Sino-nasal cancer and exposure to leather dust.

BACKGROUND In 1987, the International Agency for Research into Cancer classified shoemaking and cobbling as a definite human carcinogen. However, there are 10 times fewer articles published on Medline compared to wood dust which also induces sino-nasal cancer. AIM To improve the medical, technical and social management of this type of cancer in the shoe trades. METHODS A literature review was conducted by two independent experts to identify articles describing epidemiological studies of this link (with no stipulated time frame). RESULTS The search resulted in 14 studies, including one meta-analysis of case-control studies: four out of five of the case-control studies found an excess risk associated with exposure to leather dust. Of five cohort mortality studies, excess risk was found in all studies conducted in the shoe trades but not in the tanning industry. The four studies of the incidence of sino-nasal cancer confirm the excess risk in shoemaking. DISCUSSION In the shoe trades, there is an excess risk of sino-nasal cancer, especially among those working in shining, finishing and shoe repair. Incidence levels among employees are estimated at 1-7/100,000 depending on the specific job. The risk fraction which can be attributed to this type of exposure for this cancer in France is estimated at 3%. In the light of these findings, all involved should be made aware of the link and motivated (as has already been done in the wood industries) to get this occupational disease recognized as such for the shoe trades.