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Article

Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology

by
Enzo Emanuelli
1,
Vera Comiati
2,
Diego Cazzador
1,*,
Gloria Schiavo
1,
Enrico Alexandre
1,
Ugo Fedeli
3,
Giuliana Frasson
1,
Alessia Zanon
1,
Alessandro Martini
1,
Maria Luisa Scapellato
2 and
Giuseppe Mastrangelo
2
1
Department of Neurosciences, Operative Unit of Otorhinolaryngology, University of Padova, Via Giustiniani 2, 35125 Padova, Italy
2
Department of Cardiac Thoracic Vascular Sciences and Public Health, Preventive Medicine and Risk Assessment Unit, University of Padova, Via Giustiniani 2, 35128 Padova, Italy
3
Epidemiological Department, Veneto Region. Passaggio Gaudenzio 1, 35131 Padova, Italy
*
Author to whom correspondence should be addressed.
Int. J. Environ. Res. Public Health 2018, 15(12), 2887; https://doi.org/10.3390/ijerph15122887
Submission received: 6 November 2018 / Revised: 13 December 2018 / Accepted: 15 December 2018 / Published: 17 December 2018
(This article belongs to the Section Occupational Safety and Health)
Versions Notes

Abstract

Case-control studies on malignant sinonasal tumors and occupational risk factors are generally weakened by non-occupational confounders and the selection of suitable controls. This study aimed to confirm the association between sinonasal malignant tumors and patients’ occupations with consideration for sinonasal inverted papillomas (SNIPs) as a control group. Thirty-two patients affected by adenocarcinoma (ADC) and 21 non-adenocarcinoma epithelial tumors (NAETs) were compared to 65 patients diagnosed with SNIPs. All patients were recruited in the same clinical setting between 2004 and 2016. A questionnaire was used to collect information on non-occupational factors (age, sex, smoking, allergies, and chronic sinusitis) and occupations (wood- and leather-related occupations, textile industry, metal working). Odds ratios (OR) with 95% confidence intervals (CI) associated with selected occupations were obtained by a multinomial and exact logistic regression. Between the three groups of patients, SNIP patients were significantly younger than ADC patients (p = 0.026). The risk of NAET increased in woodworkers (OR = 9.42; CI = 1.94–45.6) and metal workers (OR = 5.65; CI = 1.12–28.6). The risk of ADC increased in wood (OR = 86.3; CI = 15.2–488) and leather workers (OR = 119.4; CI = 11.3–1258). On the exact logistic regression, the OR associated to the textile industry was 9.32 (95%CI = 1.10–Inf) for ADC, and 7.21 (95%CI = 0.55–Inf) for NAET. Comparing sinonasal malignant tumors with controls recruited from the same clinical setting allowed demonstrating an increased risk associated with multiple occupations. Well-matched samples of cases and controls reduced the confounding bias and increased the strength of the association.
Keywords: wood industry; leather industry; textile industry; metal transformation industry; sinonasal tumors; sinonasal adenocarcinoma; sinonasal squamous cell carcinoma; sinonasal inverted papilloma; occupational risk; case-control study wood industry; leather industry; textile industry; metal transformation industry; sinonasal tumors; sinonasal adenocarcinoma; sinonasal squamous cell carcinoma; sinonasal inverted papilloma; occupational risk; case-control study

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MDPI and ACS Style

Emanuelli, E.; Comiati, V.; Cazzador, D.; Schiavo, G.; Alexandre, E.; Fedeli, U.; Frasson, G.; Zanon, A.; Martini, A.; Scapellato, M.L.; et al. Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology. Int. J. Environ. Res. Public Health 2018, 15, 2887. https://doi.org/10.3390/ijerph15122887

AMA Style

Emanuelli E, Comiati V, Cazzador D, Schiavo G, Alexandre E, Fedeli U, Frasson G, Zanon A, Martini A, Scapellato ML, et al. Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology. International Journal of Environmental Research and Public Health. 2018; 15(12):2887. https://doi.org/10.3390/ijerph15122887

Chicago/Turabian Style

Emanuelli, Enzo, Vera Comiati, Diego Cazzador, Gloria Schiavo, Enrico Alexandre, Ugo Fedeli, Giuliana Frasson, Alessia Zanon, Alessandro Martini, Maria Luisa Scapellato, and et al. 2018. "Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology" International Journal of Environmental Research and Public Health 15, no. 12: 2887. https://doi.org/10.3390/ijerph15122887

APA Style

Emanuelli, E., Comiati, V., Cazzador, D., Schiavo, G., Alexandre, E., Fedeli, U., Frasson, G., Zanon, A., Martini, A., Scapellato, M. L., & Mastrangelo, G. (2018). Malignant Versus Benign Tumors of the Sinonasal Cavity: A Case-Control Study on Occupational Etiology. International Journal of Environmental Research and Public Health, 15(12), 2887. https://doi.org/10.3390/ijerph15122887

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