Fontana L, Liétin B, Catilina P, Devif C, Féneon B, Martin F, Mom T, Gilain L
Faculté de médecine, institut de médecine du travail, université d'Auvergne, 63001 Clermont-Ferrand cedex, France.
Ann Otolaryngol Chir Cervicofac. 2008 Apr;125(2):65-71. doi: 10.1016/j.aorl.2007.10.003. Epub 2008 Apr 23.
To determine the clinical, histological, epidemiological and occupational data related to exposure to wood dust in a series of 100 nasal sinus malignant tumors.
We conducted a retrospective and descriptive study of cases diagnosed between 1st January 1981 and 31 December 2000, in the Auvergne region of France. Individual, medical, and occupational data were collected from a questionnaire completed by the patient (or the patient's family in case of death) and from the medical documents available.
Forty-six cases (46 men), with an average age of 63+/-9.2 years [range, 43-82], had been exposed to occupational wood dust before the diagnosis. Fifty-four cases (30 men, 24 women), with an average age of 64.3+/-8.7 years [range, 40-96], had never been exposed. The average annual incidence increased, either for the total population or for the two subgroups distinguished on the basis of occupational exposure to wood dust. The majority of the patients presented different functional symptoms at the time of the diagnosis. For the 46 patients exposed to wood dust, the tumors were primarily ethmoid adenocarcinomas (92%). For the 54 non-exposed patients, the tumors observed were mainly epidermoid carcinomas (57%), then adenocarcinomas (15%). On the 46 patients exposed to wood dust, 85% were carpenters or cabinetmakers. For the majority of the patients, wood dust exposure started before the age of 20 (average age: 17+/-4.5) and the longest exposure began before 1981. The exposure time to wood dust before diagnosis was in the majority of cases greater than 20 years (mean exposure time: 37 years+/-11.4). Only 15% were exposed at the time of the diagnosis (mean time between the end of the exposure to the diagnosis was 11 years+/-2.8). Of the 54 non-exposed patients, no professional risk factor was evidenced.
Epidemiologic data, such as the increasing incidence, and clinical and professional data, such as the occupational exposure to wood dust, were in agreement with the French and European literature. It is still probably too early to appreciate the effectiveness of prevention, established in France since 1980, on nasal sinus tumor incidence.
确定100例鼻窦恶性肿瘤患者中与接触木尘相关的临床、组织学、流行病学和职业数据。
我们对1981年1月1日至2000年12月31日期间在法国奥弗涅地区诊断的病例进行了回顾性描述性研究。通过患者(或患者死亡情况下的患者家属)填写的问卷以及现有医疗文件收集个人、医疗和职业数据。
46例患者(46名男性),平均年龄63±9.2岁[范围43 - 82岁],在诊断前曾接触过职业性木尘。54例患者(30名男性,24名女性),平均年龄64.3±8.7岁[范围40 - 96岁],从未接触过。无论是总人口还是根据职业性木尘接触情况区分的两个亚组,年平均发病率均有所上升。大多数患者在诊断时出现了不同的功能症状。在46例接触木尘的患者中,肿瘤主要为筛窦腺癌(92%)。在54例未接触的患者中,观察到的肿瘤主要为表皮样癌(57%),其次为腺癌(15%)。在46例接触木尘的患者中,85%是木匠或细木工。对于大多数患者来说,木尘接触始于20岁之前(平均年龄:17±4.5岁),最长接触始于1981年之前。诊断前接触木尘的时间在大多数情况下超过20年(平均接触时间:37年±11.4年)。只有15%在诊断时仍有接触(从接触结束到诊断的平均时间为11年±2.8年)。在54例未接触的患者中,未发现职业危险因素。
流行病学数据(如发病率上升)以及临床和职业数据(如职业性木尘接触)与法国和欧洲的文献一致。评估自1980年起在法国实施的预防措施对鼻窦肿瘤发病率的有效性可能仍为时过早。