Work-related laryngeal cancer: Trends in France from 2001 to 2016

Our plain-English summary of Work-related laryngeal cancer: Trends in France from 2001 to 2016, by J. Grignoux, Q. Durand-Moreau, N. Vongmany, et al (European Annals of Otorhinolaryngology, Head and Neck Diseases, 2019).

The study

• Authors: J. Grignoux, Q. Durand-Moreau, N. Vongmany, S. Brunel, Rnv3p members, J.D. Dewitte
• Journal: European Annals of Otorhinolaryngology, Head and Neck Diseases
• Published: 2019;136(1):7-12
• Cited by: 12 articles, as counted by NIH iCite
• Read it: PubMed · Publisher

Abstract

Objectives: As part of the 2014-2019 cancer plan and in order to improve our knowledge of work-related cancers, we analysed the work-related laryngeal cancer risk situations identified in the French national occupational disease surveillance and prevention network (rnv3p) from 2001 to 2016.

Material And Methods: This study focused on cases of work-related laryngeal cancer, which the expert physician considered to be directly related to exposure (intermediate or strong causal relationship). Demographic data, occupational exposure circumstances (hazards, occupation, business sector), non-occupational risk factors and the occupational physician's opinion concerning notification as an occupational disease were analysed.

Results: Two hundred forty-four cases of laryngeal cancer were registered between 2001 and 2016. One hundred and forty seven cases were considered to be work-related, with an intermediate or strong causal relationship in 87 cases. This exclusively male population had a median age of 59 years. Ninety-seven different forms of exposure were identified, including asbestos in 78 cases. The main business sectors concerned were specialized construction (14 cases) and metallurgy (7 cases). Occupational disease notification was recommended in 60 patients, corresponding to asbestos exposure in 80% of cases.

Conclusions: Asbestos is the laryngeal cancer risk factor most commonly reported in the network from 2001 to 2016. This study confirms the role of asbestos in laryngeal carcinogenesis. Laryngeal cancer may therefore need to be compensated as an occupational disease in France, as in other European countries.

Copyright © 2018 Elsevier Masson SAS. All rights reserved.

In plain English

This study described laryngeal cancer (cancer of the voice box) cases recorded in France's national occupational disease surveillance and prevention network (rnv3p) from 2001 to 2016. Of two hundred forty-four laryngeal cancer cases, the authors analysed the 87 in which the examining physician judged at least one workplace exposure to be directly related to the disease (an intermediate or strong causal relationship). All 87 were men, with a median age of 59 years. Of 97 exposures with such a relationship, 78 were asbestos; the article does not name fiber types. Polycyclic aromatic hydrocarbons accounted for 5. Smoking information was missing for 39 patients. Ten had never smoked, and 8 of these 10 had been exposed to asbestos. An occupational disease claim was made or recommended in 60 cases, 48 of them involving asbestos. The authors concluded that asbestos was the laryngeal cancer risk factor most commonly reported in the network. They noted that the database cannot show how common the disease is in any business sector. It also lacks data on how long and how heavily people were exposed, and often lacks tobacco and alcohol information.

We wrote this plain-English summary from the full article with the help of AI, and a second AI model checked each sentence against the article. It is not the authors' wording; the abstract and the article are their own account.

What the study did and found

• Design: Descriptive analysis of cases recorded in a French national occupational disease surveillance database (rnv3p), 2001 to 2016
• Who was studied: 87 men seen at French occupational disease centres between 2001 and 2016. Their laryngeal cancer was judged directly related (intermediate or strong causal relationship) to at least one workplace exposure. They were drawn from two hundred forty-four laryngeal cancer cases in the database. Median age was 59 years, mean age 59.7 years, and ages ranged from 43 to 76.
• Exposure: Occupational exposures coded by physicians as having an intermediate or strong causal relationship with the cancer. These were mainly asbestos (fiber types not specified), plus polycyclic aromatic hydrocarbons, chromium and nickel, welding smoke and fumes, mineral wool, and others. No data were available on how long or how heavily people were exposed.
• Main results:
  • Of the two hundred forty-four laryngeal cancer cases in the database, 87 (35.6%) were judged to have a direct (intermediate or strong) causal relationship with a workplace exposure.
  • Among the 97 exposures with an intermediate or strong causal relationship, asbestos accounted for 78 (80.41%): 41 were coded intermediate and 37 strong.
  • Among the 97 exposures, polycyclic aromatic hydrocarbons accounted for 5 (5.16%).
  • The most frequent occupation among the 87 cases was motor vehicle mechanics and repairers, with 7 cases (8.05%).
  • The main business sectors were specialized construction (14 cases) and metallurgy (7 cases).
  • Smoking status among the 87 patients: information was not available for 39 (44.8%), 38 (43.7%) had ongoing or past smoking, and 10 (11.5%) had never smoked.
  • 8 of the 10 patients with no documented history of smoking had been exposed to asbestos.
  • Alcohol information was recorded for only 11 of the 87 cases. Ongoing or past chronic alcoholism was reported in 3 of them.
  • An occupational disease claim was made or recommended in 60 of the 87 cases (69.0%). Asbestos exposure was involved in 48 of these 60 (80%).
  • In the 27 cases where a claim was not recommended, the reasons were:
• insufficient clinical data (17 cases, 63%)
• insufficient scientific data (5 cases, 18.5%)
• predictable permanent disability below 25% (4 cases, 14.8%)
• not available (1 case).
• The authors' conclusion: The authors concluded that asbestos was the laryngeal cancer risk factor most commonly reported in the network from 2001 to 2016. They stated that the study confirms or highlights the role of asbestos in laryngeal cancer. In their view, laryngeal cancer may need to be compensated as an occupational disease in France, as in other European countries.
• Limitations the authors state:
  • There were no inclusion or exclusion criteria. Cases depended on which doctors referred patients to occupational health clinics.
  • The database does not show the real prevalence of disease in a given business sector.
  • There were no data on the duration or intensity of exposure.
  • Causal relationship ratings and claim recommendations were left to each physician's discretion, which can make coding inconsistent between centres.
  • Alcohol and tobacco data were not available in every case, which could bias the analysis.
  • Physicians' causal assessments recorded in the database cannot be revised later in light of new scientific evidence.
  • The median age of 59 was measured at the clinic visit. The comparison figure of 63 for laryngeal cancer in France was measured at diagnosis. The authors said this comparison is difficult and must be interpreted cautiously.
  • The histological type of cancer was insufficiently reported.

Topics

The National Library of Medicine indexes this study under subjects our site covers: Throat and laryngeal cancer.

Medical terms in this study, explained in our Lexicon: Laryngeal Cancer, Occupational Disease, Occupational Exposure, Asbestos Exposure, Carcinogenesis.

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