No abstract

In order to study the connection between occupation and sinonasal cancer we have reviewed the files and histological sections of 70 patients (24 females and 46 males) treated at the Department of Oto-rhino-laryngology, National Hospital of Norway. Detailed information concerning previous occupations was obtained by telephone interviews according to a standardized questionnaire. This pilot study revealed a strong association between wood dust exposure and sinonasal cancer. Of 12 wood dust exposed men, 11 had been exposed exclusively to softwood. While squamous cell carcinoma was the predominant type of cancer in joiners, carpenters and loggers, non-Hodgkin lymphomas appeared to be associated with employment in saw- and planingmill firms. A nationwide case-control study is under preparation for further substantiation of the health hazards connected with exposure to softwood and other possible occupational factors related to sinonasal cancer.

Recent reports suggest that softwood exposed woodworkers may have an increased incidence of sinonasal carcinoma. The present study was undertaken in order to evaluate the histological changes, especially the presence of possible precancerous lesions, in the nasal mucosa of furniture workers exclusively exposed to softwood. Histological examination of nasal biopsies from 44 furniture workers and 37 controls revealed a higher degree of metaplastic changes in the former group. In addition we observed four cases (9%) of dysplasia among softwood exposed workers. Nasal epithelial dysplasia is morphologically similar to dysplasia in other organs where the precancerous state of this lesion has been proved. Acceptance of nasal dysplasia as a precancerous lesion means that histological examination of biopsies is an appropriate tool in identifying occupational groups with an increased incidence of sinonasal carcinoma.

Nickel workers and wood workers have an increased incidence of carcinoma and of lesions of the nasal mucosa regarded as precancerous, i.e. dysplasia. This preliminary study demonstrates how metaplastic and dysplastic changes of the nasal epithelium may be diagnosed independently from cytological smears and from histological sections of samples from the same middle nasal turbinate. The sampling technique described yielded excellent material for cytological diagnosis and was also suitable for detailed cell surface characterization by scanning electron microscopy (SEM). Exfoliative cytology was found to be a reliable means of detecting preneoplastic changes in the nasal mucosa of individuals in selected risk groups. The sampling procedure causes less discomfort to the subjects and requires fewer resources than biopsy procedures.