Unlike the rest of the upper aerodigestive tract, smoking plays little if any role in malignant tumour development. However, for certain histology occupational factors are important. Adenocarcinoma of the ethmoids may develop from exposure to hard wood dust, whereas soft wood dust may lead to the development of squamous cell carcinoma. The relative risk of a wood worker developing adenocarcinoma is 70 times normal; adenocarcinoma has also been associated with the manufacture of chrome pigment, isopropyl alcohol, textiles, clothing, leather, and shoes.

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