Luce D, Gérin M, Leclerc A, Morcet J F, Brugère J, Goldberg M
INSERM Unité 88, Paris, France.
Int J Cancer. 1993 Jan 21;53(2):224-31. doi: 10.1002/ijc.2910530209.
A case-control study of cancer of the nose and paranasal sinuses was conducted in France to determine whether occupational exposure to formaldehyde was associated with an increased risk of sinonasal cancer. Exposures to 14 other substances or groups of substances were also studied (wood dust, leather dust, textile dust, flour dust, sugar dust, coal/coke dust, nickel compounds, chromium compounds, chromium VI, welding fumes, soldering fumes, cutting oils, paints and lacquers, glues and adhesives). Cases (n = 207) and controls (n = 409) were interviewed to obtain detailed information on job history and other potential risk factors for sinonasal cancer. In addition, a questionnaire specially designed for this study was used to help assess exposures to formaldehyde and other substances of interest. The questionnaires were translated into history of occupational exposure by an expert in industrial hygiene, without knowledge of case-control status. Several exposure variables (lifetime average level, duration, cumulative level) were used to describe the risk related to exposure to formaldehyde. Potential confounding factors (occupational and non-occupational) were examined and adjusted for when necessary. No significant association was found between exposure to formaldehyde and squamous-cell carcinomas of the sinonasal cavities. Because of the strong association between exposure to wood dust and nasal adenocarcinoma, it was not possible to assess an independent effect of formaldehyde on this type of cancer. However, among males exposed to medium or high levels of wood dust, the risk of adenocarcinoma associated with formaldehyde was significantly elevated for the highest exposure categories for average level (OR = 5.3, 95% confidence interval = 1.3-22.2), cumulative level (OR = 6.9, 95% CI = 1.7-28.2) and duration of exposure (OR = 6.9, 95% CI = 1.7-27.8). Although a residual confounding effect of wood dust could not be excluded, this study suggests that exposure to both formaldehyde and wood dust may increase the risk of nasal adenocarcinoma, by comparison with the risk due to wood dust alone. This study also indicated an increased risk among males who had been exposed to glues and adhesives, for all histologic types, which was not explained by a confounding effect of paints and lacquers, wood dust or formaldehyde. No other significant association was observed.
在法国开展了一项关于鼻和鼻窦癌的病例对照研究，以确定职业性接触甲醛是否会增加鼻窦癌风险。同时还研究了对其他14种物质或物质组的接触情况（木尘、皮革尘、纺织尘、面粉尘、糖尘、煤/焦炭尘、镍化合物、铬化合物、六价铬、焊接烟尘、钎焊烟尘、切削油、油漆和清漆、胶水和粘合剂）。对病例（n = 207）和对照（n = 409）进行访谈，以获取有关工作史及鼻窦癌其他潜在风险因素的详细信息。此外，还使用了专门为本研究设计的问卷，以帮助评估对甲醛和其他相关物质的接触情况。问卷由工业卫生专家在不知病例对照状态的情况下转化为职业接触史。使用了几个接触变量（终生平均水平、持续时间、累积水平）来描述与甲醛接触相关的风险。对潜在的混杂因素（职业性和非职业性）进行了检查，并在必要时进行了调整。未发现甲醛接触与鼻窦鳞状细胞癌之间存在显著关联。由于木尘接触与鼻腺癌之间存在强烈关联，因此无法评估甲醛对这类癌症的独立影响。然而，在接触中高水平木尘的男性中，对于平均水平（OR = 5.3，95%置信区间 = 1.3 - 22.2）、累积水平（OR = 6.9，95%CI = 1.7 - 28.2）和接触持续时间（OR = 6.9，95%CI = 1.7 - 27.8）的最高接触类别，与甲醛相关的腺癌风险显著升高。尽管不能排除木尘的残留混杂效应，但本研究表明，与仅因木尘导致的风险相比，同时接触甲醛和木尘可能会增加鼻腺癌风险。本研究还表明，对于所有组织学类型，接触胶水和粘合剂的男性风险增加，这不能用油漆和清漆、木尘或甲醛的混杂效应来解释。未观察到其他显著关联。
