Head and neck cancer and asbestos exposure

Benedicte Clin (1) , Celine Gramond (2) , Isabelle Thaon (3, 4) , Patrick Brochard (2) , Fleur Delva (2) , Soizick Chammings (5) , Antoine Gislard (6, 7) , Francois Laurent (8) , Christophe Paris (9) , Aude Lacourt (2) , Jean-Claude Pairon (5)

1 ANTICIPE - Unité de recherche interdisciplinaire pour la prévention et le traitement des cancers
2 BPH - Bordeaux population health
3 INGRES - Interactions Gènes-Risques environnementaux et Effets sur la Santé
4 CHRU Nancy - Centre Hospitalier Régional Universitaire de Nancy
5 CHIC - Centre Hospitalier Intercommunal de Créteil
6 CHU Rouen
7 ABTE - Aliments Bioprocédés Toxicologie Environnements
8 UB - Université de Bordeaux
9 Centre Hospitalier Universitaire de Rennes [CHU Rennes] = Rennes University Hospital [Ponchaillou]

OBJECTIVES: The aim of this study was to analyse, within a French cohort of workers previously occupationally exposed to asbestos, incidence and mortality from various sites of head and neck cancers (larynx excluded) and to examine the potential link of these cancers with pleural plaques. METHODS: A 10-year follow-up study was conducted in the 13 481 male subjects included in the cohort between October 2003 and December 2005. Asbestos exposure was assessed by industrial hygienist analysis of a standardised questionnaire. The final cumulative exposure index (CEI; in equivalent fibres.years/mL) for each subject was calculated as the sum of each employment period's four-level CEI. The number of head and neck cancers recorded by the National Health Insurance fund was collected in order to conduct an incidence study. Complementary analysis was restricted to men who had performed at least one chest CT scan (N=4804). A mortality study was also conducted. We used a Cox model with age as the time axis variable adjusted for smoking, time since first exposure, CEI of exposure to asbestos and pleural plaques on CT scans. RESULTS: We reported a significant dose-response relationship between CEI of exposure to asbestos and head and neck cancers after exclusion of laryngeal cancers, in the mortality study (HR 1.03, 95% CI (1.01 to 1.06) for an increase of 10 f.years/mL) and a close to significant dose-response relationship in the incidence study (HR 1.02, 95% CI (1.00 to 1.04) for an increase of 10 f.years/mL). No statistically significant association between pleural plaques and head and neck cancer incidence was observed. CONCLUSIONS: This large-scale study suggests a relationship between asbestos exposure and head and neck cancers, after exclusion of laryngeal cancers, regardless of whether associated pleural plaques were present.

Mots clés: Asbestos; Cancer; Occupational Health; Otorhinolaryngologic Diseases

Domaines: Cancer; Santé; Santé publique et épidémiologie

Benedicte Clin, Celine Gramond, Isabelle Thaon, Patrick Brochard, Fleur Delva, et al.. Head and neck cancer and asbestos exposure. Occupational and Environmental Medicine, 2022, 79 (10), pp.690-696. ⟨10.1136/oemed-2021-108047⟩. ⟨hal-03668826⟩