Occupational Risk Factors for Laryngeal Cancer in Tunisia: A Case Control Study.

BACKGROUND: Tobacco use and alcohol consumption are the primary risk factors for laryngeal cancer (LC). In most populations, occupational exposures are likely to play a minor role in laryngeal carcinogenesis. We aimed to investigate the association between occupational exposure and laryngeal cancer. METHODS: It is a case-control study that included 140 cases diagnosed between January 2013 and December 2016 and 140 controls matched by sex, age, alcohol consumption, and tobacco consumption. RESULTS: Significantly increased risks were found amongst workers of the building sector (OR=4.621; 95% CI [1.826-11.693]) and the mechanical industry sector (OR=5.074; 95% CI [1.425-18.072]). Significant association of laryngeal cancer with various carcinogens was observed such as asbestos (p=0.009; OR=3.68; 95% CI [1.29-10.46]), paint vapors (p=0.005; OR=3.35; 95% CI [1.37-8.16]), solvents (p=0.001; OR=3.29: 95% CI [1.61-6.68]) and cement dust (p=0.003; OR=3.19: 95% CI [1.43-7.12]). After binary logistic regression, cement dust was independently correlated with LC (p=0.042; OR=3.93; 95% CI [1.04-14.78]. The administration sector was associated with decreased risk (p=0.001; OR=0.07; 95% CI [0.03-0.15]) as well as the health sector (p=0.001; OR=0.098; 95% CI [0.02-0.43]). CONCLUSIONS: Our results supported the role of occupational factors in developing LC. Further studies enabling an in-depth analysis of occupational exposures are necessary to provide a clearer definition of the etiological associations between single agents and circumstances of exposure and the genesis of LC.

"Spirometric" lung age reference equations: A narrative review.

The aim of the present paper was to conduct a narrative review of the published norms of the "spirometric" lung-age (SLA). A literature search which covered the period 1970 to June 2017, was conducted using the Pubmed. The search strategy had used the following MeSH words: "Spirometry"[Majr]) AND "Aging"[Majr]. Six original studies have reported equations predicting SLA for adults aged 18-90 years [USA (n=2), Japan (n=2); Australia (n=1) and Tunisia (n=1)]. Their sample sizes varied from 125 to 15238, with a total of 32334 volunteers (11788 men). Several models of norms were developed. They included one (often, FEV1) or more spirometric data in addition to one (often, height) or more anthropometric data. All studies have validated their norms in additional one or more groups, with satisfactory results. Only three authors have proposed algorithms to interpret SLA. All studies presented several limitations concerning the sample size and/or representation, the age distribution, the use of old spirometric data and/or equipment, the application of old spirometric methods, and especially mathematical and statistical flaws.