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[鼻及鼻窦恶性肿瘤与职业医学方面的关系。病例研究]

[Nose and paranasal sinus malignancies with reference to occupational medicine aspects. A case study].

作者信息

Deitmer T, Borsch-Galetke E

机构信息

Universitäts-HNO-Klinik Münster.

出版信息

HNO. 1993 Jul;41(7):352-5.

PMID:8376182
Abstract

Asbestos is a well known inhalant cancerogenic substance, causing not only mesothelioma but also cancer of the respiratory mucosa of the bronchi. Exposure can also cause non-malignant alterations of the pleura or lung, which can be assessed radiologically. Since asbestos can also induce malignant tumors of the nose and sinuses, we identified 50 patients from the files of the ENT Department Münster and tried to complete questionnaires concerning occupation and occupational hazards using informations from insurance companies as well as at least one chest x-ray. This material could be obtained in 19 patients. Nine of the 19 patients had x-ray findings that could be associated with asbestos exposure, but in none of these 9 cases was massive occupational exposure to asbestos probable. In only two of the nine cases was definite occupational exposure to asbestos not able to be excluded. A control group was not established, since statistical calculations of significance would have been problematic in a number of the 19 patients even if a control group did exist. From the questionnaires we have found an unexpected incidence of dusty workplaces (as seen with textile workers, wood-dust workers, cement workers, quarrymen and millers). A correlation between various types of sinonasal tumors and asbestos exposure could not be made.

摘要

石棉是一种众所周知的吸入性致癌物质,不仅会引发间皮瘤,还会导致支气管呼吸黏膜癌。接触石棉还会引起胸膜或肺部的非恶性病变,这些病变可通过放射学进行评估。由于石棉还可诱发鼻和鼻窦的恶性肿瘤,我们从明斯特耳鼻喉科的档案中挑选出50名患者,并试图利用保险公司提供的信息以及至少一张胸部X光片来完成有关职业和职业危害的问卷。在19名患者中获取到了这些资料。这19名患者中有9名的X光检查结果可能与石棉接触有关,但在这9例中,没有一例可能存在大量职业性石棉接触。在这9例中,只有2例无法排除明确的职业性石棉接触。由于即使存在对照组,对这19名患者中的一些人进行统计学显著性计算也会存在问题,所以未设立对照组。从问卷中我们发现了从事粉尘作业工作场所的意外发生率(如纺织工人、木尘工人、水泥工人、采石工人和磨坊工人)。无法确定各类鼻鼻窦肿瘤与石棉接触之间的相关性。

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