ABSTRACT
O tabagismo e o consumo de álcool são os fatores de risco mais bem estabelecidos para o câncer de laringe. Com relação aos fatores ocupacionais, o único carcinógeno estabelecido é a exposição a névoas de ácidos inorgânicos fortes. Entretanto, asbesto, pesticidas, tintas, gases de combustão de gasolina e diesel e poeiras, entre outros, aparecem na literatura como agentes ocupacionais que aumentam o risco de câncer de laringe. Um estudo caso-controle de base hospitalar foi conduzido para investigar fatores de risco ocupacionais para câncer de laringe. Foram coletadas informações detalhadas sobre tabagismo, consumo de álcool e história ocupacional de 122 casos de câncer de laringe e 187 controles pareados por freqüência (segundo sexo e idade). Encontrou-se risco aumentado de câncer de laringe nos indivíduos com exposição à sílica cristalina livre respirável (OR = 1,83; IC95 por cento: 1,00-3,36), à fuligem (de carvão mineral, coque, madeira, óleo combustível) (OR = 1,78; IC95 por cento: 1,03-3,03), a fumos em geral (OR = 2,55; IC95 por cento: 1,14-5,67) e a animais vivos (OR = 1,80; IC95 por cento: 1,02-3,19).
The most solidly established risk factors for laryngeal cancer are tobacco and alcohol. As for occupational factors, the only established carcinogen is exposure to strong inorganic acid mists. However, asbestos, pesticides, paints, gasoline, diesel engine emissions, dusts, and other factors have been reported in the literature as occupational agents that increase the risk of laryngeal cancer. A hospital-based case-control study was conducted to investigate occupational risk factors for laryngeal cancer. Detailed data on smoking, alcohol consumption, and occupational history were collected for 122 laryngeal cancers and 187 controls matched by frequency (according to sex and age). Laryngeal cancer was associated with exposure to respirable free crystalline silica (OR = 1.83; 95 percentCI: 1.00-3.36), soot (from coal, coke, fuel oil, or wood) (odds ratio - OR = 1.78; 95 percent confidence interval - 95 percentCI: 1.03-3.03), fumes (OR = 2.55; 95 percentCI: 1.14-5.67), and live animals (OR = 1.80; 95 percentCI: 1.02-3.19).
Subject(s)
Humans , Male , Female , Alcoholic Beverages , Laryngeal Neoplasms/mortality , Occupational Risks , Tobacco Use Disorder , Case-Control Studies , Odds Ratio , Risk FactorsABSTRACT
CONTEXT: Around 90 percent of lung cancer worldwide is attributable to cigarette smoking, although less than 20 percent of cigarette smokers develop lung cancer. Other factors such as diet, chronic lung diseases, occupation and possibly environmental agents also contribute to this cancer. Genetic factors seem to play a role in lung cancer, but the precise characteristics influencing lung cancer susceptibility are not known, since genetic factors are easily obscured by the strong environmental determinants of lung cancer, particularly smoking. OBJECTIVE: To estimate the effect that cancer occurrence among first-degree relatives has on the risk of lung cancer. DESIGN: Hospital-based case-control study. SETTING: The metropolitan region of Säo Paulo, Brazil. PARTICIPANTS: 334 incident lung cancer cases and 578 controls matched by hospitals. MAIN MEASUREMENTS: By means of a structured questionnaire, cases and controls were interviewed about cancer occurrence in first-degree relatives, tobacco smoking, exposure to passive smoking, occupation, migration and socioeconomic status. Non-conditional logistic regression was used to calculate the risk of familial cancer aggregation, the effect of cancer in first-degree relatives and smoking in conjunction, and for controlling confounders. RESULTS: The adjusted odds ratio (OR) revealed a slight, but not statistically significant, excess risk of lung cancer for subjects with a history of lung cancer in relatives (OR 1.21; 95 percent confidence interval [CI] 0.50 -- 2.92). The same was found among those with a history of other tobacco-related cancers in relatives (OR 1.36; 95 percent CI 0.87 -- 2.14). A step gradient effect was observed regarding lung cancer risk, in accordance with increases in the number of pack-years of cigarette consumption. An interaction between familial cancer aggregation and tobacco smoking was detected. CONCLUSIONS: A mildly elevated risk of lung cancer among persons with a positive history of lung and other tobacco-related cancers was observed. The finding of an interaction between the variables of familial cancer aggregation and smoking suggests that familial cancer aggregation could be considered as a marker of susceptibility, increasing the risk of lung cancer among smokers. These results improve our knowledge of lung carcinogenesis and can guide future cancer genetic studies
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Lung Neoplasms , Urban Population , Aged, 80 and over , Brazil , Smoking , Case-Control Studies , Confidence Intervals , Logistic Models , Odds Ratio , Incidence , Surveys and Questionnaires , Risk Factors , Genetic Predisposition to Disease , Lung NeoplasmsABSTRACT
Analiza los riesgos para cáncer de pulmón asociados con exposiciones ocupacionales, en un país en vías de desarrollo donde el cáncer de pulmón es la primera causa de mortalidad por cáncer en hombres. Incluyó 200 hombres con esta patología y 397 controles hospitalarios. El OR para fumadores actuales fue 8,5, mientras que los ex-fumadores mostraron un OR de 5,3. La fracción atribuible al hábito de fumar fue de 85 por ciento. Se observaron riesgos estadísticamente significativos para: empleo en la industria de bebidas alcohólicas (4,5, 95 por ciento CI:1,02-20,2), aserradores (4,6, 95 por ciento CI:1,1-18,4), industrias químicas, plásticos (1,8 95 por ciento CI:1,04-3,2), cerámica, loza, vidrio o productos minerales no metálicos (3,4, 95 por ciento CI:1,1-10,6). Otros riesgos elevados, pero sin significación estadística, fueron encontrados para la industtria y el trabajo en la reparación del calzado de cuero (2,1, 95 por ciento CI:0,8-5,4), la industria de la goma (3,4, 95 por ciento CI:0,9-12,4), el grupo de metalúrgicos que incluye los soldadores (1,9, 95 por ciento CI:0,8-4,4), los mecánicos de automotores (2,0, 95 por ciento CI:0,9-4,2), los trabajadores en servicios de limpieza (1,9, 95 por ciento CI:0,8-4,5) y los trabajadores agrícolas (2,4, 95 por ciento CI:0,9-6,0). Si bien algunos de los presentes resultados pueden ser debidos al azar, la mayoría son consistentes con los obtenidos en investigaciones previas en otros países.