PurposeRecent epidemiologic studies indicate elevated risks for some lymphohematopoietic malignancies (LHM) related to formaldehyde exposure. We performed a systematic review of literature to assess the strength and consistency of associations.MethodsWe summarized published literature in the PubMed database of the National Library of Medicine during 1966–2012. Literature was categorized according to study design and population: industrial cohort studies, professional cohort studies, and population-based case–control studies.ResultsFindings from occupational cohort and population-based case–control studies were very inconsistent for LHM, including myeloid leukemia. Apart from some isolated exceptions, relative risks were close to the null, and there was little evidence for dose–response relations for any of the LHM.ConclusionsAt present, there is no consistent or strong epidemiologic evidence that formaldehyde is causally related to any of the LHM. The absence of established toxicological mechanisms further weakens any arguments for causation. To be informative, future epidemiologic research should improve on formaldehyde exposure assessment and apply modern diagnostic schemes for specific LHM.
The associations between participation in several specific sports, use of free weights, and use of weight lifting equipment and herniated lumbar or cervical intervertebral discs were examined in a case-control epidemiologic study. Specific sports considered were baseball or softball, golf, bowling, swimming, diving, jogging, aerobics, and racquet sports. Included in the final analysis were 287 patients with lumbar disc herniation and 63 patients with cervical disc herniation, each matched by sex, source of care, and decade of age to 1 control who was free of disc herniation and other conditions of the back or neck. Results indicated that most sports are not associated with an increased risk of herniation, and may be protective. Relative risk estimates for the association between individual sports and lumbar or cervical herniation were generally less than or close to 1.0. There was, however, a weak positive association between bowling and herniation at both the lumbar and cervical regions of the spine. Use of weight lifting equipment was not associated with herniated lumbar or cervical disc, but a possible association was indicated between use of free weights and risk of cervical herniation (relative risk, 1.87; 95% confidence interval, 0.74 to 4.74).
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