Carcinoma of the Pharynx and Tonsils in an Occupational Cohort of Asphalt Workers

Occupational Etiology of Oropharyngeal Cancer: A Literature Review

While abundant evidence exists linking alcohol, tobacco, and HPV infection to a carcinogenic impact on the oropharynx, the contribution of inhalational workplace hazards remains ill-defined. We aim to determine whether the literature reveals occupational environments at a higher-than-average risk of developing oropharyngeal cancer (OPC) and summarize the available data. To identify studies assessing the relationship between occupational exposure and risk of OPC, a search of the literature through the PubMed-NCBI database was carried out and, ultimately, 15 original articles meeting eligibility criteria were selected. Only original articles in English focusing on the association between occupational exposure and risk or death of specifically OPC were included. The available data are supportive of a potentially increased risk of OPC in waiters, cooks and stewards, artistic workers, poultry and meat workers, mechanics, and World Trade Center responders exposed to dust. However, the available literature on occupation-related OPC is limited. To identify occupational categories at risk, large cohorts with long follow-ups are needed. Identification of causal associations with occupation-related factors would require dose-response analyses adequately adjusted for confounders.

Risk of Lung Cancer and Occupational Exposure to Polycyclic Aromatic Hydrocarbons Among Workers Cohorts - Worldwide, 1969-2022

What is already known about this topic?

Lung cancer has a high mortality, resulting in a severe disease burden. Polycyclic aromatic hydrocarbons (PAHs) are definitive carcinogen to human, and occupational exposure to PAHs is associated with lung cancer.

What is added by this report?

We analyzed the cancer cases from cohort studies on various PAHs exposed workers in China and other countries, calculated the quantitative risk of lung cancer based on meta-analyses, and confirmed the increased risk from lung cancer in selected PAHs exposed occupations.

What are the implications for public health practices?

There is a clear need to prevent lung cancer on a wide range of PAHs-related occupations in China and around the world. It is crucial to establish guidelines for improving the monitoring on exposure and health promotion in related working environments.

Cancer Risk Associated With Exposure to Bitumen and Bitumen Fumes: An Updated Systematic Review and Meta-Analysis

OBJECTIVE

To evaluate whether cancer risks are increased among bitumen (asphalt) workers.

METHODS

Systematic review and meta-analysis of cancer risks (lung, upper aerodigestive tract (UADT), esophagus, bladder, kidney, stomach, and skin) and bitumen exposure. Certainty in the epidemiological evidence that bitumen-exposed workers experience increased cancer risks was rated using Grading of Recommendations Assessment, Development and Evaluation criteria.

RESULTS

After excluding lower-quality studies, lung cancer risks were not increased among bitumen-exposed workers (meta-relative risk [RR] 0.94, 95% CI 0.74 to 1.20, eight studies). Increased risks of UADT and stomach cancers were observed (meta-RR 1.31, 95% CI 1.03 to 1.67, 10 studies and meta-RR 1.29, 95% CI 1.03 to 1.62, seven studies, respectively).

CONCLUSIONS

Except for lung cancer, evidence for increased cancer risks among bitumen-exposed workers was judged to be of low certainty, due to inadequate exposure characterization and unmeasured confounders (coal tar exposure, smoking, and alcohol consumption).