Higher prevalence of nasal polyposis among textile workers: an endoscopic based and controlled study.

BACKGROUND: There is a deficit of reliable epidemiologic studies exploring the prevalence of Chronic Rhinosinusitis with Nasal Polyps (CRSwNP). Recent data suggests that occupational dust exposure may be involved in its physiopathology. OBJECTIVES: To compare the prevalence of nasal polyposis (NP) in a group of workers with occupational dust exposure (textile workers) and in a control group (retail store workers). METHODS: Cross-sectional study with a random sample of textile and retail store employees. Clinical data was gathered through a systematic interview, which included RhinoQOL and CAT questionnaires. A systematic endoscopic nasal examination was performed using a 0 degree rigid endoscope. Lund-Kennedy endoscopic score was determined for each participant. Statistical analysis was performed with SPSS. RESULTS: 316 participants were included in the study, i.e. 215 textile workers and 101 retail store workers. NP was found in 19 subjects among textile workers and none in the control group. The prevalence of NP increased by age strata and by years of dust exposition. Polypoid degeneration of the middle turbinate was more prevalent in the exposed group with Lund-Kennedy scoring also higher. RhinoQOL and CAT questionnaires had both significantly higher scores among textile employees. Previous medical diagnosis of atopic diseases or chronic lower airway diseases did not differ between exposed and control groups or even between subjects with and without NP. CONCLUSIONS: These results point to an important correlation between occupational dust exposure and NP occurrence.

Adenocarcinomas of the sinonasal tract: a case series from an Oncology Centre in Northern Portugal.

Sinonasal malignant neoplasms are rare and adenocarcinomas account for 10-20 % of these cancers. Our aim is to characterise the clinical presentation, risk factors and outcomes of patients with adenocarcinoma treated at our institution. Retrospective review of medical records of patients with sinonasal adenocarcinomas, treated at IPO-Porto from January 2008 until December 2012. Twenty-eight patients with adenocarcinomas were selected from a total of 53 patients with sinonasal cancers. There was a male predominance (93 %), a mean age at diagnosis of 56 years and a rate of occupational wood dust exposure of 71 %. The most common treatment option was surgery followed by adjuvant radiotherapy. The 5 year disease-free and cancer-specific survival was 58 and 60 %, respectively. The following factors had negative impact on disease-free survival: advanced AJCC stage (p = 0.014); skull base invasion (p = 0.002); poorly differentiated or mucinous subtypes histology (p = 0.034) and imaging findings of residual tumour before adjuvant radiotherapy (p < 0.001). Endoscopic tumour resection was not associated with adverse outcomes. The role of volume-modulated arch therapy in the treatment of sinonasal tumours has to be clarified. The higher rate of adenocarcinomas among sinonasal cancers in this series comparing with previous reports, even from our institution, suggests that this pathology is rising in Northern Portugal. Despite substantial local failure, sinonasal adenocarcinomas have a relatively favourable prognosis in terms of cancer-specific survival.