Ekpanyaskul Chatchai, Sangrajrang Suleeporn, Ekburanawat Wiwat, Brennan Paul, Mannetje Andrea, Thetkathuek Anamai, Saejiw Nutjaree, Ruangsuwan Tassanu, Boffetta Paolo
Department of Preventive and Social Medicine, Faculty of Medicine, Srinakharinwirot University, Bangkok,Thailand E-mail :
Asian Pac J Cancer Prev. 2015;16(10):4339-45. doi: 10.7314/apjcp.2015.16.10.4339.
Occupational exposure to wood dust is one cause of nasopharyngeal cancer (NPC); however, assessing this exposure remains problematic. Therefore, the objective of this study was to develop a semi-quantitative exposure assessment method and then utilize it to evaluate the association between occupational exposure to wood dust and the development of NPC. In addition, variations in risk by histology were examined. A case-control study was conducted with 327 newly diagnosed cases of NPC at the National Cancer Institute and regional cancer centers in Thailand with 1:1 controls matched for age, gender and geographical residence. Occupational information was obtained through personal interviews. The potential probability, frequency and intensity of exposure to wood dust were assessed on a job-by-job basis by experienced experts. Analysis was performed by conditional logistic regression and presented in odds ratio (ORs) estimates and 95% confidence intervals (CI). Overall, a non significant relationship between occupational wood dust exposure and NPC risk for all subjects was observed (ORs=1.61, 95%CI 0.99-2.59); however, the risk became significant when analyses focused on types 2 and 3 of NPC (ORs=1.62, 95%CI 1.03-2.74). The significant association was stronger for those exposed to wood dust for >10 year (ORs=2.26, 95%CI 1.10-4.63), for those with first-time exposure at age>25 year (ORs=2.07, 95%CI 1.08-3.94), and for those who had a high cumulative exposure (ORs=2.17, 95%CI 1.03-4.58) when compared with those considered unexposed. In conclusion, wood dust is likely to be associated with an increased risk of type 2 or 3 NPC in the Thai population. The results of this study show that semi-quantitative exposure assessment is suitable for occupational exposure assessment in a case control study and complements the information from self-reporting.
职业性接触木屑是鼻咽癌（NPC）的病因之一；然而，评估这种接触情况仍然存在问题。因此，本研究的目的是开发一种半定量接触评估方法，然后利用它来评估职业性接触木屑与鼻咽癌发生之间的关联。此外，还研究了组织学风险的差异。在泰国国家癌症研究所和地区癌症中心对327例新诊断的鼻咽癌病例进行了病例对照研究，对照组按年龄、性别和地理居住地1:1匹配。职业信息通过个人访谈获得。由经验丰富的专家逐工作岗位评估接触木屑的潜在可能性、频率和强度。通过条件逻辑回归进行分析，并以比值比（OR）估计值和95%置信区间（CI）呈现。总体而言，观察到所有受试者的职业性木屑接触与鼻咽癌风险之间无显著关系（OR = 1.61，95%CI 0.99 - 2.59）；然而，当分析集中在鼻咽癌2型和3型时，风险变得显著（OR = 1.62，95%CI 1.03 - 2.74）。对于接触木屑超过10年的人（OR = 2.26，95%CI 1.10 - 4.63）、首次接触年龄大于25岁的人（OR = 2.07，95%CI 1.08 - 3.94）以及累积接触量高的人（OR = 2.17，95%CI 1.03 - 4.58），与未接触者相比，显著关联更强。总之，木屑可能与泰国人群中2型或3型鼻咽癌风险增加有关。本研究结果表明，半定量接触评估适用于病例对照研究中的职业接触评估，并补充了自我报告的信息。
