back to 1980. Subsequent studies have provided estimates of the relative risk, ranging from 3.0 to 11.0 among woodworkers and from 8.1 to 47.1 among leatherworkers. Increased risks have been associated to the metal industry (relative risk ranging from 3.1 to 5.9), the textile industry (ranging from 2.9 to 17.0), the mining and construction industry (ranging from 2.3 to 5.3), and the agricultural industry (ranging from 1.9 to 3.3); all of these estimates are time- and place-specific. Moreover, the estimates are not reliable because of the small sample size, resulting from the low occurrence of the disease. The etiologic fraction for the population, taking into account both verified and suspected carcinogenic exposures, ranges between 50% and 65% in males. Relatively few cases of nasal cancer (all of them occurring in woodworkers) have been notified for workman's compensation; woodworkers with nasal cancer have received monetary compensation in Italy since 1988. Nasal cancer is an often fatal but largely preventable disease. Several verified and suspected occupational exposures are associated with this neoplasm. The reduction of dust and fumes in the air of the above mentioned work environments is recommended for reducing the occurrence of this disease.
自本世纪初以来，针对鼻腔和鼻窦癌开展了以病因学为导向的流行病学研究。这些研究表明，几种化学物质（铬酸盐、镍化合物、异丙醇和芥子气）以及两种职业暴露（家具行业的木尘和鞋厂的皮革接触）与鼻癌存在因果关联。即使在明显没有致病因素的情况下，几种职业（如金属工人、纺织工人、建筑工人和农民）患癌风险也有所增加。意大利最早报告木工和皮革工人患鼻癌风险增加可追溯到1980年。随后的研究给出了相对风险的估计值，木工的相对风险在3.0至11.0之间，皮革工人的相对风险在8.1至47.1之间。金属行业（相对风险在3.1至5.9之间）、纺织行业（在2.9至17.0之间）、采矿和建筑行业（在2.3至5.3之间）以及农业行业（在1.9至3.3之间）的患癌风险也有所增加；所有这些估计值都因时因地而异。此外，由于该疾病发病率低导致样本量小，这些估计并不可靠。考虑到已证实和疑似致癌暴露因素，男性人群的病因分数在50%至65%之间。相对较少的鼻癌病例（均发生在木工中）已被上报以申请工伤赔偿；自1988年以来，意大利患鼻癌的木工已获得经济赔偿。鼻癌通常是一种致命但在很大程度上可预防的疾病。几种已证实和疑似的职业暴露与这种肿瘤有关。建议减少上述工作环境空气中的粉尘和烟雾，以降低该疾病的发生率。
