[Nose and paranasal sinus malignancies with reference to occupational medicine aspects. A case study]

Asbestos is a well known inhalant cancerogenic substance, causing not only mesothelioma but also cancer of the respiratory mucosa of the bronchi. Exposure can also cause non-malignant alterations of the pleura or lung, which can be assessed radiologically. Since asbestos can also induce malignant tumors of the nose and sinuses, we identified 50 patients from the files of the ENT Department Münster and tried to complete questionnaires concerning occupation and occupational hazards using informations from insurance companies as well as at least one chest x-ray. This material could be obtained in 19 patients. Nine of the 19 patients had x-ray findings that could be associated with asbestos exposure, but in none of these 9 cases was massive occupational exposure to asbestos probable. In only two of the nine cases was definite occupational exposure to asbestos not able to be excluded. A control group was not established, since statistical calculations of significance would have been problematic in a number of the 19 patients even if a control group did exist. From the questionnaires we have found an unexpected incidence of dusty workplaces (as seen with textile workers, wood-dust workers, cement workers, quarrymen and millers). A correlation between various types of sinonasal tumors and asbestos exposure could not be made.