gms | German Medical Science

50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds)
12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie (dae)

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie
Deutsche Arbeitsgemeinschaft für Epidemiologie

12. bis 15.09.2005, Freiburg im Breisgau

Occupational wood dust exposure and the risk of laryngeal cancer in a population based case-control study in Germany

Meeting Abstract

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  • Heribert Ramroth - Universität, Heidelberg
  • Andreas Dietz - Universität, Leipzig
  • Heiko Becher - Universität, Heidelberg

Deutsche Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie. Deutsche Arbeitsgemeinschaft für Epidemiologie. 50. Jahrestagung der Deutschen Gesellschaft für Medizinische Informatik, Biometrie und Epidemiologie (gmds), 12. Jahrestagung der Deutschen Arbeitsgemeinschaft für Epidemiologie. Freiburg im Breisgau, 12.-15.09.2005. Düsseldorf, Köln: German Medical Science; 2005. Doc05gmds239

The electronic version of this article is the complete one and can be found online at:

Published: September 8, 2005

© 2005 Ramroth et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction and study question

Previous epidemiological studies have been inconclusive with respect to an association between wood dust exposure and cancer of the larynx. Increased risks for wood dust exposure were found for study subjects aged 55 or more in an international case-control study [1]. Increased risks for woodworkers and furniture workers were found in Spain [2]. In contrast, studies in Turkey [3], France [4] and Sweden [5] did not find any elevated risk.

While it is well accepted that exposure to hardwood dust increases the risk of nasal cancer, it is not clear to what extend hardwood dust is also associated with adjacent upper respiratory sites. However, Vaughan et al. 1991 [6] did not find an association between hardwood dust exposure and laryngeal cancer. In this presentation we focus on wood dust exposure as an occupational risk factor for laryngeal cancer.

Material and Methods

A population-based case-control study 1:3 frequency matched by age and sex on laryngeal cancer in south-west Germany with 257 Cases (236 males, 21 females) age 37 to 80 years, histologically confirmed and diagnosed between 1.5.1998 and 31.12.2000 and 769 population controls (702 males, 67 females) was performed. Occupational exposures and other risk factors were obtained with face-to-face interviews using a detailed standardized questionnaire. The complete individual work history was assessed. A detailed assessment of work conditions was obtained by job-specific questionnaires for selected jobs known to be associated with exposure to potential carcinogens. A specific substance list was used as a second method for assessment of exposure. For analyses wood dust exposure was divided into different job tasks (lumberman, furniture working) and into softwood (fir, spruce, etc.) or hardwood exposure (oak and beech-tree). Lifelong exposure time to wood dust exposure was divided into three exposure categories (never, low and high) according to the median of exposed controls. In a further step we assigned some individuals into the non-exposed category if the verbal description of tasks performed made an exposure to wood dust unlikely. This was done with blinded case/control status.


42 (16.3%) cases (40 males, 2 females) and 104 (13.5%) controls (102 males, 2 females) reported a wood dust exposure. Numbers are almost identical for both methods of exposure assessment, however, for controls the agreement of both methods was limited.

A strong effect on laryngeal cancer risk after adjustment for smoking, alcohol and education was observed for high exposure to hardwood dust (OR=2.6, 95% CI 1.3-5.3), as assessed by substance list. The median lifelong exposure time in controls for distinction between low or high exposure was 3,880 hours. Under the manual exposure rating procedure as described above 10 controls and 3 cases were assigned to the non-exposed category. This yields to an adjusted OR in the high exposure group of 3.0, 95% CI 1.5-6.2, p=0.003. The effect for high exposure for softwood was lower OR=2.0, 95% CI 1.0-4.0 and OR=2.1, 95% CI 1.1-4.3, respectively (Median lifelong exposure time: 2,200 hours). Concerning the job-specific questionnaire we could not find an effect for wood dust exposure and laryngeal cancer risk, neither for lumberman, nor for working with softwood or hardwood.


Case-control studies have significantly contributed in the past to the identification and quantification of occupational exposures as cancer risk factors. Our findings for higher exposure to hardwood dust contribute to the evidence that wood dust, in particular from hardwood is an independent additional risk factor, however, these results are obtained using only one of two methods of exposure assessment. Since the reported exposures took place several decades ago, a recall bias can not completely excluded. With improving exposure conditions in industrialized countries over the recent years, the further relevance of wood dust exposure on laryngeal cancer occurrence will most likely decrease.


This study was supported by grant No. 01GB9702/3 from the German Ministry of Education and Research. We acknowledge the contribution of Dr Marie-Luise Groß who organised the interviews of patients and controls. The study would not have been possible without the cooperation of clinicians from the following clinics: Universität HNO-Klinik Heidelberg (Prof. Dr. H. Weidauer), Universität HNO-Klinik Mannheim (Prof. Dr. K. Hörmann), HNO-Klinik der Städt. Kliniken Darmstadt, (Prof. Dr. K. Reck), HNO-Klinik der Städt. Kliniken Ludwigshafen (Prof. Dr. G. Münker †, PD Dr. K.-W. Delank), and HNO-Klinik der Städt. Krankenanstalten Heilbronn (Prof. Dr. C. Naumann).


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