Pesch B, Pierl C B, Gebel M, Gross I, Becker D, Johnen G, Rihs H-P, Donhuijsen K, Lepentsiotis V, Meier M, Schulze J, Brüning T
BGFA-Forschungsinstitut für Arbeitsmedizin der Deutschen Gesetzlichen Unfallversicherung, Bürkle-de-la-Camp-Platz 1, 44789 Bochum, Germany.
Occup Environ Med. 2008 Mar;65(3):191-6. doi: 10.1136/oem.2007.033886. Epub 2007 Sep 19.
To examine the risk of wood dust and chemical exposures for adenocarcinoma of the nasal cavity and paranasal sinuses (ADCN) among German wood workers.
An industry-based case-control study with 86 male ADCN cases and 204 controls was conducted in the German wood-working industries. Cumulative and average wood-dust exposure was quantified with a job-exposure matrix based on wood-dust measurements at recent and historical workplaces. Probabilities of exposure to wood preservatives, stains, varnishes, and formaldehyde were semi-quantitatively rated. Odds ratios and 95% confidence intervals were calculated with logistic regression analysis conditional on age and adjusted for smoking and other factors. For estimating the risks of either wood dust or chemical additives, the authors additionally adjusted for the corresponding co-exposure.
ADCN occurred relatively more frequently among wood workers that had ever worked as cabinet makers or joiners (OR 2.96, 95% CI 1.46 to 6.01) than as saw millers (OR 0.15, 95% CI 0.03 to 0.68). Average exposure to inhalable wood dust >/=5 mg/m(3) was associated with a high risk (OR 48.47, 95% CI 13.30 to 176.63) compared to levels below 3.5 mg/m(3). Assuming 40 years of exposure under these concentrations, the corresponding OR was 4.20 (95% CI 1.69 to 10.43). Exposure between 3.5 and 5 mg/m(3) was also found to pose a risk (OR 10.54, 95% CI 3.34 to 33.27). Exposure to pigment stains before 1970 was associated with an increased risk (OR 3.03; 95% CI 1.11 to 8.26). No significant associations were estimated for wood preservatives, varnishes, and formaldehyde.
The authors found an elevated ADCN risk for exposure to inhalable wood dust above 3.5 mg/m(3). The rareness of the disease does not allow the exclusion of risk below that concentration. For pigment stains, there is evidence for an association of historical exposure with the development of ADCN in German wood workers.
研究德国木材加工工人中,接触木尘和化学物质与鼻腔及鼻窦腺癌(ADCN)的风险关系。
在德国木材加工行业开展了一项基于行业的病例对照研究,纳入86例男性ADCN病例和204例对照。根据近期和历史工作场所的木尘测量结果,通过工作暴露矩阵对累积和平均木尘暴露进行量化。对接触木材防腐剂、染色剂、清漆和甲醛的可能性进行半定量评分。采用逻辑回归分析计算比值比和95%置信区间,并根据年龄进行条件分析,同时对吸烟和其他因素进行校正。为估计木尘或化学添加剂的风险,作者还对相应的共同暴露进行了校正。
曾从事橱柜制作工或细木工的木材加工工人中ADCN的发生频率相对较高(比值比2.96,95%置信区间1.46至6.01),而锯木工中ADCN的发生频率相对较低(比值比0.15,95%置信区间0.03至0.68)。与低于3.5mg/m³的水平相比,可吸入木尘平均暴露量≥5mg/m³与高风险相关(比值比48.47,95%置信区间13.30至176.63)。假设在这些浓度下暴露40年,相应的比值比为4.20(95%置信区间1.69至10.43)。还发现暴露于3.5至5mg/m³之间也存在风险(比值比10.54,95%置信区间3.34至33.27)。1970年前接触颜料染色剂与风险增加相关(比值比3.03;95%置信区间1.11至8.26)。未发现木材防腐剂、清漆和甲醛存在显著关联。
作者发现,可吸入木尘暴露量高于3.5mg/m³会增加ADCN风险。由于该疾病罕见,不能排除低于该浓度时的风险。对于颜料染色剂,有证据表明德国木材加工工人的历史暴露与ADCN的发生有关。