Rhinoscopical Findings in Nickel Workers, with Special Emphasis on the Influence of Nickel Exposure and Smoking Habits

Abstract

Rhinoscopy and X-ray examination were performed on 318 nickel workers and 57 controls, to study the significance of these methods in detecting cancerous and precancerous mucosal changes. The clinical and radiological findings were compared with histopathological data and mucosal nickel concentrations determined in nasal biopsy material from the middle turbinate, with duration of nickel exposure, and with tobacco smoking habits. The nickel-exposed subjects had statistically significantly more pathological changes (43%) than the controls (26%), (0.01> P > 0.02), mainly due to differences in the frequency of hyperplastic rhinitis. Thirteen nickel workers (4%) had nasal polyps. Two of these cases, both employed at the nickel refinery for 28 years, appeared to have nasal carcinoma, according to histological examination. No distinct association was established between rhinoscopical findings and epithelial dysplasia found by histological examination. The explanatory values for the rhinoscopical findings of different factors, such as working category, age, duration of nickel exposure, grams tobacco smoked per week, and nickel content of nasal mucosa, were evaluated by applying a stepwise multiple regression analysis. Number of years from first employment at the nickel refinery and tobacco consumption were the only explanatory factors that showed a statistically significant correlation to the rhinoscopical findings. The radiological examination revealed few characteristic findings. Chemical analysis of cigarettes handrolled by nickel workers showed high nickel concentrations compared with non-contaminated cigarettes.