1
|
Wang SS. Epidemiology and etiology of diffuse large B-cell lymphoma. Semin Hematol 2023; 60:255-266. [PMID: 38242772 PMCID: PMC10962251 DOI: 10.1053/j.seminhematol.2023.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 11/15/2023] [Accepted: 11/21/2023] [Indexed: 01/21/2024]
Abstract
As the most common non-Hodgkin lymphoma subtype, diffuse large B-cell lymphoma (DLBCL) incidence patterns generally parallel that for NHL overall. Globally, DLBCL accounts for a third of all NHLs, ranging between 20% and 50% by country. Based on United States (U.S.) cancer registry data, age-standardized incidence rate for DLBCL was 7.2 per 100,000. DLBCL incidence rises with age and is generally higher in males than females; in the U.S., incidence is highest among non-Hispanic whites (9.2/100,000). Like NHL incidence, DLBCL incidence rose in the first half of the 20th century but has largely plateaued. However, there is some evidence that incidence rates are rising in areas of historically low rates, such as Asia; there are also estimates for rising DLBCL incidence in the near future due to the changing demographics in developed countries whose aging population is growing. Established risk factors for DLBCL include those that result in severe immune deficiency such as HIV/AIDS, inherited immunodeficiency syndromes, and organ transplant recipients. Factors that lead to chronic immune dysregulations are also established risk factors, and include a number of autoimmune conditions (eg, Sjögren syndrome, systemic lupus erythematosus, rheumatoid arthritis), viral infections (eg, HIV, KSHV/HHV8, HCV, EBV), and obesity. Family history of NHL/DLBCL, personal history of cancer, and multiple genetic susceptibility loci are also well-established risk factors for DLBCL. There is strong evidence for multiple environmental exposures in DLBCL etiology, including exposure to trichloroethylene, benzene, and pesticides and herbicides, with recent associations noted with glyphosate. There is also strong evidence for associations with other viruses, such as HBV. Recent estimates suggest that obesity accounts for nearly a quarter of DLBCLs that develop, but despite recent gains in the understanding of DLBCL etiology, the majority of disease remain unexplained. An understanding of the host and environmental contributions to disease etiology, and concerted efforts to expand our understanding to multiple race/ethnic groups, will be essential for constructing clinically relevant risk prediction models and develop effective strategies for disease prevention.
Collapse
Affiliation(s)
- Sophia S Wang
- City of Hope Comprehensive Cancer Center, Duarte, CA.
| |
Collapse
|
2
|
Francisco LFV, da Silva RN, Oliveira MA, Dos Santos Neto MF, Gonçalves IZ, Marques MMC, Silveira HCS. Occupational Exposures and Risks of Non-Hodgkin Lymphoma: A Meta-Analysis. Cancers (Basel) 2023; 15:cancers15092600. [PMID: 37174074 PMCID: PMC10177442 DOI: 10.3390/cancers15092600] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2023] [Revised: 04/10/2023] [Accepted: 04/14/2023] [Indexed: 05/15/2023] Open
Abstract
Non-Hodgkin lymphoma (NHL) is a heterogeneous group with different types of diseases. It remains unclear as to what has led to an increase in incidences of NHL, however, chemical substance exposure is known to be one of the risk factors for the disease. Therefore, we performed a systematic review and meta-analysis including case-control, cohort, and cross-sectional observational epidemiological studies to verify the association between occupational exposure to carcinogens and NHL risk. Articles between the years 2000 and 2020 were collected. Two different reviewers performed a blind selection of the studies using the Rayyan QCRI web app. Post-completion, the selected articles were extracted and analyzed via the RedCap platform. Our review resulted in 2719 articles, of which 51 were included in the meta-analysis, resulting in an overall OR of 1.27 (95% CI 1.04-1.55). Furthermore, it was observed that the main occupation associated with the increased risk of NHL was that in which workers are exposed to pesticides. We therefore conclude that the evidence synthesis of the epidemiological literature supports an increased risk for NHL, regardless of subtype, considering occupational exposure to certain chemical compounds, mainly pesticides, benzene, and trichlorethylene, and certain classes of work, primarily in the field of agriculture.
Collapse
Affiliation(s)
| | - Rogério Nunes da Silva
- Postgraduate Program in Environment and Health, University of Cuiabá, Cuiabá 78008-000, MT, Brazil
| | - Marco Antônio Oliveira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784-390, SP, Brazil
| | | | | | - Márcia M C Marques
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784-390, SP, Brazil
| | - Henrique C S Silveira
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784-390, SP, Brazil
- Postgraduate Program in Environment and Health, University of Cuiabá, Cuiabá 78008-000, MT, Brazil
- Campus São Paulo, University of Anhanguera, São Paulo 04119-901, SP, Brazil
| |
Collapse
|
3
|
Deen L, Hougaard KS, Clark A, Meyer HW, Frederiksen M, Gunnarsen L, Andersen HV, Hougaard T, Petersen KKU, Ebbehøj NE, Bonde JP, Tøttenborg SS. Cancer Risk following Residential Exposure to Airborne Polychlorinated Biphenyls: A Danish Register-Based Cohort Study. ENVIRONMENTAL HEALTH PERSPECTIVES 2022; 130:107003. [PMID: 36306207 PMCID: PMC9616107 DOI: 10.1289/ehp10605] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Revised: 08/14/2022] [Accepted: 09/19/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs) are biopersistent chemicals classified as human carcinogens. This classification is primarily based on evidence on higher-chlorinated PCBs found in food. The carcinogenic potential of airborne lower-chlorinated PCBs remains largely unexplored. OBJECTIVES We aimed to investigate cancer risk following residential exposure to airborne PCBs. METHODS Cancer risk was examined in the Health Effects of PCBs in Indoor Air (HESPAIR) cohort of 38,613 residents of two partly PCB-contaminated residential areas in Greater Copenhagen, identified by nationwide registries. PCB exposure was based on relocation dates and indoor air PCB measurements in subsets of apartments. Cancer diagnoses were extracted from the Danish Cancer Registry for the follow-up period of 1970-2018. We estimated adjusted hazard ratios with time-varying cumulative exposure and a 10-y lag using Cox regression. RESULTS Overall risk of cancer was not associated with PCByear, [hazard ratio (HR) for high-exposed vs. low-exposed =0.98; 95% confidence interval (CI): 0.88, 1.09], but residents exposed to ≥3,000 ng/m3 PCB×year had higher risk of liver cancer (HR =2.81; 95% CI: 1.28, 6.15) and meningiomas (HR =3.49; 95% CI: 1.84, 6.64), with indications of exposure-response relationships. Results were suggestive of a higher risk of pancreatic cancer (HR =1.59; 95% CI: 0.95, 2.64) at the highest aggregated PCB level. For testis cancer, a higher risk was observed among residents exposed to 300-949 ng/m3 PCB×year relative to residents exposed to <300 ng/m3 PCB×year (HR =2.97; 95% CI: 1.41, 6.28), but the risk was not higher for residents exposed to ≥950 ng/m3 PCB×year. Apart from this, the risk of specific cancers was similar across exposure groups. DISCUSSION In this, to our knowledge, first population-based cohort study of residential exposure to airborne PCBs, we found no association between exposure to PCBs in indoor air in private homes and the risk for most of the specific cancers. Higher risk of liver cancer and meningiomas were observed. https://doi.org/10.1289/EHP10605.
Collapse
Affiliation(s)
- Laura Deen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Karin Sørig Hougaard
- Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Alice Clark
- Department of Epidemiology, Novo Nordisk, Copenhagen, Denmark
| | - Harald William Meyer
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Marie Frederiksen
- National Research Centre for the Working Environment, Copenhagen, Denmark
| | - Lars Gunnarsen
- Department of the Built Environment, Aalborg University Copenhagen, Copenhagen, Denmark
| | - Helle Vibeke Andersen
- Department of the Built Environment, Aalborg University Copenhagen, Copenhagen, Denmark
| | | | - Kajsa Kirstine Ugelvig Petersen
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Niels Erik Ebbehøj
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
| | - Jens Peter Bonde
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Sandra Søgaard Tøttenborg
- Department of Occupational and Environmental Medicine, Copenhagen University Hospital – Bispebjerg and Frederiksberg, Copenhagen, Denmark
- Department of Public Health, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
4
|
Anetor GO, Nwobi NL, Igharo GO, Sonuga OO, Anetor JI. Environmental Pollutants and Oxidative Stress in Terrestrial and Aquatic Organisms: Examination of the Total Picture and Implications for Human Health. Front Physiol 2022; 13:931386. [PMID: 35936919 PMCID: PMC9353710 DOI: 10.3389/fphys.2022.931386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2022] [Accepted: 06/24/2022] [Indexed: 11/13/2022] Open
Abstract
There is current great international concern about the contribution of environmental pollution to the global burden of disease particularly in the developing, low- and medium-income countries. Industrial activities, urbanization, developmental projects as well as various increased anthropogenic activities involving the improper generation, management and disposal of pollutants have rendered today’s environment highly polluted with various pollutants. These pollutants include toxic metals (lead, cadmium, mercury, arsenic), polycyclic aromatic hydrocarbons, polychlorinated biphenyls, pesticides and diesel exhaust particles most of which appear to be ubiquitous as well as have long-term environmental persistence with a wide range of toxicities such as oxidative stress among others. Oxidative stress, which may arise from increased production of damaging free radicals emanating from increased pollutant burden and depressed bioavailability of antioxidant defenses causes altered biochemical and physiological mechanisms and has been implicated in all known human pathologies most of which are chronic. Oxidative stress also affects both flora and fauna and plants are very important components of the terrestrial environment and significant contributors of nutrients for both man and animals. It is also remarkable that the aquatic environment in which sea animals and creatures are resident is also highly polluted, leading to aquatic stress that may affect the survival of the aquatic animals, sharing in the oxidative stress. These altered terrestrial and aquatic environments have an overarching effect on human health. Antioxidants neutralize the damaging free radicals thus, they play important protective roles in the onset, progression and severity of the unmitigated generation of pollutants that ultimately manifest as oxidative stress. Consequently, human health as well as that of aquatic and terrestrial organisms may be protected from environmental pollution by mitigating oxidative stress and employing the principles of nutritional medicine, essentially based on antioxidants derived mainly from plants, which serve as the panacea of the vicious state of environmental pollutants consequently, the health of the population. Understanding the total picture of oxidative stress and integrating the terrestrial and aquatic effects of environmental pollutants are central to sustainable health of the population and appear to require multi-sectoral collaborations from diverse disciplinary perspectives; basically the environmental, agricultural and health sectors.
Collapse
Affiliation(s)
- Gloria Oiyahumen Anetor
- Department of Human Kinetics and Health Education, National Open University of Nigeria, Abuja, Nigeria
| | - Nnenna Linda Nwobi
- Department of Chemical Pathology, BenCarson School of Medicine, Babcock University, Ilishan, Nigeria
| | - Godwin Osaretin Igharo
- Department of Medical Laboratory Science, School of Basic Medical Sciences, College of Medical Sciences, University of Benin, Benin, Nigeria
| | | | - John Ibhagbemien Anetor
- Department of Chemical Pathology, College of Medicine, University of Ibadan, Ibadan, Nigeria
- *Correspondence: John Ibhagbemien Anetor,
| |
Collapse
|
5
|
Symeonides C, Brunner M, Mulders Y, Toshniwal P, Cantrell M, Mofflin L, Dunlop S. Buy-now-pay-later: Hazards to human and planetary health from plastics production, use and waste. J Paediatr Child Health 2021; 57:1795-1804. [PMID: 34792231 PMCID: PMC9299614 DOI: 10.1111/jpc.15777] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2021] [Accepted: 09/27/2021] [Indexed: 12/15/2022]
Abstract
More than 8 billion tonnes of plastic were produced between 1950 and 2015, that is 1 tonne for every man, woman and child on our planet. Global plastic production has been growing exponentially with an annual growth rate of 8.4% since 1950, equating to approximately 380 million tonnes per annum. A further 50 kg of plastic is now being produced for each person every year with production continuing to accelerate. Here, we discuss the human and planetary health hazards of all that plastic. We consider each step in the journey of these complex and pervasive industrial materials: from their synthesis predominantly from fossil fuel feedstocks, through an often-brief consumer use as plastic products, and onto waste streams as fuel, permanent landfill or as unmanaged waste in our environment, food, air and bodies.
Collapse
Affiliation(s)
- Christos Symeonides
- Plastics & Human HealthThe Minderoo FoundationPerthWestern AustraliaAustralia,Murdoch Children's Research InstituteRoyal Children's HospitalMelbourneVictoriaAustralia
| | - Manuel Brunner
- Plastics & Human HealthThe Minderoo FoundationPerthWestern AustraliaAustralia
| | - Yannick Mulders
- Plastics & Human HealthThe Minderoo FoundationPerthWestern AustraliaAustralia
| | - Priyanka Toshniwal
- Plastics & Human HealthThe Minderoo FoundationPerthWestern AustraliaAustralia
| | - Matthew Cantrell
- Plastics & Human HealthThe Minderoo FoundationPerthWestern AustraliaAustralia
| | - Louise Mofflin
- Plastics & Human HealthThe Minderoo FoundationPerthWestern AustraliaAustralia
| | - Sarah Dunlop
- Plastics & Human HealthThe Minderoo FoundationPerthWestern AustraliaAustralia,School of Biological SciencesThe University of Western AustraliaPerthWestern AustraliaAustralia
| |
Collapse
|
6
|
Vidali MS, Dailianis S, Vlastos D, Georgiadis P. PCB cause global DNA hypomethylation of human peripheral blood monocytes in vitro. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2021; 87:103696. [PMID: 34171487 DOI: 10.1016/j.etap.2021.103696] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Revised: 06/18/2021] [Accepted: 06/20/2021] [Indexed: 06/13/2023]
Abstract
We have recently reported significant associations between exposure to polychlorinated biphenyls (PCB) and alterations on genome-wide methylation of leukocyte DNA of healthy volunteers and provided evidence in support of an etiological link between the observed CpG methylation variations and chronic lymphocytic leukemia. The present study aimed to elucidate the effects of PCB in human lymphocytes' methylome in vitro. Therefore, U937 cells and human peripheral blood monocytes (PBMC) were exposed in vitro to the dioxin-like PCB-118, the non-dioxin-like PCB-153, and hexachlorobenzene (HCB) and thorough cytotoxicity, genotoxicity and global CpG methylation analyses were performed. All compounds currently tested did not show any consistent significant genotoxicity at all exposure periods and concentrations used. On the contrary, extensive dose-dependent hypomethylation was observed, even at low concentrations, in stimulated PBMC treated with PCB-118 and PCB-153 as well as a small but statistically significant hypomethylation in HCB-treated stimulated cells.
Collapse
Affiliation(s)
- Maria-Sofia Vidali
- Institute of Chemical Biology, National Hellenic Research Foundation, 48 Vas.Constantinou Av, GR-11635, Athens, Greece; Section of Animal Biology, Department of Biology, University of Patras, GR-26500, Patras, Greece
| | - Stefanos Dailianis
- Section of Animal Biology, Department of Biology, University of Patras, GR-26500, Patras, Greece
| | - Dimitris Vlastos
- Department of Environmental Engineering, University of Patras, GR-30100, Agrinio, Greece
| | - Panagiotis Georgiadis
- Institute of Chemical Biology, National Hellenic Research Foundation, 48 Vas.Constantinou Av, GR-11635, Athens, Greece.
| |
Collapse
|
7
|
Fiolet T, Mahamat-Saleh Y, Frenoy P, Kvaskoff M, Romana Mancini F. Background exposure to polychlorinated biphenyls and all-cause, cancer-specific, and cardiovascular-specific mortality: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2021; 154:106663. [PMID: 34082240 DOI: 10.1016/j.envint.2021.106663] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/23/2021] [Revised: 05/08/2021] [Accepted: 05/21/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs) are a large family of man-made organic, ubiquitous, and persistent contaminants with endocrine-disrupting properties. PCBs have been associated with numerous adverse health effects and were classified as carcinogenic to humans, but their long-term impact on mortality risk in the general population is unknown. OBJECTIVE To conduct a systematic review and meta-analysis in order to assess whether background exposure levels of PCBs increase all-cause and cancer- and cardiovascular-specific mortality risk in the general population. METHODS We searched the Pubmed, Web of Science, Cochrane Library, and Embase databases for eligible studies up to 1st of January, 2021. We included cohort and nested-case control studies comparing the lowest vs. the highest background exposure level of PCBs in the general population and reporting data for all-cause mortality and/or cancer-/cardiovascular-specific mortality. Studies reporting occupational and accidental exposures were excluded. Random-effects meta-analysis was used to estimate summary relative risks (SRRs) and 95% confidence intervals (CIs). Heterogeneity across studies was assessed by I2 statistics, and publication bias both graphically and using Egger's and Begg's tests. Quality of included studies was assessed using the National Toxicology Program/Office of Health Assessment and Translation (NTP/OHAT). Confidence in the body of evidence and related level of evidence were assessed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) based on the NTP/OHAT framework. The protocol was registered in PROSPERO (CRD42020178079). RESULTS The initial search led to 2,132 articles. Eight prospective cohort studies met our inclusion criteria, leading to 72,852 participants including 17,805 deaths. Overall exposure to PCBs was not statistically significantly associated with all-cause mortality (SRR = 1.13, 95% CI = 0.90-1.41, n = 7 studies, low certainty); however, dietary exposure to PCBs was associated with an increased risk of cardiovascular-specific mortality (SRR = 1.38, 95% CI = 1.14-1.66, n = 3 studies, moderate certainty), while no association was found with cancer-specific mortality (SRR = 1.07, 95% CI = 0.72-1.59, n = 5 studies, low certainty). CONCLUSION Our meta-analysis suggests that background exposure to PCBs is associated with an increased risk of cardiovascular-specific mortality in the general population with a "moderate" level of evidence. These findings should be interpreted with caution given the small number of studies on mortality in the general population.
Collapse
Affiliation(s)
- Thibault Fiolet
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, F-94805 Villejuif, France
| | - Yahya Mahamat-Saleh
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, F-94805 Villejuif, France
| | - Pauline Frenoy
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, F-94805 Villejuif, France
| | - Marina Kvaskoff
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, F-94805 Villejuif, France
| | - Francesca Romana Mancini
- Paris-Saclay University, UVSQ, Inserm, Gustave Roussy, "Exposome and Heredity" Team, CESP UMR1018, F-94805 Villejuif, France.
| |
Collapse
|
8
|
Odutola MK, Benke G, Fritschi L, Giles GG, van Leeuwen MT, Vajdic CM. A systematic review and meta-analysis of occupational exposures and risk of follicular lymphoma. ENVIRONMENTAL RESEARCH 2021; 197:110887. [PMID: 33607095 DOI: 10.1016/j.envres.2021.110887] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/03/2021] [Accepted: 02/10/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The etiology of follicular lymphoma (FL), a common non-Hodgkin lymphoma subtype, is largely unknown. OBJECTIVE We performed a systematic review and meta-analysis of observational studies examining the relationship between occupational exposures and FL risk. METHODS We searched Ovid MEDLINE, Ovid EMBASE, and Web of Science for eligible observational studies examining job titles or occupational exposures prior to January 1, 2020. We performed a narrative synthesis and used random-effects models to generate meta-estimates of relative risk (RR) with 95% confidence intervals (95%CI) for exposures reported by three or more studies. RESULTS Fifty-eight studies were eligible. Ten cohort and 37 case-control studies quantified FL risk in relation to any exposure to one or more occupational groups or agents. Eight cohort and 19 case-control studies examined dose-response relationships. We found evidence of a positive association with increasing plasma concentration of dichlorodiphenyldichloroethylene (DDE; meta-RR = 1.51, 95%CI = 0.99, 2.31; I2 = 0.0%) and polychlorinated biphenyls (PCBs; meta-RR = 1.47, 95%CI = 0.97, 2.24; I2 = 8.6%). We observed a positive association with exposure to any solvent (meta-RR = 1.16, 95%CI = 1.00, 1.34; I2 = 0.0%) and chlorinated solvents (meta-RR = 1.35, 95%CI = 1.09, 1.68; I2 = 0.0%). Single studies reported a significant positive dose-response association for exposure to any pesticide, hexachlorobenzene, any organophosphate, diazinon, metolachlor, carbaryl, lindane, trichloroethylene, oils/greases, and extremely low-frequency magnetic fields. Job title-only analyses suggested increased risk for medical doctors and spray painters, and decreased risk for bakers and teachers. Overall, studies demonstrated low risk of bias, but most studies examined small numbers of exposed cases. CONCLUSIONS Current evidence indicates a positive association between FL and occupational exposure to DDE, PCBs, any solvent and chlorinated solvents. Our findings may help guide policies and practices on the safe use of solvents and inform models of lymphomagenesis. Future studies with larger sample sizes and comprehensive quantitative exposure measures may elucidate other avoidable carcinogenic exposures.
Collapse
Affiliation(s)
- Michael K Odutola
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Geza Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia; Precision Medicine, School of Clinical Sciences at Monash Health Monash University, Melbourne, Australia
| | - Marina T van Leeuwen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
| |
Collapse
|
9
|
Lemaitre M, Frenoy P, Fiolet T, Besson C, Mancini FR. Dietary exposure to polychlorinated biphenyls (PCB) and risk of Non-Hodgkin's lymphoma: Evidence from the French E3N prospective cohort. ENVIRONMENTAL RESEARCH 2021; 197:111005. [PMID: 33722527 DOI: 10.1016/j.envres.2021.111005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 02/09/2021] [Accepted: 03/06/2021] [Indexed: 06/12/2023]
Abstract
INTRODUCTION Polychlorinated biphenyls (PCB) are persistent and bioaccumulative lipophilic substances, mostly used in the past by industry. Known to be cancerogenic, PCB are suspected to increase Non-Hodgkin's Lymphoma (NHL) risk in the general population mainly due to evidence from cases-controls studies. Since their interdiction in 1987, diet represents the main route of exposure for the general population, nevertheless no study has assessed the relationship between PCB dietary exposure and NHL risk. The aim of this study was to analyze the association between dietary exposures to dioxin like PCB (DL PCB) and non-dioxin like PCB (NDL PCB) and NHL risk in the E3N prospective cohort of French women. MATERIALS AND METHODS Among 67,879 women included in this study, 457 cases of NHL were confirmed during 21 years of follow-up. Dietary exposure to PCB was estimated combining food consumption data collected in E3N and food contamination data provided by French Agency for Food, Environmental and Occupational Health & Safety (ANSES) in the second French total diet study. Cox regression models, adjusted for potential confounders, were used to estimate hazard ratio (HR) and 95% confidence intervals (CI). RESULTS Average age at diagnosis was 67 years. The median dietary exposure to DL PCB and NDL PCB was, 18.5 pg TEQ/d and 138,843.2 pg/d, respectively. While no association was found between dietary exposure to DL PCB or NDL PCB and overall NHL risk, analyses by NHL histological subgroups showed a positive association between dietary exposures to DL PCB and Diffuse Large B Cell Lymphoma (OR3vs1 1.90, 95%CI [1.03-3.51], ptrend 0.02). Nevertheless these findings were no longer statistically significant when the models were adjusted for fish and dairy products consumption. In addition, an inverse association was found between dietary exposure to NDL PCB and the risk of follicular lymphoma (OR3vs1 0.46, 95%CI [0.24-0.87], ptrend 0.01). CONCLUSION This is the first study to evaluate the association between dietary exposure to DL and NDL PCB and the risk of NHL in a prospective cohort study. Overall, the findings suggest a lack of association between dietary exposure to DL or NDL PCB and NHL risk. Additional studies are needed to reproduce these findings.
Collapse
Affiliation(s)
- Marine Lemaitre
- CESP, Faculté de Médecine - Université. Paris-Sud - UVSQ, INSERM, Université Paris Saclay, Gustave Roussy, 94805, Villejuif, France
| | - Pauline Frenoy
- CESP, Faculté de Médecine - Université. Paris-Sud - UVSQ, INSERM, Université Paris Saclay, Gustave Roussy, 94805, Villejuif, France
| | - Thibault Fiolet
- CESP, Faculté de Médecine - Université. Paris-Sud - UVSQ, INSERM, Université Paris Saclay, Gustave Roussy, 94805, Villejuif, France
| | - Caroline Besson
- CESP, Faculté de Médecine - Université. Paris-Sud - UVSQ, INSERM, Université Paris Saclay, Gustave Roussy, 94805, Villejuif, France; Hematology-Oncology Unit, Centre Hospitalier de Versailles, 78150, Le Chesnay, France; Université de Versailles Saint Quentin en Yvelines, Université de Paris Saclay, France
| | - Francesca Romana Mancini
- CESP, Faculté de Médecine - Université. Paris-Sud - UVSQ, INSERM, Université Paris Saclay, Gustave Roussy, 94805, Villejuif, France.
| |
Collapse
|
10
|
Matrat M, Gain M, Haioun C, Le Bras F, Nisse C, Morschhauser F, Clin B, Baldi I, Verdun-Esquer C, Garnier R, Laborde-Castérot H, Hérin F, Esquirol Y, Andujar P, Belacel M, Chouaïd C, Chauvet C, Lasfargues G, Pairon JC. Development of a Questionnaire for the Search for Occupational Causes in Patients with Non-Hodgkin Lymphoma: The RHELYPRO Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:4008. [PMID: 33920383 PMCID: PMC8068898 DOI: 10.3390/ijerph18084008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 11/17/2022]
Abstract
Non-Hodgkin lymphoma (NHL), multiple myeloma and chronic lymphocytic leukemia are possibly related to environmental and/or occupational exposure. The primary objective of this study was to develop a questionnaire for screening patients with these blood disorders who might benefit from a specialized consultation for possible recognition of the disease as an occupational disease. The study included 205 subjects (male gender, 67.3%; mean age, 60 years; NHL, 78.5%). The questionnaire performed very satisfactorily in identifying the exposures most frequently retained by experts for their potential involvement in the occurrence of NHL. Its sensitivity and specificity in relation to the final expertise were 96% and 96% for trichloroethylene, 85% and 82% for benzene, 78% and 87% for solvents other than trichloroethylene and dichloromethane, 87% and 95% for pesticides, respectively. Overall, 15% of the subjects were invited to ask National Social Insurance for compensation as occupational disease. These declarations concerned exposure to pesticides (64%), solvents (trichloroethylene: 29%; benzene: 18%; other than chlorinated solvents: 18%) and sometimes multiple exposures. In conclusion, this questionnaire appears as a useful tool to identify NHL patients for a specialized consultation, in order to ask for compensation for occupational disease.
Collapse
Affiliation(s)
- Mireille Matrat
- Service des Pathologies Professionnelles et de l’Environnement, CHI Créteil, F-94010 Créteil, France; (M.M.); (M.G.); (P.A.)
| | - Murielle Gain
- Service des Pathologies Professionnelles et de l’Environnement, CHI Créteil, F-94010 Créteil, France; (M.M.); (M.G.); (P.A.)
| | - Corinne Haioun
- INSERM, IMRB, Paris Est Créteil University, F-94010 Créteil, France;
- AP-HP, Hôpital Henri Mondor, Unité Hémopathies Lymphoïdes, F-94010 Créteil, France;
| | - Fabien Le Bras
- AP-HP, Hôpital Henri Mondor, Unité Hémopathies Lymphoïdes, F-94010 Créteil, France;
| | - Catherine Nisse
- CHU Lille, Institut Pasteur de Lille, Université de Lille, 4483-IMPECS-Impact de l’environnement Chimique sur la Santé Humaine, F-59000 Lille, France;
| | - Franck Morschhauser
- ULR 7365-GRITA-Groupe de Recherche sur les Formes Injectables et les Technologies Associées, Université de Lille, CHU Lille, F-59000 Lille, France;
| | - Bénédicte Clin
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU de Caen, INSERM U1086, Cancers et Préventions, Université de Caen Normandie, F-14033 Caen, France;
| | - Isabelle Baldi
- Service Santé Travail Environnement, CHU Bordeaux, INSERM U1219, EPICENE, Bordeaux University, F-33076 Bordeaux, France; (I.B.); (C.V.-E.)
| | - Catherine Verdun-Esquer
- Service Santé Travail Environnement, CHU Bordeaux, INSERM U1219, EPICENE, Bordeaux University, F-33076 Bordeaux, France; (I.B.); (C.V.-E.)
| | - Robert Garnier
- Centre Antipoison de Paris, Consultation de Pathologie Professionnelle et de l’Environnement, AP-HP, Nord-Université de Paris, Hôpital Lariboisière-Fernand Widal-St Louis, F-75475 Paris, France; (R.G.); (H.L.-C.)
| | - Hervé Laborde-Castérot
- Centre Antipoison de Paris, Consultation de Pathologie Professionnelle et de l’Environnement, AP-HP, Nord-Université de Paris, Hôpital Lariboisière-Fernand Widal-St Louis, F-75475 Paris, France; (R.G.); (H.L.-C.)
| | - Fabrice Hérin
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Toulouse, F-31059 Toulouse, France; (F.H.); (Y.E.)
| | - Yolande Esquirol
- Centre Régional de Pathologies Professionnelles et Environnementales, CHU Toulouse, F-31059 Toulouse, France; (F.H.); (Y.E.)
| | - Pascal Andujar
- Service des Pathologies Professionnelles et de l’Environnement, CHI Créteil, F-94010 Créteil, France; (M.M.); (M.G.); (P.A.)
- INSERM, IMRB, Paris Est Créteil University, F-94010 Créteil, France;
| | - Milia Belacel
- Institut Santé-Travail Paris-Est, CHI Créteil, F-94010 Créteil, France;
| | - Christos Chouaïd
- Centre de Recherche Clinique, CHI Créteil, F-94010 Créteil, France;
| | - Claire Chauvet
- Anses, Agence Nationale de Sécurité Sanitaire de l’alimentation, de l’environnement et du Travail, F-94700 Maisons-Alfort, France; (C.C.); (G.L.)
| | - Gérard Lasfargues
- Anses, Agence Nationale de Sécurité Sanitaire de l’alimentation, de l’environnement et du Travail, F-94700 Maisons-Alfort, France; (C.C.); (G.L.)
| | - Jean-Claude Pairon
- Service des Pathologies Professionnelles et de l’Environnement, CHI Créteil, F-94010 Créteil, France; (M.M.); (M.G.); (P.A.)
- INSERM, IMRB, Paris Est Créteil University, F-94010 Créteil, France;
| |
Collapse
|