Gender Differences in Sinonasal Cancer Incidence: Data from the Italian Registry.

BACKGROUND: Although rare, sinonasal cancers (SNCs) have a high occupational attributable fraction. METHODS: We applied gender-based approaches to descriptive analyses, incidence, and patterns of exposures using the Italian National Sinonasal Cancer Registry (ReNaTuNS: Registro Nazionale Tumori Naso-Sinusali). RESULTS: The study included 2851 SNC patients. SNC was diagnosed more often in men (73%) than in women (27%). The most frequent morphology in men was intestinal-type adenocarcinoma (33%), whereas in women, it was squamous cell carcinoma (49%). Nasal cavities were predominant in both genders (50%), ethmoidal sinus in men (24%), and maxillary in women (24%). Incidence rates were 0.76 (per 100,000 person-years) in men and 0.24 in women and increased by age, more evidently in men, peaking over 75 years in both. Occupational exposures to wood and leather dusts were the most frequent (41% for men, 33% for women). Few exposures were extra-occupational or domestic. Unlikely exposure was relevant in women (57%). CONCLUSIONS: The surveillance of SNC cases through a registry that allows for the identification of and compensation for this occupational disease is important in Italy, where numerous workers are exposed to carcinogens for SNC, without even being aware. Considering the rarity of the disease, particularly among women, the ReNaTuNS can provide a method to analyze gender differences.

Exposures to IARC Carcinogenic Agents in Work Settings Not Traditionally Associated with Sinonasal Cancer Risk: The Experience of the Italian National Sinonasal Cancer Registry.

The aim of this study is to highlight tasks and jobs not commonly considered at high risk for sinonasal cancer (SNC) identified by Regional Operating Centers currently active in the Italian National Sinonasal Cancer Registry (ReNaTuNS), which retrieve occupational histories through a standardized questionnaire. Data on exposures to IARC carcinogenic agents in work settings unknown to be associated with SNC risk were collected and analyzed. Out of 2,208 SNC cases recorded in the ReNaTuNS database, 216 cases and their worked exposure periods were analyzed. Unsuspected jobs with exposure to wood dust include construction-related tasks, production of resins, agriculture and livestock jobs (straw and sawdust), and heel factory work (cork dust). Other examples are hairdressers, bakers (formaldehyde), dressmakers, technical assistants, wool and artificial fiber spinners, and upholsterers (textile dusts). Moreover, settings with coexposure to different agents (e.g., wood with leather dusts and chromium-nickel compounds) were recognized. The study describes jobs where the existence of carcinogenic agents associated with SNC risk is unexpected or not resulting among primary materials employed. The systematic epidemiological surveillance of all epithelial SNC cases with a detailed collection of their work history, as performed by a dedicated population registry, is essential for detecting all potential occupational cases and should be considered in the context of forensic medicine and the compensation process.

Feasibility study for interspecialistic collaboration in active research of urothelial neoplasms of professional origin.

INTRODUCTION: In Italy only a small fraction of cancer is reported to the supervisory body and recognised as professional by the insurance institution. Among the causes of this sub-notification, especially for lowgrade etiologic fractional cancers such as bladder cancers are the lack of knowledge of carcinogenicity in the occupational field and the consequent incomplete medical history collections. OBJECTIVES: Diagnosis of occupational bladder neoplasms and activation of systematic surveillance of tumors of professional origin through an "active research" program. METHODS: From July 2010 to July 2017, all patients diagnosed with Bladder Cancer in the departments of Urology of Area Vasta 3 ASUR Marche underwent a first interview and a further anamnestic study in selected cases.When an occupational exposure was recognised, more information for preventive, social security and criminal justice has been acquired. RESULTS: The study highlighted 18 cases of bladder tumors due to occupational exposure to aromatic amines and polycyclic aromatic hydrocarbons, which are the most important risk factor for BC after tobacco smoking. CONCLUSIONS: Our study confirmed that active research is an useful tool both for the activation of epidemiological surveillance and for the regional registration of professional tumors. In addition active research of occupational exposure allow obtaining information that can be used for preventive purposes, for criminal justice and for the initiation of medico-legal actions and improvement of working conditions aimed at guaranteeing workers' rights.

[Biological monitoring of PAH exposure among asphalt workers]. / Monitoraggio biologico dell'esposizione a IPA negli asfaltatori.

Aim of this work was the assessment of exposure to polycyclic aromatic hydrocarbons (PAHs) by urinary 1-hydroxypyrene (1-OHPyr) in asphalt workers. Median levels of 1-OHPyr resulted higher in asphalt workers than in controls (184 vs. < 20 ng/L, p < 0.001). The determinants of exposure of 1-OHPyr resulted smoking habit, the number of consecutive days at work and the job task; 1-OHPyr was also associated to urinary creatinine. End of work week 1-OHPyr is suggested as an useful indicator of occupational exposure to PAHs in bitumen fumes.

[Assessment of exposure to polycyclic aromatic hydrocarbons in asphalt workers by measurement of urinary 1-hydroxypyrene]. / Valutazione dell'esposizione a idrocarburi policiclici aromatici in addetti ad opere di asfaltatura autostradale mediante misura di 1-idrossipirene urinario.

INTRODUCTION: Asphalt workers are potentially exposed to polycyclic aromatic hydrocarbons (PAHs). As some PAHs are classified as carcinogenic, the assessment of occupational exposure to these agents is of the utmost importance in preventing toxic effects. OBJECTIVES: To assess exposure to PAHs by urinary 1-hydroxypyrene (1-OHPyr). METHODS: We studied 22 asphalt workers (14 smokers) and 5 control subjects (1 smoker). Multiple samples of urine (up to 4per subject) were collected at the end of the shift for the measurement of 1-OHPyr by LCMS/MS. Univariate and multivariate linear models for repeated measurements were used to evaluate the differences between groups and to identify the variables influencing of exposure. RESULTS: The median urinary excretion of 1-OHPyr in asphalt workers was low, but higher than that of control subjects (184 vs. <20 ng/L, or 106 vs. <20 ng/g creatinine, p < 0.001); cigarette smoking marginally increased 1-OHPyr in smoking asphalt workers in comparison to non-smokers (129 vs. 208 ng/L p= 0.09 or 94 vs. 121 ng/g creatinine, p = 0.06). The number of consecutive days at work significantly influenced the urinary excretion of l-OHPyr [+59% every day, CI: (2, 147), p = 0.04]. Subjects using paving machines had the highest exposure. A strong association between 1-OHPyr and urinary creatinine was observed. CONCLUSIONS: urinary 1-OHPyr is a useful indicator of occupational exposure to low levels of PAHs, such as those found in the subjects studied; in using this biomarker it is recommended to collect urine samples at the end of the working week and to express levels of the biomarker corrected for urinary creatinine.