Occupational exposure to wood dust and formaldehyde and risk of nasal, nasopharyngeal, and lung cancer among Finnish men

Sie Sie Siew,^1,2 Timo Kauppinen,¹ Pentti Kyyrönen,³ Pirjo Heikkilä,¹ Eero Pukkala^2,3
1Finnish Institute of Occupational Health, Helsinki, Finland; ²School of Health Sciences, University of Tampere, Tampere, Finland; ³Finnish Cancer Registry, Institute for Statistical and Epidemiological Cancer Research, Helsinki, Finland

Abstract: Controversy exists over whether or not occupational inhalation exposure to wood dust and/or formaldehyde increases risk for respiratory cancers. The objective of this study was to examine the risk of nasal, nasopharyngeal, and lung cancer in relation to occupational exposure to wood dust and formaldehyde among Finnish men. The cohort of all Finnish men born between the years 1906 and 1945 and in employment during 1970 was followed up through the Finnish Cancer Registry for cases of cancers of the nose (n = 292), nasopharynx (n = 149), and lung (n = 30,137) during the period 1971–1995. The subjects' occupations, as recorded in the population census in 1970, were converted to estimates of exposure to wood dust, formaldehyde, asbestos, and silica dust through the Finnish job-exposure matrix. Cumulative exposure (CE) was calculated based on the prevalence, average level, and estimated duration of exposure. The relative risk (RR) estimates for the CE categories of wood dust and formaldehyde were defined by Poisson regression, with adjustments made for smoking, socioeconomic status, and exposure to asbestos and/or silica dust. Men exposed to wood dust had a significant excess risk of nasal cancer overall (RR, 1.59; 95% confidence interval [CI], 1.06–2.38), and specifically nasal squamous cell carcinoma (RR, 1.98; 95% CI, 1.19–3.31). Workers exposed to formaldehyde had an RR of 1.18 (95% CI, 1.12–1.25) for lung cancer. There was no indication that CE to wood dust or formaldehyde would increase the risk of nasopharyngeal cancer. Occupational exposure to wood dust appeared to increase the risk of nasal cancer but not of nasopharyngeal or lung cancer. The slight excess risk of lung cancer observed for exposure to formaldehyde may be the result of residual confounding from smoking. In summary, this study provides further evidence that exposure to wood dust in a variety of occupations may increase the risk of nasal cancer.

Keywords: job-exposure matrix, inhalation exposure, cumulative exposure, cancer risk