Sinonasal Cancer

Background

What is sinonasal cancer?

Sinonasal cancer is a cancer of the nasal cavities and surrounding sinus tissue. Sinonasal cancer is rare, with an annual incidence rate of about 1 case per 100,000 people in most developed countries. Inhalation of certain dusts and metal compounds are known causes of sinonasal cancer.

 

Occupational risk factors
    • Wood dust
    • Leather dust
    • Nickel compounds
Possible occupational risk factors
    • Chromium (VI) compounds
    • Formaldehyde
    • Textile manufacturing
Key Findings

Elevated risk of sinonasal cancer was observed among workers with potential exposure to wood dust, nickel compounds, chromium (VI), and formaldehyde. Given the rarity of this type of cancer, many groups had a relatively small number of cases and results should be interpreted with caution.

 

Work associated with exposure to wood dust

Elevated risks were found among groups commonly exposed to wood dust, shown below. Formaldehyde exposure is also possible among these workers, from resins used in wood products such as fibreboard, or during pulp and paper processing.

    • Fabricating, assembling and repairing occupations, wood products: 1.2 times the risk
    • Carpenters and related occupations: 1.3 times the risk
    • Pulp and papermaking and related occupations: 3.9 times the risk
    • Wholesalers of lumber and building materials: 1.7 times the risk
Work associated with exposure to formaldehyde

Formaldehyde is a known human carcinogen, although the evidence linking it to sinonasal cancer is more limited. Elevated risks of sinonasal cancer were detected among janitors and in the beverage industry. It is possible that workers in these groups may be exposed to formaldehyde in cleaning agents.

    • Janitors, charworkers and cleaners: 1.4 times the risk
    • Beverage industries: 2.6 times the risk
Work associated with exposure to nickel and chromium

A number of different occupation and industry groups with potential exposure to nickel and chromium showed increased risk of sinonasal cancer. Nickel is used in metal alloys, as well as batteries and electroplating, while chromium is used in metal finishing. Workers may be exposed to metal fumes and dusts during tasks such as welding and grinding. Chromium may also be present in cement.

    • Construction
      • Excavating, grading, paving and related occupations: 2.5 times the risk
      • Highway, bridge and street construction 2.7 times the risk
    • Manufacturing industries
      • Miscellaneous machinery and equipment manufacturers: 1.3 times the risk
    • Metal shaping and forming occupations
      • Sheet metal workers: 1.5 times the risk
      • Metalworking-machine operators, not elsewhere classified: 1.1 times the risk
      • Welding and flame cutting occupations: 1.2 times the risk
    • Product fabricating, assembling and repairing occupations
      • All product fabricating, assembling and repairing occupations: 1.3 times the risk
        • Fabricating and assembling occupations, metal products, not elsewhere classified: 1.4 times the risk
        • Fabricating, assembling, installing and repairing occupations, electrical and electronic and related equipment: 1.7 times the risk
        • Motor vehicle fabricating and assembling occupations, not elsewhere classified: 1.5 times the risk
        • Motor vehicle mechanics and repairmen: 1.5 times the risk
        • Industrial, farm, and construction machinery mechanics and repairmen: 1.4 times the risk
    • Mining
      • All mining industries: 1.5 times the risk
        • Metal mines: 1.7 times the risk
        • Miscellaneous metal mines (primarily nickel): 2.5 times the risk
Relative Risk by Industry and Occupation

Figure 1. Risk of sinonasal cancer diagnosis among workers employed in each industry group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater risk of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Figure 2. Risk of sinonasal cancer diagnosis among workers employed in each occupation group relative to all others, Occupational Disease Surveillance System (ODSS), 1999-2016 

The hazard ratio is an estimate of the average time to diagnosis among workers in each industry/occupation group divided by that in all others during the study period. Hazard ratios above 1.00 indicate a greater risk of disease in a given group compared to all others. Estimates are adjusted for birth year and sex. The width of the 95% Confidence Interval (CI) is based on the number of cases in each group (more cases narrows the interval).

Table of Results

Table 1. Surveillance of Sinonasal Cancer: Number of cases, workers employed, and hazard ratios in each industry (SIC)

SIC Code * Industry Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
1 Agriculture <5 35,120 —
2/3 Forestry, Fishing and
Trapping		 <5 10,722 —
4 Mines, Quarries and
Oil Wells		 9 23,231 1.45 (0.75, 2.82)
5 Manufacturing 150 694,927 1.00 (0.81, 1.22)
6 Construction 34 211,580 0.83 (0.58, 1.18)
7 Transportation, Communication
and Other Utilities		 38 197,578 1.03 (0.74, 1.44)
8 Trade 75 429,965 1.16 (0.90, 1.49)
9 Finance, Insurance and
Real Estate		 <5 24,024 —
10 Community, Business and
Personal Service		 85 600,441 0.97 (0.76, 1.25)
11 Public Administration and
Defense		 38 191,135 1.06 (0.76, 1.48)
         
* SIC: Standard Industrial Classification (1970)
† Hazard rate in each group relative to all others

 

Table 2. Surveillance of Sinonasal Cancer: Number of cases, workers employed, and hazard ratios in each occupation (CCDO) group

CCDO Code * Occupation Group Number of cases Number of workers employed Hazard Ratio (95% CI) †
11 Managerial, administrative
and related		 <5 31,036 —
21 Natural sciences, engineering
and mathematics		 5 26,369 1.21 (0.50, 2.93)
23 Social sciences and
related fields		 6 30,729 1.97 (0.87, 4.45)
25 Religion 0 129 —
27 Teaching and related 8 48,523 1.31 (0.65, 2.66)
31 Medicine and health 16 135,474 0.83 (0.49, 1.40)
33 Artistic, literary,
recreational and related		 <5 15,009 —
41 Clerical and related 32 197,585 1.04 (0.72, 1.49)
51 Sales 17 148,271 0.97 (0.60, 1.58)
61 Service 64 371,369 1.11 (0.84, 1.45)
71 Farming, horticultural
and animal husbandry		 6 50,270 0.78 (0.35, 1.75)
73 Fishing, hunting,
trapping and related		 <5 558 —
75 Forestry and logging <5 10,710 —
77 Mining and quarrying,
including oil and gas field		 <5 13,046 —
81 Processing
(mineral, metal, chemical)		 8 79,390 0.53 (0.26, 1.07)
82 Processing
(food, wood, textile)		 15 99,380 0.86 (0.52, 1.45)
83 Machining and related 41 189,805 1.04 (0.75, 1.45)
85 Product fabricating,
assembling and repairing		 86 328,823 1.34 (1.06, 1.70)
87 Construction trades 45 216,125 1.03 (0.75, 1.41)
91 Transport equipment
operating		 36 168,486 1.13 (0.80, 1.59)
93 Materials handling and related,
not elsewhere classified		 31 153,321 1.11 (0.77, 1.61)
95 Other crafts and
equipment operating		 <5 28,363 —
99 Other occupations not elsewhere classified 36 215,624 0.95 (0.67, 1.34)
         
* CCDO: Canadian Classification Dictionary of Occupations (1971)
† Hazard rate in each group relative to all others

Please note that ODSS results shown here may differ from those previously published or presented. This may occur due to changes in case definitions, methodological approaches, and the ongoing nature of the surveillance cohort.