Machine Workers at Higher Risk for Oral Cancer

EXPOSURE TO CERTAIN SUBSTANCES PUTS MACHINE WORKERS AT HIGHER RISK FOR ORAL CANCER

A team of German researchers finds that metal dust, paints, and lacquers may play a role in the increased incidence of oral cancer in an industrial work force

New Orleans -- Since 1978, the incidence of job-related cancers in the former nation of West Germany has increased. A number of epidemiological studies provided evidence that certain work-related substances and procedures may be risk factors for developing head neck cancers. According to a new German study, machine and industrial workers are at higher risk than the general population for oral cancer due to exposure to metal dust and paints, lacquers, varnishes, and solvents.

The authors of the study, "Oral Cancer in Machine Workers," are Matthias Tisch, MD, Heinz Maier, MD, and Stephen Nolte, MD, all from Federal Armed Forces Hospital at Ulm, and Arno Keller, MD, from BWU, Eselsberg. The research results were presented before the American Academy of Otolaryngology--Head and Neck Surgery Foundation Annual Meeting and Oto Expo being held September 26-29, at the Ernest N. Morial Convention Center in New Orleans, LA. At the gathering, the Academy's 11,000 members will have the opportunity to hear the latest research in the diagnosis and treatment of disorders of the ear, nose, throat, and related structures of the head and neck.

Methodology:

A case control study on the risk of occupational factors for squamous cell carcinoma of the oral cavity consisted of two population groups: (1) One hundred male subjects with histologically confirmed squamous cell cancer of the oral cavity that were treated in the Department of Otolaryngology at the University of Heidelberg; (2) The control group, consisting of 400 male patients treated in the Otolaryngology or Maxillofacial Surgery Clinic for diseases with no history of cancer.

Cases and controls were matched by age and residential location of each patient using a matching design from one patient of the first group described above to four patients with no history of cancer. Interviews were conducted with each patient using a structured questionnaire. Sessions lasted 30-60 minutes and covered lifestyle (tobacco and alcohol consumption, previous medical conditions, and family history of certain diseases) and occupational issues (name and history of the employer, duration of employment, description of the workplace, full or part-time work, use of protective clothing, special decontamination measures, and adherence to safety measures).

Workers were asked about long term exposure (at least ten years) to the following substances: asbestos, asbestos cement, asbestos clothing/sheathing, brake and clutch linings, machining of insulating materials, eternet/figurite sheets, electric gas welding and shielded arc welding, chromium and nickel containing paints, lacquers and varnishes, iron, steel, stainless steel, coal, tar, wood dust, and pesticides.

Results:

The research study revealed the following:

The cancers were located in the tongue (32 percent), the alveolar ridge (25 percent), and the floor of the mouth (43 percent). The average age was 56.8 + 10.5 years.

There was a trend to a higher percentage of cancer patients being employed in the wood, paper, textile, or construction industries. In the cancer group, a significantly higher percentage of subjects were employed in construction (14 versus seven percent in the control group) or as machine workers (22 percent of cancer patients versus 8.5 percent of the control group).

Average tobacco and alcohol use was higher in the cancer group than control group.

A high exposure to dusts in general was reported by 68.2 percent of the machine workers in the cancer group versus 13 percent in the control group with the difference in exposures to wood dust being most significant. Furthermore, a higher percentage of machine workers in the cancer group were exposed to paints, lacquers, varnishes and solvents, chemicals in general, cement dust, asbestos and poycyclic aromatic hydrocarbons than those in the control group.

Conclusion:

According to the researchers, previous studies in this issue did not include the histology and sites of the tumors nor adjust for alcohol and tobacco consumption. The research findings also suggest that since machine workers in the cancer group not only had higher exposure to various hazardous agents but also tobacco and alcohol, there is a significant role of combined lifestyle/occupational factors.

This study does account for alcohol/tobacco use. After the adjustment, researchers conclude that the risk for oral cancer among machine workers is higher, due to increased exposure to metal and wood dusts.

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Editor's Note: For a copy of this study or an interview with Dr. Tisch, contact Ken Satterfield at 703-519-1563 (until 9-21); 9/23-23, call the Annual Meeting Newsroom at 540-670-5410.