Nasal cancer in the Northamptonshire boot and shoe industry.

A survey of the incidence of nasal cancer in Northamptonshire during the period 1953 to 1967 is reported. Of the 46 patients with nasal cancer ascertained during the 15-year period 21 (19 males and 2 females) had been employed at some time in the boot and shoe industry. Five other cases diagnosed either before 1953 or after 1967 in persons who had worked in the boot and shoe industry in Northamptonshire were ascertained from various sources.The incidence of nasal cancer (all histological types considered together) was significantly higher in male boot and shoe operatives in Northamptonshire than in males of all occupational classes in the Cancer Register areas selected for comparison and in males working in other occupations in Northamptonshire. The excess incidence has recently given rise to the occurrence of between 1 and 2 new cases per annum in the Northamptonshire boot and shoe industry.The cases within the Northamptonshire industry occurred almost entirely in the relatively small number of workers who are exposed to the dust of the materials used in the manufacture of footwear.Possibly there are two carcinogenic factors in the industry-one related to the production of nasal adenocarcinoma, and the other to squamous and possibly other types of carcinoma in the nasal cavity and sinuses. This requires further study. Our best estimate of the latent period for the adenocarcinoma cases was 54.6 years, which is substantially longer than for the patients with squamous, transitional, and anaplastic tumours (41.7 years). We have no evidence to answer the question whether the facts are still present in the industrial environment, though undoubtedly the standards of hygiene in the industry has improved substantially since these men were first exposed.There is probably an increased risk of nasal adenocarcinoma in the footwear repairing industry, but this requires further study. Our evidence suggests that snuff taking should be considered as a possible contributory factor in both industrial and non-industrial nasal cancer.A survey of the footwear manufacturing and repairing industry is recommended regarding cancer of the respiratory tract. Further attempts should be made to minimize the inhalation of dust. The case for the prescription of nasal cancer in the footwear industry should be considered.