Lymphoma, myeloma and occupation: Results of a case-control study

Abstract

The known risk factors for lymphoma and myeloma cannot account for the current incidence rates of these cancers, and there is increasing interest in exploring occupational causes. We present results regarding lymphoma and myeloma from a large case-control study of hundreds of occupational exposures and 19 cancer sites. We examine in more detail those exposures previously considered to be related to these cancers, as well as exposures which were strongly related in our initial analyses. Lymphoma was not associated in our data with exposure to solvents or pesticides, or employment in agriculture or woodrelated occupations, although numbers of exposed cases were sometimes small. Hodgkin's lymphoma was associated with exposure to fabric dust, and non-Hodgkin's lymphoma was associated with exposure to copper dust, ammonia and a number of fabric and textile-related occupations and exposures. Employment as a sheet metal worker was associated with development of myeloma.o 1996 Wiley-Liss, Inc.The aetiology of myeloma and lymphoma are still unknown, although there are several suspected risk factors for these cancers. The incidence of non-Hodgkin's lymphoma (NHL) appears to be increasing in most developed countries (Hartge et a/., 1994), and established risk factors such as HIV infection, rare genetic syndromes and immunosuppressant therapy cannot account for the magnitude of this increase (Hartge and Devesa. 1992). Similarly, a proportion of Hodgkin's lymphomas are associated with viruses, particularly the Epstein-Barr virus (Jarret, 1992), but this virus is less commonly associated with the subtypes of Hodgkin's lymphoma which have been increasing in incidence (Hartge et al., 1994). The aetiology of multiple myeloma also remains elusive, although a number of occupational factors are being considered (Riedel and Pottern, 1992).We carried out a large case-control study of 19 cancer sites, including lymphoma and myeloma (Siemiatycki, 1991) to generate hypotheses about the occupational causes of cancer. Information was obtained on exposure to each of a large number of occupational substances using a new method of assessing occupational exposures which decreases misclassification of exposure status. We have previously published initial analyses from this study. In this report we present further and more detailed examination of positive findings from our study regarding occupational risk factors for lymphoma and myeloma. MATERIAL AND METHODSThe design and data collection methods of the case-control study of occupational exposures and 19 cancer sites have been described previously (Siemiatycki, 1991;Siemiatycki et al., 1994) and will be summarized here. Subjects were males aged 35-70 years, resident in Montreal, and with a new, histologically confirmed cancer. There were 4,576 eligible cancer patients between 1979 and 1985, and 3,730 of these (82%) were successfully interviewed. Eighty-one percent of subjects responded for themselves, and proxies provided information for the rest. There were 215 NHL cases interviewed out of 25...

Occupation, pesticide exposure and risk of multiple myeloma

“…Our finding of an increased risk of myeloma for several metal work-related occupations is consistent with the results of several other studies (30,(47)(48)(49)(50)(51)(52). There is only limited information about exposure to specific metals and multiple myeloma.…”

“…We found elevated OR values for several occupations that had been previously reported, such as timber cutting and related occupations (20), plumbers, pipefitters and steamfitters (17,20), painters (20,44,45), food and beverage preparation workers (17), health and science technicians (46), and janitors and cleaners (47). Our finding of an increased risk of myeloma for several metal work-related occupations is consistent with the results of several other studies (30,(47)(48)(49)(50)(51)(52).…”

The non-Hodgkin lymphomas: A review of the epidemiologic literature

“…When solvents were evaluated as a general category, most studies observed nonsignificant positive associations with NHL risk, 20,21,29,71,105,118,129,170,202 and 2 reported inverse associations. 114,142 No association between occupational exposure to organic solvents and lymphatic and hematopoietic cancer was reported in a meta-analysis of 26 studies (meta-SMR 5 1.05, 95% CI: 0.92-1.21). 203 In a Swedish case-control study, NHL cases were significantly more likely to report exposure to ''high-grade'' organic solvents (OR 5 3.5, 95% CI: 1.7-7.1).…”

“…142 Other case-control studies that evaluated general classes of pesticides have reported odds ratios both above and below 1.0. 29,31,32,53,88,105,114,143 In a German case-control study that evaluated parental pesticide exposure and relative risk of NHL in children positive associations were observed with paternal and maternal exposure, based on small numbers. 144 Evaluating pesticides or categories of pesticides may obscure a chemical-specific association.…”

Multiple myeloma: A review of the epidemiologic literature

“…A number of cohort [33][34][35][36][37][38][39] and case-control 18,24,28,30,[40][41][42][43][44][45][46][47][48][49][50][51][52] studies have examined the relationship between cigarette smoking and multiple myeloma. Relative risk estimates for current cigarette smoking ranged from 0.8 to 1.3 in all cohort studies except the cohort of 34,000 California Seventh Day Adventists, which found a relative of risk of 6.79 (95% CI: 1.37, 33.61).…”