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Tan Z, Wang Y, Xing X, Shen Z, Sang W. Socioeconomic status, individual behaviors and risk for Lymphomas: a Mendelian randomization study. J Cancer 2024; 15:3760-3765. [PMID: 38911370 PMCID: PMC11190779 DOI: 10.7150/jca.96413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2024] [Accepted: 05/05/2024] [Indexed: 06/25/2024] Open
Abstract
Background: The association of socioeconomic status and individual behavior (SES/IB) with human health is receiving increasing attention. However, the causal effects between SES/IB and lymphomas remain unclear. Methods: A two-sample Mendelian randomization (MR) study was used to assess the causal effects of 25 SES/IB traits (dietary habits, physical activity, smoking/drinking behaviors, sleeping behaviors, leisure sedentary behaviors, risky behaviors, and reproductive behaviors) on six distinct types of lymphomas, including Hodgkin lymphoma (HL), follicular lymphoma (FL), diffuse large B-cell lymphoma (DLBCL), mature T/NK-cell lymphomas, marginal zone B-cell lymphoma (MZL), and mantle cell lymphoma (MCL). The inverse variance weighted (IVW) method was the primary approach used for the MR analysis. A series of sensitivity analyses were also conducted to ensure the robustness of the findings. Results: Two-sample MR revealed six SES/IB traits causally associated with lymphomas, including relative fat intake, drive time, television watching time, computer use time, vigorous physical activity, and number of children ever born. After false discovery rate (FDR) correction, the causal associations between longer television watching time and DLBCL (OR: 4.048, 95% CI: 1.688 to 9.708, P fdr=0.009), and the number of children ever born with both FL (OR: 0.008, 95% CI: 1.412E-04 to 0.484, P fdr=0.021) and DLBCL (OR: 0.001, 95% CI:1.587E-05 to 0.081, P fdr=0.002) were identified. Conclusions: These findings suggest that certain lifestyle and behavioral factors have a measurable impact on specific lymphoma types.
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Affiliation(s)
- Zaixiang Tan
- Research Center of Health Policy and Health Management, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
| | - Ying Wang
- Research Center of Health Policy and Health Management, Xuzhou Medical University, Xuzhou 221004, Jiangsu, China
- Department of Personnel, Suqian First Hospital, Suqian 223800, Jiangsu, China
| | - Xing Xing
- Department of Epidemiology and Biostatistics, School of Public Health, Anhui Medical University, Hefei 230032, Anhui, China
| | - Ziyuan Shen
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu, China
| | - Wei Sang
- Department of Hematology, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu, China
- Blood Diseases Institute, Xuzhou Medical University, Xuzhou 221006, Jiangsu, China
- Key Laboratory of Bone Marrow Stem Cell, Xuzhou 221006, Jiangsu, China
- Cell Research and Translational Medicine Center, The Affiliated Hospital of Xuzhou Medical University, Xuzhou 221006, Jiangsu, China
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2
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Odutola MK, van Leeuwen MT, Bruinsma FJ, Benke G, Turner MC, Trotman J, Turner J, Seymour JF, Prince HM, Milliken ST, Tiley C, Hertzberg M, Roncolato F, Opat S, Lindeman R, Verner E, Underhill CR, Cardis E, Giles G, Vajdic CM. Occupational exposure to extremely low-frequency magnetic fields and follicular lymphoma risk: a family case-control study. Occup Environ Med 2023; 80:599-602. [PMID: 37722828 PMCID: PMC10591762 DOI: 10.1136/oemed-2023-108949] [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: 04/13/2023] [Accepted: 08/30/2023] [Indexed: 09/20/2023]
Abstract
OBJECTIVES We aimed to examine the relationship between occupational exposure to extremely low-frequency magnetic fields (ELF-MFs) and follicular lymphoma (FL) risk. METHODS We conducted a family case-control study between 2011 and 2016 in Australia and included 681 cases. Controls were either a family member of cases (related (n=294), unrelated (n=179)) or were unrelated recruited for a similarly designed Australian multiple myeloma study (n=711). We obtained detailed job histories using lifetime work calendars. We assigned exposure to ELF-MFs using an enhanced job exposure matrix, with a lag period of 10 years. We examined associations with FL risk using logistic regression accounting for relatedness between cases and controls. We performed sensitivity analyses including by control type, by sex, complete case analyses, ELF-MF exposure percentiles in addition to quartiles, ELF-MF exposure in the maximum exposed job, a shorter lag period (1 year) and the cumulative exposure in the most recent time period (1-9 years). RESULTS We observed no association with the average intensity, duration or lifetime cumulative exposure to occupational ELF-MF exposure in the primary or sensitivity analyses. CONCLUSIONS Our findings do not support an association between occupational ELF-MF exposure and FL risk. Although the inclusion of family members as part of the larger control group may have biased our risk estimates towards the null, findings were similar in sensitivity analyses restricted to cases and unrelated controls. Further research incorporating enhanced exposure assessment to ELF-MF is warranted to inform occupational safety regulations and any potential role in lymphomagenesis.
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Affiliation(s)
- Michael K Odutola
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Marina T van Leeuwen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Fiona J Bruinsma
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Geza Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Michelle C Turner
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Department of Global Health, Pompeu Fabra University (UPF), Barcelona, Spain
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Judith Trotman
- Concord Repatriation General Hospital and University of Sydney, Concord, New South Wales, Australia
| | - Jennifer Turner
- Anatomical Pathology, Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia
- Department of Clinical Medicine, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, New South Wales, Australia
| | - John F Seymour
- Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia
| | - H Miles Prince
- Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
| | - Samuel T Milliken
- Haematology Department, St. Vincent's Hospital, Sydney, New South Wales, Australia
| | - Campbell Tiley
- Cancer Day Unit, Gosford Hospital, Gosford, New South Wales, Australia
| | - Mark Hertzberg
- Department of Haematology, Prince of Wales Hospital and University of New South Wales, Sydney, New South Wales, Australia
| | - Fernando Roncolato
- Clinical Haematology, St. George Hospital, Kogarah, New South Wales, Australia
| | - Stephen Opat
- Clinical Haematology, Monash Health, Clayton, Victoria, Australia
| | - Robert Lindeman
- Clinical Operations, New South Wales Health Pathology, Sydney, New South Wales, Australia
| | - Emma Verner
- Concord Repatriation General Hospital and University of Sydney, Concord, New South Wales, Australia
| | - Craig R Underhill
- Border Medical Oncology Research Unit, Albury, New South Wales, Australia
| | - Elisabeth Cardis
- ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
- Department of Global Health, Pompeu Fabra University (UPF), Barcelona, Spain
- Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
| | - Graham Giles
- Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
- Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
- The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
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3
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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.
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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
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Kundu S, Jha SB, Rivera AP, Flores Monar GV, Islam H, Puttagunta SM, Islam R, Sange I. Multiple Myeloma and Renal Failure: Mechanisms, Diagnosis, and Management. Cureus 2022; 14:e22585. [PMID: 35371791 PMCID: PMC8958144 DOI: 10.7759/cureus.22585] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/24/2022] [Indexed: 11/05/2022] Open
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5
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Cocco P, Satta G, Meloni F, Pilia I, Ahmed F, Becker N, Casabonne D, de Sanjosé S, Foretova L, Maynadié M, Nieters A, Staines A, 't Mannetje A, Zucca M, Ennas MG, Campagna M, De Matteis S, Benavente Y. Occupational exposure to organic dust and risk of lymphoma subtypes in the EPILYMPH case-control study. Scand J Work Environ Health 2021; 47:42-51. [PMID: 33103203 PMCID: PMC7801142 DOI: 10.5271/sjweh.3925] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2020] [Indexed: 11/23/2022] Open
Abstract
Objectives This study aimed to estimate the risk of lymphoma and its major subtypes in relation to occupational exposure to specific organic dusts. Methods We explored the association in 1853 cases and 1997 controls who participated in the EpiLymph case-control study, conducted in six European countries in 1998-2004. Based on expert assessment of lifetime occupational exposures, we calculated the risk of the major lymphoma subtypes associated with exposure to six specific organic dusts, namely, flour, hardwood, softwood, natural textile, synthetic textile, and leather, and two generic (any types) groups: wood and textile dusts. Risk was predicted with unconditional regression modeling, adjusted by age, gender, study center, and education. Results We observed a 2.1-fold increase in risk of follicular lymphoma associated with ever exposure to leather dust [95% confidence interval (CI) 1.01-4.20]. After excluding subjects who ever worked in a farm or had ever been exposed to solvents, risk of B-cell lymphoma was elevated in relation to ever exposure to leather dust [odd ratio (OR) 2.2, 95% CI 1.00-4.78], but it was not supported by increasing trends with the exposure metrics. Risk of Hodgkin lymphoma was elevated (OR 2.0, 95% CI 0.95-4.30) for exposure to textile dust, with consistent upward trends by cumulative exposure and three independent exposure metrics combined (P=0.023, and P=0.0068, respectively). Conclusions Future, larger studies might provide further insights into the nature of the association we observed between exposure to textile dust and risk of Hodgkin lymphoma.
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Affiliation(s)
- Pierluigi Cocco
- Department of Medical Sciences and Public Health, Occupational Medicine unit, University of Cagliari, Monserrato (Cagliari) Italy.
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Moubadder L, McCullough LE, Flowers CR, Koff JL. Linking Environmental Exposures to Molecular Pathogenesis in Non-Hodgkin Lymphoma Subtypes. Cancer Epidemiol Biomarkers Prev 2020; 29:1844-1855. [PMID: 32727723 DOI: 10.1158/1055-9965.epi-20-0228] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2020] [Revised: 05/27/2020] [Accepted: 07/20/2020] [Indexed: 12/24/2022] Open
Abstract
Non-Hodgkin lymphoma comprises a heterogeneous group of hematologic malignancies, with about 60 subtypes that arise via various pathogenetic mechanisms. Although establishing etiology for specific NHL subtypes has been historically difficult given their relative rarity, environmental exposures have been repeatedly implicated as risk factors across many subtypes. Large-scale epidemiologic investigations have pinpointed chemical exposures in particular, but causality has not been established, and the exact biologic mechanisms underpinning these associations are unclear. Here we review chemical exposures that have been associated with development of NHL subtypes and discuss their biologic plausibility based on current research.
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Affiliation(s)
- Leah Moubadder
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Lauren E McCullough
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Christopher R Flowers
- Department of Lymphoma & Myeloma, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Jean L Koff
- Department of Hematology and Medical Oncology, Winship Cancer Institute, Emory University, Atlanta, Georgia.
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Magangane PS, Mohamed Z, Naidoo R. Diffuse large B-cell lymphoma in a high human immunodeficiency virus (HIV) prevalence, low-resource setting. SOUTH AFRICAN JOURNAL OF ONCOLOGY 2020. [DOI: 10.4102/sajo.v4i0.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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8
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Bunch KJ, Kendall GM, Stiller CA, Vincent TJ, Murphy MFG. Case-control study of paternal occupational exposures and childhood lymphoma in Great Britain, 1962-2010. Br J Cancer 2019; 120:1153-1161. [PMID: 31105271 PMCID: PMC6738046 DOI: 10.1038/s41416-019-0469-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 04/16/2019] [Accepted: 04/18/2019] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND This nationwide study investigates associations between paternal occupational exposure and childhood lymphoma. METHODS The UK National Registry of Childhood Tumours provided cases of childhood lymphoma born and diagnosed in Great Britain 1962-2010. Control births, unaffected by childhood cancer, were matched on sex, birth period and birth registration sub-district. Fathers' occupations were assigned to one or more of 33 exposure groups and also coded for occupational social class. RESULTS We analysed 5033 childhood lymphoma cases and 4990 controls. Total lymphoma and the subgroups Hodgkin, Burkitt and non-Hodgkin lymphoma were considered separately. No one exposure was significantly associated with increased risk within all subgroups and for total lymphoma. However, exposure to "ceramics and glass" was significantly associated with increased risk of total lymphoma, Hodgkin and non-Hodgkin lymphoma. Paternal lead exposure was associated with Burkitt lymphoma and exposure to metal fumes was associated with Hodgkin lymphoma. CONCLUSIONS This study provides no support for previous suggestions of an association between childhood lymphoma and paternal occupational exposure to pesticides, solvents/hydrocarbons or infections potentially transmitted by father's social contacts. An association with exposure to "ceramics and glass" was noted for the two major lymphoma subtypes together comprising 80% of total lymphoma.
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Affiliation(s)
- Kathryn J Bunch
- National Perinatal Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Gerald M Kendall
- Cancer Epidemiology Unit, Nuffield Department of Population Health, University of Oxford, Richard Doll Building, Old Road Campus, Oxford, OX3 7LF, UK
| | - Charles A Stiller
- National Cancer Registration and Analysis Service, Public Health England, Chancellor Court, Oxford Business Park South, Oxford, OX4 2GX, UK
| | - Timothy J Vincent
- Formerly of Childhood Cancer Research Group, University of Oxford, Oxford, UK
| | - Michael F G Murphy
- Nuffield Department of Women's and Reproductive Health John Radcliffe Hospital, University of Oxford, Oxford, OX3 9DU, UK
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Huss A, Spoerri A, Egger M, Kromhout H, Vermeulen R. Occupational extremely low frequency magnetic fields (ELF-MF) exposure and hematolymphopoietic cancers - Swiss National Cohort analysis and updated meta-analysis. ENVIRONMENTAL RESEARCH 2018; 164:467-474. [PMID: 29587222 DOI: 10.1016/j.envres.2018.03.022] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Revised: 02/26/2018] [Accepted: 03/12/2018] [Indexed: 06/08/2023]
Abstract
PURPOSE Previous studies have examined risks of leukaemia and selected lymphoid malignancies in workers exposed to extremely low frequency magnetic fields (ELF-MF). Most studies evaluated hematolymphopoietic malignancies as a combined category, but some analyses suggested that effects may be contained to some specific leukaemia or lymphoma subtypes, with inconsistent results. METHODS We examined exposure to ELF-MF and mortality 1990-2008 from different types of hematolymphopoietic cancers in the Swiss National Cohort, using a job exposure matrix for occupations recorded at censuses 1990 and 2000. We analysed 3.1 million workers exposed at different levels to ELF-MF: ever-high, only-medium, only-low exposure using Cox proportional hazard models. We evaluated risk of death from acute myeloid leukaemia (AML), chronic myeloid leukaemia, lymphoid leukaemia, diffuse large B-cell lymphomas, follicular lymphoma, Waldenström's macroglobulinemia, multiple myeloma and Hodgkin lymphoma. RESULTS Mortality from hematolymphopoietic cancers was not associated with exposure to ELF-MF with the exception of an increase in ever-high exposed men of myeloid leukaemias (HR 1.31, 95% CI 1.02-1.67), and AML (HR 1.26, 95%CI 0.93-1.70). If workers had been high exposed during their vocational training and at both censuses, these HR increased to 2.24 (95%CI 0.91-5.53) and 2.75 (95%CI 1.11-6.83), respectively. CONCLUSIONS Our analysis provided no convincing evidence for an increased risk of death from a range of hematolymphopoietic cancers in workers exposed to high or medium levels of ELF magnetic fields. However, we observed an increased risk of acute myeloid leukaemia in workers exposed to high levels for a longer duration. Observed risks are in line with meta-analysed previous reports on ELF-MF exposure and AML risk, with a summary relative risk of 1.21 (95%CI 1.08-1.37).
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Affiliation(s)
- Anke Huss
- Institute for Risk Assessment Sciences, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands; Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland.
| | - Adrian Spoerri
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland
| | - Matthias Egger
- Institute of Social and Preventive Medicine (ISPM), University of Bern, Switzerland; School of Social and Community Medicine, University of Bristol, United Kingdom
| | - Hans Kromhout
- Institute for Risk Assessment Sciences, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Utrecht University, PO Box 80178, 3508 TD Utrecht, The Netherlands; Julius Centre for Public Health Sciences and Primary Care, University Medical Centre, Utrecht, The Netherlands
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Depczynski J, Dobbins T, Armstrong B, Lower T. Comparison of cancer incidence in Australian farm residents 45 years and over, compared to rural non-farm and urban residents - a data linkage study. BMC Cancer 2018; 18:33. [PMID: 29304761 PMCID: PMC5756349 DOI: 10.1186/s12885-017-3912-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Accepted: 12/13/2017] [Indexed: 01/23/2023] Open
Abstract
BACKGROUND It is not known if the incidence of common cancers in Australian farm residents is different to rural non-farm or urban residents. METHODS Data from farm, rural non-farm and urban participants of the 45 and Up Study cohort in New South Wales, Australia, were linked with state cancer registry data for the years 2006-2009. Directly standardised rate ratios for cancer incidence were compared for all-cancer, prostate, breast, colorectal cancer, melanoma and non-Hodgkin Lymphoma (NHL). Proportional hazards regression was used to generate incidence hazard ratios for each cancer type adjusted for relevant confounders. RESULTS Farm women had a significantly lower all-cancer hazard ratio than rural non-farm women (1.14, 1.01-1.29). However, the lower all-cancer risk observed in farm men, was not significant when compared to rural non-farm and urban counterparts. The all-cancer adjusted hazard ratio for combined rural non-farm and urban groups compared to farm referents, was significant for men (1.08,1.01-1.17) and women (1.13, 1.04-1.23). Confidence intervals did not exclude unity for differences in risk for prostate, breast, colorectal or lung cancers, NHL or melanoma. Whilst non-significant, farm residents had considerably lower risk of lung cancer than other residents after controlling for smoking and other factors. CONCLUSIONS All-cancer risk was significantly lower in farm residents compared to combined rural non-farm and urban groups. Farm women had a significantly lower all-cancer adjusted hazard ratio than rural non-farm women. These differences appeared to be mainly due to lower lung cancer incidence in farm residents.
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Affiliation(s)
- Julie Depczynski
- Australian Centre for Agricultural Health and Safety, The University of Sydney, Moree, Australia
| | - Timothy Dobbins
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Bruce Armstrong
- School of Global and Population Health, The University of Western Australia, Perth, Australia
- School of Public Health, The University of Sydney, Sydney, Australia
| | - Tony Lower
- Australian Centre for Agricultural Health and Safety, The University of Sydney, Moree, Australia
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Ferri GM, Specchia G, Mazza P, Ingravallo G, Intranuovo G, Guastadisegno CM, Congedo ML, Lagioia G, Loparco MC, Giordano A, Perrone T, Gaudio F, Spinosa C, Minoia C, D'Onghia L, Strusi M, Corrado V, Cavone D, Vimercati L, Schiavulli N, Cocco P. Risk of lymphoma subtypes by occupational exposure in Southern Italy. J Occup Med Toxicol 2017; 12:31. [PMID: 29201133 PMCID: PMC5701427 DOI: 10.1186/s12995-017-0177-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Accepted: 10/24/2017] [Indexed: 12/22/2022] Open
Abstract
Background Occupational exposure is known to play a role in the aetiology of lymphomas. The aim of the present work was to explore the occupational risk of the major B-cell lymphoma subtypes using a case–control study design. Methods From 2009 to 2014, we recruited 158 lymphoma cases and 76 controls in the provinces of Bari and Taranto (Apulia, Southern Italy). A retrospective assessment of occupational exposure based on complete work histories and the Carcinogen Exposure (CAREX) job-exposure matrix was performed. Results After adjusting for major confounding factors, farmers showed an increased risk of diffuse large B-cell lymphoma (DLBCL) [odds ratio (OR) = 10.9 (2.3–51.6)] and multiple myeloma (MM) [OR = 16.5 (1.4–195.7)]; exposure to the fungicide Captafol was significantly associated with risk of non-Hodgkin lymphoma (NHL) [OR = 2.6 (1.1–8.2)], particularly with the risk of DLBCL [OR = 5.3 (1.6–17.3)]. Conclusions Agricultural activity seems to be a risk factor for developing lymphoma subtypes, particularly DLBCL, in the provinces of Bari and Taranto (Apulia Region, Southern Italy). Exposure to the pesticides Captafol, Paraquat and Radon might be implicated. Trial registration Protocol number UNIBA 2207WEJLZB_004 registered 22/09/2008.
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Affiliation(s)
- Giovanni Maria Ferri
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy.,Interdisciplinary Department of Medicine (DIM), University Hospital. Policlinico-Giovanni XXIII, University of Bari, Piazza Giulio Cesare, 11, 70124 Bari, Italy
| | - Giorgina Specchia
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Patrizio Mazza
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Giuseppe Ingravallo
- Department of Emergency and Transplantation (DETO), Regional University Hospital "Policlinico - Giovanni XXIII° ", Unit of Pathology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Graziana Intranuovo
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Chiara Monica Guastadisegno
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Maria Luisa Congedo
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Gianfranco Lagioia
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Maria Cristina Loparco
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Annamaria Giordano
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Tommasina Perrone
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Francesco Gaudio
- Department of Emergency and Transplantation (DETO), Regional Universitary Hospital "Policlinico - Giovanni XXIII°, Unit of Hematology, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Caterina Spinosa
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Carla Minoia
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Lucia D'Onghia
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Michela Strusi
- ASL Taranto, Moscati Hospital, Unity of Haematology, Via Paisiello 1, 74100 Taranto, Italy
| | - Vincenzo Corrado
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Domenica Cavone
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Luigi Vimercati
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Nunzia Schiavulli
- Department of Interdisciplinary Medicine (DIM), Section "B. Ramazzini", Regional University Hospital "Policlinico - Giovanni XXIII°", Unit of Occupational Medicine, University of Bari, Piazza G. Cesare, 11, 70124 Bari, Italy
| | - Pierluigi Cocco
- Department of Public Health, Clinical & Molecular Medicine, Occupational Health Section, University of Cagliari, 09100 Cagliari, Italy
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Rieutort D, Moyne O, Cocco P, de Gaudemaris R, Bicout DJ. Ranking occupational contexts associated with risk of non-Hodgkin lymphoma. Am J Ind Med 2016; 59:561-74. [PMID: 27214653 DOI: 10.1002/ajim.22604] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2016] [Indexed: 01/27/2023]
Abstract
BACKGROUND Risk factors associated with non-Hodgkin lymphoma (NHL) remain unknown, but certain occupational contexts (OCs) have been implicated. The objective of this study was to inventory, from the accumulated knowledge, associations between OCs and NHL risk. METHODS Literature was used to identify the NHL-associated OCs. For each context, items were ranked both by scientific interest and the association strength. RESULTS Three ranked lists of OCs related to NHL were constructed. We found that NHL was associated with 31 occupational activities, 91 occupational exposures, and 35 occupational activity-exposure combinations. Among them, 5 activities, 2 exposures, and 3 combinations, involving agricultural or industrial sector and solvents or pesticides, were highlighted with the highest publications number and the strongest association with NHL risk. CONCLUSION These results could be useful in both providing a ranked inventory of OCs associated with NHL risk and highlighting "hot" occupational activities and exposures. Am. J. Ind. Med. 59:561-574, 2016. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Delphine Rieutort
- UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525 (EPSP Team-Environment and Health Prediction of Populations); Grenoble France
| | - Oriane Moyne
- UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525 (EPSP Team-Environment and Health Prediction of Populations); Grenoble France
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section; University of Cagliari; Cagliari Italy
| | - Régis de Gaudemaris
- UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525 (EPSP Team-Environment and Health Prediction of Populations); Grenoble France
- Occupational and Environmental Diseases Centre; Grenoble Teaching Hospital (CHU Grenoble); Grenoble France
| | - Dominique J. Bicout
- UJF-Grenoble 1/CNRS/TIMC-IMAG UMR 5525 (EPSP Team-Environment and Health Prediction of Populations); Grenoble France
- Biomathematics and Epidemiology EPSP-TIMC, VetAgro Sup; Veterinary Campus of Lyon; Marcy l'Etoile France
- Laue-Langevin Institute; Theory Group; Grenoble Cedex 9 France
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13
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‘t Mannetje A, De Roos AJ, Boffetta P, Vermeulen R, Benke G, Fritschi L, Brennan P, Foretova L, Maynadié M, Becker N, Nieters A, Staines A, Campagna M, Chiu B, Clavel J, de Sanjose S, Hartge P, Holly EA, Bracci P, Linet MS, Monnereau A, Orsi L, Purdue MP, Rothman N, Lan Q, Kane E, Costantini AS, Miligi L, Spinelli JJ, Zheng T, Cocco P, Kricker A. Occupation and Risk of Non-Hodgkin Lymphoma and Its Subtypes: A Pooled Analysis from the InterLymph Consortium. ENVIRONMENTAL HEALTH PERSPECTIVES 2016; 124:396-405. [PMID: 26340796 PMCID: PMC4829988 DOI: 10.1289/ehp.1409294] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/02/2014] [Accepted: 09/02/2015] [Indexed: 05/27/2023]
Abstract
BACKGROUND Various occupations have been associated with an elevated risk of non-Hodgkin lymphoma (NHL), but results have been inconsistent across studies. OBJECTIVES We investigated occupational risk of NHL and of four common NHL subtypes with particular focus on occupations of a priori interest. METHODS We conducted a pooled analysis of 10,046 cases and 12,025 controls from 10 NHL studies participating in the InterLymph Consortium. We harmonized the occupational coding using the 1968 International Standard Classification of Occupations (ISCO-1968) and grouped occupations previously associated with NHL into 25 a priori groups. Odds ratios (ORs) adjusted for center, age, and sex were determined for NHL overall and for the following four subtypes: diffuse large B-cell lymphoma (DLBCL), follicular lymphoma (FL), chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), and peripheral T-cell lymphoma (PTCL). RESULTS We confirmed previously reported positive associations between NHL and farming occupations [field crop/vegetable farm workers OR = 1.26; 95% confidence interval (CI): 1.05, 1.51; general farm workers OR = 1.19; 95% CI: 1.03, 1.37]; we also confirmed associations of NHL with specific occupations such as women's hairdressers (OR = 1.34; 95% CI: 1.02, 1.74), charworkers/cleaners (OR = 1.17; 95% CI: 1.01, 1.36), spray-painters (OR = 2.07; 95% CI: 1.30, 3.29), electrical wiremen (OR = 1.24; 95% CI: 1.00, 1.54), and carpenters (OR = 1.42; 95% CI: 1.04, 1.93). We observed subtype-specific associations for DLBCL and CLL/SLL in women's hairdressers and for DLBCL and PTCL in textile workers. CONCLUSIONS Our pooled analysis of 10 international studies adds to evidence suggesting that farming, hairdressing, and textile industry-related exposures may contribute to NHL risk. Associations with women's hairdresser and textile occupations may be specific for certain NHL subtypes. CITATION 't Mannetje A, De Roos AJ, Boffetta P, Vermeulen R, Benke G, Fritschi L, Brennan P, Foretova L, Maynadié M, Becker N, Nieters A, Staines A, Campagna M, Chiu B, Clavel J, de Sanjose S, Hartge P, Holly EA, Bracci P, Linet MS, Monnereau A, Orsi L, Purdue MP, Rothman N, Lan Q, Kane E, Seniori Costantini A, Miligi L, Spinelli JJ, Zheng T, Cocco P, Kricker A. 2016. Occupation and risk of non-Hodgkin lymphoma and its subtypes: a pooled analysis from the InterLymph Consortium. Environ Health Perspect 124:396-405; http://dx.doi.org/10.1289/ehp.1409294.
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Affiliation(s)
- Andrea ‘t Mannetje
- Centre for Public Health Research, Massey University, Wellington Campus, Wellington, New Zealand
| | - Anneclaire J. De Roos
- Department of Environmental and Occupational Health, Drexel University School of Public Health, Philadelphia, Pennsylvania, USA
| | - Paolo Boffetta
- Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Roel Vermeulen
- Division of Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht University, Utrecht, the Netherlands
| | - Geza Benke
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lin Fritschi
- School of Public Health, Curtin University, Bentley, Western Australia, Australia
| | - Paul Brennan
- International Agency for Research on Cancer, Lyon, France
| | - Lenka Foretova
- Department of Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute, Brno, Czech Republic
| | - Marc Maynadié
- Biological Hematology Unit, University of Burgundy, Dijon, France
| | - Nikolaus Becker
- Division of Cancer Epidemiology, German Cancer Research Center Heidelberg, Heidelberg, Germany
| | - Alexandra Nieters
- Center for Chronic Immunodeficiency, University Medical Center Freiburg, Freiburg, Germany
| | - Anthony Staines
- School of Nursing and Human Sciences, Dublin City University, Dublin, Ireland
| | - Marcello Campagna
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Brian Chiu
- Department of Public Health Sciences, University of Chicago, Chicago, USA
| | - Jacqueline Clavel
- Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Institut national de la santé et de la recherche médicale (INSERM), Villejuif, France
- French National Registry of Childhood Hematological Malignancies (NRCH), Villejuif, France
| | - Silvia de Sanjose
- Cancer Epidemiology Research Programme, Catalan Institute of Oncology–Spain Institut d’Investigació Biomèdica de Bellvitge (IDIBELL), Barcelona, Spain
- CIBER en Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Patricia Hartge
- Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), National Institutes of Health (NIH), Department of Health and Human Services (DHHS), Bethesda, Maryland, USA
| | - Elizabeth A. Holly
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Paige Bracci
- Department of Epidemiology and Biostatistics, School of Medicine, University of California San Francisco, San Francisco, California, USA
| | - Martha S. Linet
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Alain Monnereau
- Centre d’investigation clinique (CIC), INSERM, Bordeaux, France
- Registre des Hémopathies Malignes de la Gironde, Institut Bergonié, Bordeaux, France
| | - Laurent Orsi
- Epidemiology and Biostatistics Sorbonne Paris Cité Center (CRESS), Institut national de la santé et de la recherche médicale (INSERM), Villejuif, France
| | - Mark P. Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Nathaniel Rothman
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Qing Lan
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, NCI, NIH, DHHS, Bethesda, Maryland, USA
| | - Eleanor Kane
- Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, United Kingdon
| | - Adele Seniori Costantini
- Environmental and Occupational Epidemiology Unit, ISPO Cancer Research and Prevention Institute, Florence, Italy
| | - Lucia Miligi
- Environmental and Occupational Epidemiology Unit, ISPO Cancer Research and Prevention Institute, Florence, Italy
| | - John J. Spinelli
- Cancer Control Research, British Columbia Cancer Agency, Vancouver, British Columbia, Canada
| | - Tongzhang Zheng
- Department of Environmental Health Sciences, Yale University School of Public Health, New Haven, Connecticut, USA
| | - Pierluigi Cocco
- Department of Public Health, Clinical and Molecular Medicine, University of Cagliari, Cagliari, Italy
| | - Anne Kricker
- Sydney School of Public Health, University of Sydney, Sydney, New South Wales, Australia
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14
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Dalia S, Dunker K, Sokol L, Mhaskar R. Hepatitis B seropositivity and risk of developing multiple myeloma or Hodgkin lymphoma: A meta-analysis of observational studies. Leuk Res 2015; 39:1325-33. [PMID: 26394533 DOI: 10.1016/j.leukres.2015.09.008] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 08/25/2015] [Accepted: 09/06/2015] [Indexed: 01/15/2023]
Abstract
Multiple myeloma (MM) and Hodgkin lymphoma (HL) are common hematological malignancies. There is conflicting data on the potential role of hepatitis B virus (HBV) infection and developing MM or HL. The main aim of this study is to evaluate the association of HBV seropositivity and HL or MM through a meta-analysis of epidemiological studies A literature search through March 2015 found 10 studies that evaluated the association between HBV and MM or HL. Meta-analysis was calculated as an odds ratio (OR). Our analysis showed an OR of developing MM of 1.41 (P=0.03) and an OR of developing HL of 1.54 (P=0.03) in patients with HBV seropositivity. Our results did not change based on study design, quality of studies and use of HBV seropositivity to determine HBV status. Our results suggest that HBV seropositivity increases the risk of developing MM and HL. Further research is needed to confirm these findings.
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Affiliation(s)
- Samir Dalia
- Oncology and Hematology Mercy Clinic Joplin, 100 Mercy Way, Joplin, MO 64804, United States.
| | - Kelli Dunker
- Morsani College of Medicine, The University of South Florida, 12901 Bruce B Downs Blvd, Tampa, FL 33612, United States.
| | - Lubomir Sokol
- Division of Hematological Malignancies, H. Lee Moffitt Cancer Center and Research Institute, 12902 Magnolia Drive, Tampa, FL 33612, United States.
| | - Rahul Mhaskar
- Division of Evidence Based Medicine, Department of Internal Medicine, The University of South Florida, 12901 Bruce B Downs Blvd MDC 27, Tampa, FL 33612, United States.
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15
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Smedby KE, Sampson JN, Turner JJ, Slager SL, Maynadié M, Roman E, Habermann TM, Flowers CR, Berndt SI, Bracci PM, Hjalgrim H, Weisenburger DD, Morton LM. Medical history, lifestyle, family history, and occupational risk factors for mantle cell lymphoma: the InterLymph Non-Hodgkin Lymphoma Subtypes Project. J Natl Cancer Inst Monogr 2015; 2014:76-86. [PMID: 25174028 DOI: 10.1093/jncimonographs/lgu007] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND The etiology of mantle cell lymphoma (MCL), a distinctive subtype accounting for 2%-10% of all non-Hodgkin lymphoma, is not known. METHODS We investigated associations with self-reported medical history, lifestyle, family history, and occupational risk factors in a pooled analysis of 557 patients with MCL and 13766 controls from 13 case-control studies in Europe, North America, and Australia. Odds ratios (ORs) and 95% confidence intervals (CIs) associated with each exposure were examined using multivariate logistic regression models. RESULTS The median age of the MCL patients was 62 years and 76% were men. Risk of MCL was inversely associated with history of hay fever (OR = 0.63, 95% CI = 0.48 to 0.82), and the association was independent of other atopic diseases and allergies. A hematological malignancy among first-degree relatives was associated with a twofold increased risk of MCL (OR = 1.99, 95% CI = 1.39 to 2.84), which was stronger in men (OR = 2.21, 95% CI = 1.44 to 3.38) than women (OR = 1.61, 95% CI = 0.82 to 3.19). A modestly increased risk of MCL was also observed in association with ever having lived on a farm (OR = 1.40, 95% CI = 1.03 to 1.90). Unlike some other non-Hodgkin lymphoma subtypes, MCL risk was not statistically significantly associated with autoimmune disorders, tobacco smoking, alcohol intake, body mass index, or ultraviolet radiation. CONCLUSIONS The novel observations of a possible role for atopy and allergy and farm life in risk of MCL, together with confirmatory evidence of a familial link, suggest a multifactorial etiology of immune-related environmental exposures and genetic susceptibility. These findings provide guidance for future research in MCL etiology.
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Affiliation(s)
- Karin E Smedby
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
| | - Joshua N Sampson
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Jennifer J Turner
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Susan L Slager
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Marc Maynadié
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Eve Roman
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Thomas M Habermann
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Christopher R Flowers
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Sonja I Berndt
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Paige M Bracci
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Henrik Hjalgrim
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Dennis D Weisenburger
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Lindsay M Morton
- Unit of Clinical Epidemiology, Department of Medicine Solna, Karolinska Institutet, Karolinska University Hospital, Stockholm, Sweden (KES); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (JNS, SIB, LMM); Department of Histopathology, Douglass Hanly Moir Pathology, Macquarie Park, Australia The Australian, School of Advanced Medicine, Macquarie University, Sydney, Australia (JJT); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SLS, TMH); Biological Hematology Unit; CRB Ferdinand Cabanne, University Hospital of Dijon, Dijon, France, EA4184, University of Burgundy, Dijon, France (MM); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (ER); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Epidemiology and Biostatistics, University of California San Francisco, San Francisco, CA (PMB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (HH); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
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16
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Costas L, Infante-Rivard C, Zock JP, Van Tongeren M, Boffetta P, Cusson A, Robles C, Casabonne D, Benavente Y, Becker N, Brennan P, Foretova L, Maynadié M, Staines A, Nieters A, Cocco P, de Sanjosé S. Occupational exposure to endocrine disruptors and lymphoma risk in a multi-centric European study. Br J Cancer 2015; 112:1251-6. [PMID: 25742473 PMCID: PMC4385964 DOI: 10.1038/bjc.2015.83] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/02/2015] [Accepted: 01/27/2015] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Incidence rates of lymphoma are usually higher in men than in women, and oestrogens may protect against lymphoma. METHODS We evaluated occupational exposure to endocrine disrupting chemicals (EDCs) among 2457 controls and 2178 incident lymphoma cases and subtypes from the European Epilymph study. RESULTS Over 30 years of exposure to EDCs compared to no exposure was associated with a 24% increased risk of mature B-cell neoplasms (P-trend=0.02). Associations were observed among men, but not women. CONCLUSIONS Prolonged occupational exposure to endocrine disruptors seems to be moderately associated with some lymphoma subtypes.
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Affiliation(s)
- L Costas
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908 Barcelona, Spain
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - C Infante-Rivard
- Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, QC, Canada H3A 1A2
| | - J-P Zock
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
- Netherlands Institute for Health Services Research (NIVEL), 3500 Utrecht, The Netherlands
- Centre for Research in Environmental Epidemiology (CREAL), 08003 Barcelona, Spain
- Universitat Pompeu Fabra (UPF), 08003 Barcelona, Spain
| | - M Van Tongeren
- Centre for Human Exposure Science (CHES), Institute of Occupational Medicine, EH14 4AP Edinburgh, UK
| | - P Boffetta
- Tisch Cancer Institute and Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, 10029 NY, USA
| | - A Cusson
- Centre de Recherche, CHU Sainte-Justine, Montréal, QC, Canada H3T 1C4
| | - C Robles
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908 Barcelona, Spain
| | - D Casabonne
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908 Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Y Benavente
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908 Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - N Becker
- Division of Cancer Epidemiology, German Cancer Research Center, Im Neuenheimer Feld 280, 69120 Heidelberg, Germany
| | - P Brennan
- IARC, International Agency for Research on Cancer, 69372 Lyon, France
| | - L Foretova
- Cancer Epidemiology and Genetics, Masaryk Memorial Cancer Institute and MF MU, 65653 Brno, Czech Republic
| | - M Maynadié
- Biological Hematology Unit, CRB Ferdinand Cabanne, Universitary Hospital of Dijon and EA4184, University of Burgundy, EA 4184 Dijon, France
| | - A Staines
- Public Health University College, Dublin, Ireland
| | - A Nieters
- Centre of Chronic Immunodeficiency, Molecular Epidemiology, University Medical Center Freiburg, 79106 Freiburg, Germany
| | - P Cocco
- Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, 09124 Cagliari, Italy
| | - S de Sanjosé
- Unit of Infections and Cancer, Cancer Epidemiology Research Programme, IDIBELL, Catalan Institute of Oncology, 08908 Barcelona, Spain
- Department of Medicine, University of Barcelona, 08036 Barcelona, Spain
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
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17
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Perrotta C, Kleefeld S, Staines A, Tewari P, De Roos AJ, Baris D, Birmann B, Chiu B, Cozen W, Becker N, Foretova L, Maynadié M, Nieters A, de Sanjosé S, Miligi L, Seniori Costantini A, Purdue M, Spinelli J, Cocco P. Multiple myeloma and occupation: a pooled analysis by the International Multiple Myeloma Consortium. Cancer Epidemiol 2013; 37:300-5. [PMID: 23403129 DOI: 10.1016/j.canep.2013.01.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2012] [Revised: 01/16/2013] [Accepted: 01/19/2013] [Indexed: 10/27/2022]
Abstract
OBJECTIVE We investigated occupational risk of multiple myeloma (MM) in a pooled analysis of five international case-control studies. METHODS We calculated the odds ratio and its 95% confidence interval for selected occupations with unconditional regression analysis in 1959 MM cases and 6192 controls, by pooling study-specific risks using random-effects meta-analysis. Exposure to organic solvents was assessed with a job-exposure matrix (JEM). RESULTS Gardeners and nursery workers combined, most likely exposed to pesticides, showed a 50% increase in risk (OR = 1.50, 95% CI 0.9-2.3), while other farming jobs did not. Metal processors (OR = 1.55, 95% CI 0.9-2.3), female cleaners (OR = 1.32, 95% CI 1.0-1.8), and high level exposure to organic solvents (OR = 1.38, 95% CI 0.96-1.8) also showed moderately increased risks. CONCLUSIONS Additional case-control studies of MM aetiology are warranted to further investigate the nature of the repeatedly reported increase in MM risk in several occupational groups.
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Affiliation(s)
- Carla Perrotta
- Family and Community Medicine Department, Hospital Italiano de Buenos Aires, Buenos Aires, Argentina
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18
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Hansen J, Sallmén M, Seldén AI, Anttila A, Pukkala E, Andersson K, Bryngelsson IL, Raaschou-Nielsen O, Olsen JH, McLaughlin JK. Risk of cancer among workers exposed to trichloroethylene: analysis of three Nordic cohort studies. J Natl Cancer Inst 2013; 105:869-77. [PMID: 23723420 DOI: 10.1093/jnci/djt107] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Trichloroethylene (TCE) is a widely used chlorinated solvent with demonstrated carcinogenicity in animal assays. Some epidemiologic studies have reported increased risk of cancer of the kidney, cervix, liver and biliary passages, non-Hodgkin lymphoma, and esophageal adenocarcinoma. METHODS We established a pooled cohort, including 5553 workers with individual documented exposure to TCE in Finland, Sweden, and Denmark. Study participants were monitored for the urinary TCE metabolite trichloroacetic acid from 1947 to 1989 and followed for cancer. Standardized incidence ratios (SIRs) were calculated based on cancer incidence rates in the three national populations. Cox proportionate hazard analyses were used for internal comparisons. Tests of statistical significance are two-sided. RESULTS Overall, 997 cases of cancer (n = 683 in men; n = 314 in women) were identified during 154 778 person-years of follow-up. We observed statistically significant elevated standardized incidence ratios for primary liver cancer (1.93; 95% confidence interval [CI] = 1.19 to 2.95) and cervical cancer (2.31; 95% CI = 1.32 to 3.75). The standardized incidence ratio for kidney cancer was 1.01 (95% CI = 0.70 to 1.42) based on 32 cases; we did not observe a statistically significant increased risk of non-Hodgkin's lymphoma (SIR = 1.26; 95% CI = 0.89 to 1.73) or esophageal adenocarcinoma (SIR = 1.84; 95% CI = 0.65 to 4.65). Tobacco- and alcohol-associated cancers were not statistically significantly increased. CONCLUSIONS Our results suggest TCE exposure is possibly associated with an increased risk for liver cancer. The relationship between TCE exposure and risks of cancers of low incidence and those with confounding by lifestyle and other factors not known in our cohort require further study.
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Affiliation(s)
- Johnni Hansen
- Danish Cancer Society Research Center, Copenhagen, Denmark.
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19
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Siegel DS. Relapsed/Refractory multiple myeloma: defining refractory disease and identifying strategies to overcome resistance. Semin Hematol 2012; 49 Suppl 1:S3-15. [PMID: 22727390 DOI: 10.1053/j.seminhematol.2012.05.005] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Despite the development of more effective therapies for multiple myeloma (MM) over the past decade, nearly all patients will eventually experience disease relapse and require further therapy. Designing the next generation of therapies for relapsed and refractory disease will depend on understanding the complex molecular pathogenesis of MM and mechanisms of resistance. Oncogenomic studies have identified many potential therapeutic targets and have led to emerging models of the multistep molecular pathogenesis of MM. The key to overcoming resistance may depend on interrupting the complex interactions between MM cells and the bone microenvironment. Direct interaction between MM cells and bone marrow cells activates pleiotropic signaling pathways that mediate growth, survival, and migration of MM cells as well as resistance to chemotherapy (known as cell adhesion-mediated drug resistance). The bone marrow also secretes growth factors and cytokines that maintain MM cells and inhibit apoptosis. Therefore, successful therapeutic strategies must target not only the MM plasma cell but also the bone microenvironment. The benefit of immunomodulatory drugs such as thalidomide and lenalidomide and the proteasome inhibitor bortezomib in relapsed/refractory MM is related to their ability to target both. Novel agents and combination strategies are building on the success of these agents and targeting synergistic pathways.
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Affiliation(s)
- David S Siegel
- Hackensack University Medical Center, Hackensack, NJ 07601, USA.
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20
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Current understanding of lifestyle and environmental factors and risk of non-hodgkin lymphoma: an epidemiological update. J Cancer Epidemiol 2012; 2012:978930. [PMID: 23008714 PMCID: PMC3447374 DOI: 10.1155/2012/978930] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2012] [Revised: 07/20/2012] [Accepted: 08/04/2012] [Indexed: 01/07/2023] Open
Abstract
The incidence rates of non-Hodgkin lymphoma (NHL) have steadily increased over the last several decades in the United States, and the temporal trends in incidence can only be partially explained by the HIV epidemic. In 1992, an international workshop sponsored by the United States National Cancer Institute concluded that there was an “emerging epidemic” of NHL and emphasized the need to investigate the factors responsible for the increasing incidence of this disease. Over the past two decades, numerous epidemiological studies have examined the risk factors for NHL, particularly for putative environmental and lifestyle risk factors, and international consortia have been established in order to investigate rare exposures and NHL subtype-specific associations. While few consistent risk factors for NHL aside from immunosuppression and certain infectious agents have emerged, suggestive associations with several lifestyle and environmental factors have been reported in epidemiologic studies. Further, increasing evidence has suggested that the effects of these and other exposures may be limited to or stronger for particular NHL subtypes. This paper examines the progress that has been made over the last twenty years in elucidating the etiology of NHL, with a primary emphasis on lifestyle factors and environmental exposures.
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21
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Zakerinia M, Namdari M, Amirghofran S. The Relationship between Exposure to Pesticides and the Occurrence of Lymphoid Neoplasm. IRANIAN RED CRESCENT MEDICAL JOURNAL 2012; 14:337-44. [PMID: 22924112 PMCID: PMC3420024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/10/2012] [Accepted: 03/25/2012] [Indexed: 11/24/2022]
Abstract
BACKGROUND The etiology of malignant lymphoma is still largely unknown. This study determines the relationship between exposure to pesticides and the occurrence of lymphoid neoplasms in Shiraz, Southern Iran. METHODS Between 2007 and 2008, in a case control study conducted in Nemazee Hospital in Shiraz, Southern Iran, 200 subjects diagnosed with lymphoma according to the World Health Organization (WHO) classification were enrolled. Controls (n=200) were frequency matched to the cases by sex, age, and center. Subjects who were a farmer were compared with all other occupations. RESULTS Out of the 200 cases that were diagnosed as lymphoid neoplasms, 100 were non-Hodgkin's lymphoma, 54 Hodgkin's lymphoma and 46 multiple myeloma. Seventy two percent of the NHL's were of the B-cell type, 15% of the T-cell type and the rest were not classified. Furthermore, subjects exposed to pesticides were at an increased risk of non-Hodgkin lymphoma and MM, but not Hodgkin lymphoma. CONCLUSION Risk of non-Hodgkin lymphoma and MM was highest for exposure to pesticides, among them, insecticide's risk was confirmed.
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Affiliation(s)
- M Zakerinia
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran,Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran,Correspondence: Maryam Zakerinina, MD, Associate Professor of Internal Medicine, The Director of Bone Marrow Transplant Unit, Department of Internal Medicine, Hematology Research Center, Shiraz University of Medical Sciences, Shiraz, Iran. Tel.: +98-711-6474301, Fax: +98-711-6474301, E-mail:
| | - M Namdari
- Department of Internal Medicine, Shiraz University of Medical Sciences, Shiraz, Iran
| | - S Amirghofran
- Kish International Branch, Shiraz University of Medical Sciences, Shiraz, Iran
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22
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Park HJ, Park EH, Jung KW, Kong HJ, Won YJ, Lee JY, Yoon JH, Park BK, Lee H, Eom HS, Park S. Statistics of hematologic malignancies in Korea: incidence, prevalence and survival rates from 1999 to 2008. THE KOREAN JOURNAL OF HEMATOLOGY 2012; 47:28-38. [PMID: 22479275 PMCID: PMC3317467 DOI: 10.5045/kjh.2012.47.1.28] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/03/2012] [Revised: 03/16/2012] [Accepted: 03/19/2012] [Indexed: 11/29/2022]
Abstract
Background The nationwide statistical analysis of hematologic malignancies in Korea has not been reported yet. Methods The Korea Central Cancer Registry and the Korean Society of Hematology jointly investigated domestic incidence rates and prevalence of hematologic malignancies occurred between 1999 and 2008, and analyzed survival rates of patients who were diagnosed between 1993 and 2008. Data of hematologic malignancies from 1993 to 2008 were obtained from the Korean National Cancer Incidence Data base. The crude incidence rates, age-specific incidence rates, age-standardized incidence rates, annual percentage change of incidence, and prevalence from 1999-2008 were calculated. Survival rates for patients diagnosed in 1993-2008 were estimated. Results In 2008, a total of 8,006 cases of hematologic malignancies were occurred, which comprised 4.5% of all malignancies. In all genders, non-Hodgkin lymphoma, myeloid leukemia, and multiple myeloma were most frequent diseases. In terms of age, ages between 60 and 69 were most prevalent. From 1999 to 2008, the age-standardized incidence rates increased from 10.2 to 13.7, and the annual percentage change was 3.9%. The 5-year survival rate increased from 38.2% during 1993-1995 to 55.2% during 2004-2008. As of January 2009, number of patients with 10-year prevalence was 33,130, and with 5- to 10-year prevalence was 10,515. Conclusion This is the first nationwide statistical report of hematologic malignancies in Korea. It could be used as the basic information to help investigate epidemiologic characteristics, evaluate progress during the past years, and establish future strategies for hematologic malignancies. Periodic statistical analysis of hematologic malignancies in Korea should be continued.
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Affiliation(s)
- Hyeon Jin Park
- Center for Pediatric Oncology, National Cancer Center, Goyang, Korea
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23
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Aminian O, Abedi A, Chavoshi F, Ghasemi M, Rahmati-Najarkolaei F. Evaluation of Occupational Risk Factors in Non-Hodgkin Lymphoma and Hodgkin's Disease in Iranian Men. IRANIAN JOURNAL OF CANCER PREVENTION 2012; 5:189-93. [PMID: 25352969 PMCID: PMC4209571] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 06/05/2012] [Accepted: 08/14/2012] [Indexed: 12/04/2022]
Abstract
BACKGROUND Lymphoma is a malignancy, arises from lymphoid tissue. Nowadays, it is the ninth most common cancer in Iran. The risk factors of malignant lymphomas have not well determined, but since 20 years ago till now, too many epidemiological researches have been concerning either Non-Hodgkin Lymphoma (NHL) or Hodgkin's Disease (HD). It is a common usual hypothesis that idiosyncratic reaction to common physical, chemical, and viral agents could lead to lymphoma without obvious immune deficiency. Some occupations has reported to cause increasing "NHL" risks, such as rubber industry, veterinaries, uranium mining, metal working, asbestos exposing, farming, textile industry, and benzene exposing. The roles of ionizing radiation, benzene and other environmental agents have not been clear, because of the lack of confirmed evidences for relation between the occupational and environmental agents with "HD". METHODS A case-control study with 150 cases of malignant lymphoma and 150 controls have performed in Tehran. Data have selected through face-to-face interviews about the medical and occupational histories. RESULTS In this study, there was a significantly increased risk for Non-Hodgkin Lymphoma in these occupations; welders, metal workers, founders, aluminium workers OR=4.6 [Confidence Interval (CI): 1.47-14.35] and increased risk for Hodgkin's Disease in drivers OR=2.34 [(CI):0.86-6.35]. We have found out decreased NHL risk in office workers OR=0.54 [(CI):0.29-1.02] and also found out a non-significant increased NHL risk in farmers OR=1.58 [(CI):0.82-3.03]. In this study, we have found no relation between smoking and HD, or NHL. CONCLUSION The results of this study suggest that several occupations could alter the risk of Non-Hodgkin Lymphoma and Hodgkin's Disease.
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Affiliation(s)
- Omid Aminian
- Dept. of Occupational Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Ali Abedi
- Dept. of Occupational Medicine, Tehran University of Medical Sciences, Tehran, Iran
| | - Farzaneh Chavoshi
- Dept. of Occupational Medicine, Tehran University of Medical Sciences, Tehran, Iran,Corresponding Author:
Farzaneh Chavoshi, MD;
Tel: (+98) 21 66 40 55 88
| | - Mohammad Ghasemi
- Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran
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Chia SE, Wong KY, Tai BC. Occupation and risk of non-Hodgkin's lymphoma in Singapore. Occup Med (Lond) 2011; 62:29-33. [PMID: 22116951 DOI: 10.1093/occmed/kqr188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Some epidemiological studies have reported that teachers may be at increased risk of non-Hodgkin's lymphoma (NHL), but results are inconsistent. AIMS To examine the possible association between occupation and risk of NHL in the Singapore population. METHODS A hospital-based interviewer-administered case-control study was carried out in five major hospitals in Singapore between April 2004 and December 2008. A complete occupational history, which included all jobs lasting over 1 year since graduation from school, was obtained for each participant. The Singapore Standard Occupational Classification was used for coding all occupations recorded. RESULTS Eight hundred and thirty controls and 465 NHL cases, comprising B-cell (n = 404, 87%) as well as T- and NK-cell (n = 61, 13%) neoplasms, were recruited. Having ever worked as a teacher was associated with a significantly higher risk of NHL (adjusted OR 2.04, 95% CI 1.12-3.72). Teachers who had taught for ≤10 years had a significantly higher risk of NHL (adjusted OR 2.44, 95% CI 1.11-5.34), but we did not observe an elevated risk for those who reported teaching for >10 years. Among the 31 teachers with NHL, 23% taught in upper secondary schools, with equal proportions (13%) teaching in primary and pre-primary schools, respectively. The remainder taught in other settings. CONCLUSIONS Teachers come into frequent contact with children and may consequently have higher rates of exposure to common infectious agents. Therefore, the hypothesis of an infective aetiology of NHL may be supported by our findings.
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Affiliation(s)
- S E Chia
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore.
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25
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Gold LS, Stewart PA, Milliken K, Purdue M, Severson R, Seixas N, Blair A, Hartge P, Davis S, De Roos AJ. The relationship between multiple myeloma and occupational exposure to six chlorinated solvents. Occup Environ Med 2011; 68:391-9. [PMID: 20833760 PMCID: PMC3094509 DOI: 10.1136/oem.2009.054809] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
OBJECTIVES Few studies have examined whether exposure to chlorinated solvents is associated with multiple myeloma. We evaluated associations between multiple myeloma and occupational exposure to six chlorinated solvents: 1,1,1-trichloroethane, trichloroethylene (TCE), methylene chloride (DCM), perchloroethylene, carbon tetrachloride and chloroform. METHODS In-person interviews obtained occupational histories and information on jobs with likely solvent exposure. We assigned exposure metrics of probability, frequency, intensity and confidence using job-exposure matrices modified by job-specific questionnaire information. We used logistic regression to estimate ORs and 95% CIs for associations between multiple myeloma and ever exposure to each, and any, chlorinated solvent and analysed whether associations varied by duration and cumulative exposure. We also considered all occupations that were given the lowest confidence scores as unexposed and repeated all analyses. RESULTS Risk of multiple myeloma was elevated for subjects ever exposed to 1,1,1-trichloroethane (OR (95% CI): 1.8 (1.1 to 2.9)). Ever exposure to TCE or DCM also entailed elevated, but not statistically significant, risks of multiple myeloma; these became statistically significant when occupations with low confidence scores were considered unexposed (TCE: 1.7 (1.0 to 2.7); DCM: 2.0 (1.2 to 3.2)). Increasing cumulative exposure to perchloroethylene was also associated with increasing multiple myeloma risk. We observed non-significantly increased multiple myeloma risks with exposure to chloroform; however, few subjects were exposed. CONCLUSIONS Evidence from this relatively large case-control study suggests that exposures to certain chlorinated solvents may be associated with increased incidence of multiple myeloma; however, the study is limited by relatively low participation (52%) among controls.
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Affiliation(s)
- Laura S Gold
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
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26
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Kokouva M, Bitsolas N, Hadjigeorgiou GM, Rachiotis G, Papadoulis N, Hadjichristodoulou C. Pesticide exposure and lymphohaematopoietic cancers: a case-control study in an agricultural region (Larissa, Thessaly, Greece). BMC Public Health 2011; 11:5. [PMID: 21205298 PMCID: PMC3022699 DOI: 10.1186/1471-2458-11-5] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2010] [Accepted: 01/04/2011] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The causality of lymphohaematopoietic cancers (LHC) is multifactorial and studies investigating the association between chemical exposure and LHC have produced variable results. The aim of this study was to investigate the relationships between exposure to pesticides and LHC in an agricultural region of Greece. METHODS A structured questionnaire was employed in a hospital-based case control study to gather information on demographics, occupation, exposure to pesticides, agricultural practices, family and medical history and smoking. To control for confounders, backward conditional and multinomial logistic regression analyses were used. To assess the dose-response relationship between exposure and disease, the chi-square test for trend was used. RESULTS Three hundred and fifty-four (354) histologically confirmed LHC cases diagnosed from 2004 to 2006 and 455 sex- and age-matched controls were included in the study. Pesticide exposure was associated with total LHC cases (OR 1.46, 95% CI 1.05-2.04), myelodysplastic syndrome (MDS) (OR 1.87, 95% CI 1.00-3.51) and leukaemia (OR 2.14, 95% CI 1.09-4.20). A dose-response pattern was observed for total LHC cases (P = 0.004), MDS (P = 0.024) and leukaemia (P = 0.002). Pesticide exposure was independently associated with total LHC cases (OR 1.41, 95% CI 1.00 - 2.00) and leukaemia (OR 2.05, 95% CI 1.02-4.12) after controlling for age, smoking and family history (cancers, LHC and immunological disorders). Smoking during application of pesticides was strongly associated with total LHC cases (OR 3.29, 95% CI 1.81-5.98), MDS (OR 3.67, 95% CI 1.18-12.11), leukaemia (OR 10.15, 95% CI 2.15-65.69) and lymphoma (OR 2.72, 95% CI 1.02-8.00). This association was even stronger for total LHC cases (OR 18.18, 95% CI 2.38-381.17) when eating simultaneously with pesticide application. CONCLUSIONS Lymphohaematopoietic cancers were associated with pesticide exposure after controlling for confounders. Smoking and eating during pesticide application were identified as modifying factors increasing the risk for LHC. The poor pesticide work practices identified during this study underline the need for educational campaigns for farmers.
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Affiliation(s)
- Maria Kokouva
- Department of Hygiene and Epidemiology, Medical Faculty, University of Thessaly, Larissa, Greece
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27
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Gold LS, Milliken K, Stewart P, Purdue M, Severson R, Seixas N, Blair A, Davis S, Hartge P, De Roos AJ. Occupation and multiple myeloma: an occupation and industry analysis. Am J Ind Med 2010; 53:768-79. [PMID: 20623662 PMCID: PMC3085317 DOI: 10.1002/ajim.20857] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
BACKGROUND Multiple myeloma (MM) is an incurable plasma cell malignancy with a poorly understood etiology. The purpose of our research was to examine the relationships between lifetime occupations and MM in a relatively large case-control study. METHODS MM cases (n = 180) were identified through cancer registries in the Seattle-Puget Sound area and Detroit. Population-based controls (n = 481) were identified using random digit dialing and Medicare and Medicaid Services files. In-person interviews were conducted to ascertain occupational histories. Standard occupational classification (SOC) and standard industrial classification (SIC) codes were assigned to each job held by each participant. Unconditional logistic regression was used to generate odds ratios (ORs) and 95% confidence intervals (CIs) for associations between MM and having ever worked in each occupation/industry and according to duration of employment in an occupation/industry. RESULTS The risk of MM was associated with several manufacturing occupations and industries, including machine operators and tenders, not elsewhere classified (SOC 76) (OR = 1.8, CI = 1.0-3.3); textile, apparel, and furnishing machine operators and tenders (SOC 765) (OR = 6.0, CI = 1.7-21); and machinery manufacturing, except electrical (SIC 35) (OR = 3.3, CI = 1.7-6.7). Several service occupations and industries, such as food and beverage preparation (SOC 521) (OR = 2.0, CI = 1.1-3.8), were also associated with MM. One occupation that has been associated with MM in several previous studies, painters, paperhangers, and plasterers (SOC 644) was associated with a non-significantly elevated risk (OR = 3.6, CI = 0.7-19). CONCLUSIONS We found associations between the risk of MM and employment in several manufacturing and service-related occupations and industries.
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Affiliation(s)
- Laura S Gold
- Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA.
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A hospital-based case–control study of non-Hodgkin lymphoid neoplasms in Shanghai: Analysis of environmental and occupational risk factors by subtypes of the WHO classification. Chem Biol Interact 2010; 184:129-46. [DOI: 10.1016/j.cbi.2009.10.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2009] [Revised: 10/26/2009] [Accepted: 10/27/2009] [Indexed: 01/08/2023]
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Seidler A, Becker N, Nieters A, Arhelger R, Mester B, Rossnagel K, Deeg E, Elsner G, Melis M, Sesler S, Avataneo G, Meloni M, Cocco P. Asbestos exposure and malignant lymphoma: a multicenter case–control study in Germany and Italy. Int Arch Occup Environ Health 2009; 83:563-70. [DOI: 10.1007/s00420-009-0502-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2009] [Accepted: 12/09/2009] [Indexed: 11/24/2022]
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Associations of common variants in genes involved in metabolism and response to exogenous chemicals with risk of multiple myeloma. Cancer Epidemiol 2009; 33:276-80. [PMID: 19736056 DOI: 10.1016/j.canep.2009.08.005] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2009] [Accepted: 08/14/2009] [Indexed: 11/20/2022]
Abstract
BACKGROUND We examined risk of multiple myeloma (MM) associated with variants in genes involved in metabolism and response to exogenous chemicals [cytochrome P450 enzymes (CYP1B1, CYP2C9), epoxide hydrolase (EPHX1), paraoxonase 1 (PON1), arylhydrocarbon hydroxylase receptor (AHR), and NAD(P)H:quinone oxidoreductase (NQO1)]. METHODS This study included 279 MM cases and 782 controls in a pooled analysis of two population-based case-control studies. One common variant from each candidate gene was genotyped using DNA from blood or buccal cells. We estimated risk of MM associated with each genotype, controlling for race, gender, study site, and age, using odds ratios (OR) and 95% confidence intervals (CI). RESULTS Evaluations of the CYP1B1 V432L variant (rs1056836) suggested increased risk of MM among persons with the CG and GG genotypes compared to the CC genotype [OR (95% CI)=1.4 (1.0-2.0)]. Similar results were seen in analyses stratified by race and gender. We did not find any associations between MM and the CYP2C9, EPHX1, NQO1, or PON1 genes. CONCLUSIONS CYP1B1 activates chemicals such as polycyclic aromatic hydrocarbons and dioxins to create oxidized, reactive intermediates, and higher gene activity has been shown for the G allele. We conducted the largest analysis to date on MM and these genetic variants and our results provide preliminary evidence that variation in CYP1B1 may influence susceptibility to MM.
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Purdue MP, Severson RK, Colt JS, Stewart P, De Roos AJ, Cerhan JR, Cozen W, Davis S, Hartge P, Schenk M, Blair A. Degreasing and risk of non-Hodgkin lymphoma. Occup Environ Med 2009; 66:557-60. [PMID: 19017696 PMCID: PMC2995288 DOI: 10.1136/oem.2008.040386] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVE To investigate the relationship between selected solvent-related workplace tasks (degreasing, painting, gluing, stripping paint, staining) and risk of non-Hodgkin lymphoma (NHL). METHODS We analysed occupational data from a large population-based case-control study of NHL conducted in the USA. For participants reporting occupations with possible exposure to organic solvents, job-specific interview modules were administered to elicit in-depth information on solvent-related workplace tasks and other exposure-related factors (225 cases, 189 controls). Unconditional logistic regression models were fit to calculate odds ratios (ORs) and 95% CI for average frequency, maximal frequency and cumulative number of hours having performed each task. Individuals with jobs rated as unexposed to organic solvents in the workplace (180 cases, 213 controls) were used as a reference group. RESULTS We observed an increased risk of NHL among subjects in the highest category of maximal degreasing frequency (>520 h/year: OR 2.1, 95% CI 0.9 to 4.9, trend test p = 0.02). We found similar associations for the highest levels of average frequency and, among men, cumulative number of hours. Other solvent-related tasks were not associated with NHL. CONCLUSION Findings from this case-control analysis of solvent-related tasks suggest that frequent degreasing work may be associated with an elevated risk of NHL.
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Affiliation(s)
- M P Purdue
- Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, EPS 8114, 6120 Executive Blvd, Bethesda, MD 20892, USA.
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Schenk M, Purdue MP, Colt JS, Hartge P, Blair A, Stewart P, Cerhan JR, De Roos AJ, Cozen W, Severson RK. Occupation/industry and risk of non-Hodgkin's lymphoma in the United States. Occup Environ Med 2009; 66:23-31. [PMID: 18805886 PMCID: PMC3051169 DOI: 10.1136/oem.2007.036723] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
AIMS To identify occupations and industries associated with non-Hodgkin's lymphoma (NHL) in a large population-based, case-control study in the USA. METHODS Cases (n = 1189) of histologically confirmed malignant NHL ages 20-74 were prospectively identified in four geographic areas covered by the National Cancer Institute SEER Program. Controls (n = 982) were selected from the general population by random digit dialling (<65 years of age) and from residents listed in Medicare files (65-74 years of age). Odds ratios and 95% confidence intervals for occupations and industries were calculated by unconditional logistic regression analyses, adjusting for age, gender, ethnicity and study centre. Further analyses stratified for gender and histological subtype were also performed. RESULTS Risk of NHL was increased for a few occupations and industries. Several white collar occupations, with no obvious hazardous exposures, had elevated risks, including purchasing agents and buyers, religious workers, physical therapists and information clerks. Occupations with excesses that may have exposures of interest include launderers and ironers, service occupations, food/beverage preparation supervisors, hand packers and packagers, roofing and siding, leather and leather products, transportation by air, nursing and personal care facilities, and specialty outpatient clinics. Significantly decreased risks of NHL were found for a number of occupations and industries including post-secondary teachers and chemical and allied products. CONCLUSIONS The results of this study suggest that several occupations and industries may alter the risk of NHL. Our results support previously reported increased risks among farmers, printers, medical professionals, electronic workers and leather workers. These findings should be evaluated further in larger studies that have the power to focus on specific exposures and histological subtypes of NHL.
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Affiliation(s)
- M Schenk
- Department of Family Medicine and Public Health Sciences, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan 48201, USA.
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Perrotta C, Staines A, Cocco P. Multiple myeloma and farming. A systematic review of 30 years of research. Where next? J Occup Med Toxicol 2008; 3:27. [PMID: 19014617 PMCID: PMC2628921 DOI: 10.1186/1745-6673-3-27] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2008] [Accepted: 11/17/2008] [Indexed: 11/22/2022] Open
Abstract
Background Multiple myeloma has been linked to farming for over thirty years. However, there is little clarity about the magnitude of the risk, nor about the specific agricultural exposures which contribute to the risk. Methods We have carried out a systematic review of case-control studies of multiple myeloma published from 1970 to October 2007. Studies were identified through database searches and from references in the literature. Studies reporting risk estimates from farming, agricultural exposures, and exposure to animals were identified, and details abstracted. The impact of study heterogeneity, publication bias, variation in methods of case identification and exposure ascertainment between studies were considered in analysis. Results Case control studies showed a pooled odds ratio (OR) for working as a farmer of 1.39 95% CI 1.18 to 1.65. There was no graphic evidence of publication bias, for pesticide exposure 1.47; 95% 1.11 to 1.94, for DDT 2.19; CI 95% 1.30 to 2.95; for exposed to herbicides 1.69; 95 %CI 1.01 to 1.83. For working on a farm for more than ten years OR was 1.87; 95% CI 1.15 to 3.16. Conclusion Farmers seem to have increase risk for MM. However, a major limitation of this analysis is the presence of significant heterogeneity across the studies and the evidence of publication bias in some models. A pooled analysis using individual level data could provide more power and permit the harmonization of occupational and exposure coding data.
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Affiliation(s)
- Carla Perrotta
- School of Public Health and Population Science, University College Dublin, Woodview House, Belfield, Dublin 4, Ireland.
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Keegan GM, Learmonth ID, Case C. A Systematic Comparison of the Actual, Potential, and Theoretical Health Effects of Cobalt and Chromium Exposures from Industry and Surgical Implants. Crit Rev Toxicol 2008; 38:645-74. [DOI: 10.1080/10408440701845534] [Citation(s) in RCA: 116] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
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Richardson DB, Terschüren C, Hoffmann W. Occupational risk factors for non-Hodgkin's lymphoma: a population-based case-control study in Northern Germany. Am J Ind Med 2008; 51:258-68. [PMID: 18213641 DOI: 10.1002/ajim.20552] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVES To identify occupational factors associated with non-Hodgkin's lymphoma (NHL). METHODS A population-based case-control study was conducted in which incident cases of high-malignancy NHL (NHL(high)), low-malignancy NHL (NHL(low)), and chronic lymphocytic leukemia (CLL) were ascertained during the period 1986-1998 among men and women aged 15-75 years residing in six German counties; controls were drawn from population registries. Occupational histories were collected and agent-specific exposures were estimated via a job-exposure-matrix. Odds ratios were estimated by conditional logistic regression. RESULTS A total of 858 cases were included in these analyses. Agricultural workers [odds ratio (OR) = 2.67, 95% confidence interval (CI): 0.99, 7.21) and farmers (OR = 1.98, 95% CI: 0.98, 3.98] had elevated risk of NHL(high). Risk of NHL(low) was elevated among agricultural workers (OR = 2.46, 95% CI: 1.17, 5.16), and among blacksmiths, toolmakers, and machine tool operators (OR = 3.12, 95% CI: 1.31, 7.47). Workers in sales and construction had elevated risks of NHL(high) and NHL(low). Exposure to arsenic compounds, chlorophenols, diesel fuel, herbicides, nitrites/nitrates/nitrosamines, and organic dusts were associated with NHL(high) and NHL(low), while exhibiting little association with CLL. A positive monotonic trend in NHL(low) risk across tertiles of cumulative diesel fuel exposure was observed [P-value for test of linear trend (P) = 0.03]. CONCLUSIONS These findings provide insights into several potential occupational risk factors for NHL and suggest some specific occupational agents for further investigation.
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Affiliation(s)
- David B Richardson
- Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
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Clapp RW, Jacobs MM, Loechler EL. Environmental and occupational causes of cancer: new evidence 2005-2007. REVIEWS ON ENVIRONMENTAL HEALTH 2008; 23:1-37. [PMID: 18557596 PMCID: PMC2791455 DOI: 10.1515/reveh.2008.23.1.1] [Citation(s) in RCA: 205] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
What do we currently know about the occupational and environmental causes of cancer? As of 2007, the International Agency for Research on Cancer (IARC) identified 415 known or suspected carcinogens. Cancer arises through an extremely complicated web of multiple causes, and we will likely never know the full range of agents or combinations of agents. We do know that preventing exposure to individual carcinogens prevents the disease. Declines in cancer rates-such as the drop in male lung cancer cases from the reduction in tobacco smoking or the drop in bladder cancer among cohorts of dye workers from the elimination of exposure to specific aromatic amines-provides evidence that preventing cancer is possible when we act on what we know. Although the overall age-adjusted cancer incidence rates in the United States among both men and women have declined in the last decade, the rates of several types of cancers are on the rise; some of which are linked to environmental and occupational exposures. This report chronicles the most recent epidemiologic evidence linking occupational and environmental exposures with cancer. Peer-reviewed scientific studies published from January 2005 to June 2007 were reviewed, supplementing our state-of-the-evidence report published in September 2005. Despite weaknesses in certain individual studies, we consider the evidence linking the increased risk of several types of cancer with specific exposures somewhat strengthened by recent publications, among them brain cancer from exposure to non-ionizing radiation, particularly radiofrequency fields emitted by mobile telephones; breast cancer from exposure to the pesticide dichlorodiphenyltrichloroethane (DDT) before puberty; leukemia from exposure to 1,3-butadiene; lung cancer from exposure to air pollution; non-Hodgkin's lymphoma (NHL) from exposure to pesticides and solvents; and prostate cancer from exposure to pesticides, polyaromatic hydrocarbons (PAHs), and metal working fluids or mineral oils. In addition to NHL and prostate cancer, early findings from the National Institutes of Health Agricultural Health Study suggest that several additional cancers may be linked to a variety of pesticides. Our report also briefly describes the toxicological evidence related to the carcinogenic effect of specific chemicals and mechanisms that are difficult to study in humans, namely exposures to bis-phenol A and epigenetic, trans-generational effects. To underscore the multi-factorial, multi-stage nature of cancer, we also present a technical description of cancer causation summarizing current knowledge in molecular biology. We argue for a new cancer prevention paradigm, one based on an understanding that cancer is ultimately caused by multiple interacting factors rather than a paradigm based on dubious attributable fractions. This new cancer prevention paradigm demands that we limit exposure to avoidable environmental and occupational carcinogens, in combination with additional important risk factors like diet and lifestyle. The research literature related to environmental and occupational causes of cancer is constantly growing, and future updates will be carried out in light of new biological understanding of the mechanisms and new methods for studying exposures in human populations. The current state of knowledge is sufficient to compel us to act on what we know. We repeat the call of ecologist Sandra Steingraber: "From the right to know and the duty to inquire flows the obligation to act."
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Affiliation(s)
- Richard W Clapp
- Boston University School of Public Health, Boston, MA 02118, USA.
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Occupation and Lymphoid Malignancies: Results From a French Case-Control Study. J Occup Environ Med 2007; 49:1339-50. [DOI: 10.1097/jom.0b013e3181569a49] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Beall C, Corn M, Cheng H, Matthews R, Delzell E. Mortality and cancer incidence among tire manufacturing workers hired in or after 1962. J Occup Environ Med 2007; 49:680-90. [PMID: 17563612 DOI: 10.1097/jom.0b013e318074bb30] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE This study evaluated mortality during 1962 through 2003 and cancer incidence during 1995 through 2003 at a tire manufacturing plant. METHODS The mortality study included 3425 men and women, employed for at least one year. Of these, 3069 were eligible for the cancer incidence study. RESULTS Employees experienced 390 deaths compared with 608 expected (standardized mortality ratio (SMR)=64; 95% confidence interval (CI)=58-71). Total cancer mortality (123 observed, SMR=75, CI=62-89) and lung cancer mortality (47 observed, SMR=72, CI=53-96) were lower than expected. Hourly white men had small increases in stomach cancer, bladder cancer, and leukemia deaths. During 1995 through 2003, 169 incident cancers were observed compared with 197 expected (SIR=86, 95% CI=74-100). Three mesothelioma cases occurred among hourly white men (SIR=653, CI=135-1907); all were exposed potentially to asbestos before starting at the rubber plant. CONCLUSIONS Small numbers and limited information on jobs, occupational agents, and lifestyle preclude attribution of observed increases to workplace exposures.
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Affiliation(s)
- Colleen Beall
- Department of Epidemiology, University of Alabama at Birmingham, Bermingham, AL 35294-0022, USA.
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Alexander DD, Mink PJ, Adami HO, Chang ET, Cole P, Mandel JS, Trichopoulos D. The non-Hodgkin lymphomas: a review of the epidemiologic literature. Int J Cancer 2007; 120 Suppl 12:1-39. [PMID: 17405121 DOI: 10.1002/ijc.22719] [Citation(s) in RCA: 256] [Impact Index Per Article: 15.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
The non-Hodgkin lymphomas (NHL) are a heterogeneous group of B-cell and T-cell neoplasms that arise primarily in the lymph nodes. NHL incidence rates in the US doubled between about 1970 and 1990, and stabilized during the 1990s. NHL accounts for approximately 3.4% of cancer deaths in the US. Although some of the observed patterns in NHL have been related to HIV/AIDS, these conditions cannot fully explain the magnitude of the changes; neither do changes in classification systems nor improved diagnostic capabilities. Studies of occupational and environmental exposures (e.g., pesticides, solvents) have produced no consistent pattern of significant positive associations. Inverse associations with ultraviolet radiation exposure and alcohol and fish intake, and positive associations with meat and saturated fat intake have been reported in several studies; additional studies are needed to confirm or refute these associations. Family history of NHL or other hematolympho-proliferative cancers and personal history of several autoimmune disorders are associated with increased risk of NHL, but are not likely to account for a large proportion of cases. HIV and other infectious agents, such as human herpesvirus 8 and Epstein-Barr, appear to be associated with differing types of NHL, such as some B-cell lymphomas. Future epidemiologic studies should evaluate associations by NHL type, enhance exposure information collected, and elucidate factors that may identify susceptible (or resistant) subpopulations because of genetic, immunologic or other characteristics. The extent to which the etiology of NHL types may differ is important to resolve in ongoing and future studies.
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Abstract
Although thus far no occupational agents have been classified as established causes of non-Hodgkin lymphoma (NHL), employment as a farmer, teacher, dry cleaner, meat worker, printer, or wood worker has been associated with elevated risk in the peer-reviewed literature. We conducted several meta-analyses to assess risk in these occupations and industries from articles published in MEDLINE up to August 1, 2006. The summary risk estimates suggest a homogeneous excess risk for NHL among workers in the printing industry [relative risk (RR), 1.86; 95% confidence interval (95% CI), 1.37-2.52] and wood workers (RR, 1.15; 95% CI, 1.00-1.31). Considerable heterogeneity but elevated risks were found for farmers (RR, 1.11; 95% CI, 1.05-1.17), especially in animal husbandry (RR, 1.31; 95% CI, 1.08-1.60), and teaching (RR, 1.47; 95% CI, 1.34-1.61). An increased risk was absent for employment in the meat processing industry (RR, 0.99; 95% CI, 0.77-1.29). These results suggest that although excess risk is found for employment in the printing industry, wood processing industry, teaching, and farming, it is unlikely that occupation represents a major risk factor for NHL in most populations. At present, no conclusive evidence of causal relations between occupations and increased NHL risk exists; this can be ascribed to methodologic problems in studying the link between NHL risk and occupation, including heterogeneity of disease and exposure circumstances and low statistical power. Implementing state-of-the-art exposure assessment technologies, including biomarker-based assessment, and aiming to identify susceptible subgroups can increase the statistical power enough to analyze etiologically relevant NHL subtypes and provide clues on possible causal agents in future studies. These goals can be best attained within the framework of large-scale, international collaborative projects.
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Affiliation(s)
- Paolo Boffetta
- Gene-Environment Epidemiology Group, IARC, 150 cours Albert-Thomas, 69008 Lyon, France.
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Seidler A, Möhner M, Berger J, Mester B, Deeg E, Elsner G, Nieters A, Becker N. Solvent exposure and malignant lymphoma: a population-based case-control study in Germany. J Occup Med Toxicol 2007; 2:2. [PMID: 17407545 PMCID: PMC1851965 DOI: 10.1186/1745-6673-2-2] [Citation(s) in RCA: 45] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2007] [Accepted: 04/02/2007] [Indexed: 12/01/2022] Open
Abstract
Aims To analyze the relationship between exposure to chlorinated and aromatic organic solvents and malignant lymphoma in a multi-centre, population-based case-control study. Methods Male and female patients with malignant lymphoma (n = 710) between 18 and 80 years of age were prospectively recruited in six study regions in Germany (Ludwigshafen/Upper Palatinate, Heidelberg/Rhine-Neckar-County, Würzburg/Lower Frankonia, Hamburg, Bielefeld/Gütersloh, and Munich). For each newly recruited lymphoma case, a gender, region and age-matched (± 1 year of birth) population control was drawn from the population registers. In a structured personal interview, we elicited a complete occupational history, including every occupational period that lasted at least one year. On the basis of job task-specific supplementary questionnaires, a trained occupational physician assessed the exposure to chlorinated hydrocarbons (trichloroethylene, tetrachloroethylene, dichloromethane, carbon tetrachloride) and aromatic hydrocarbons (benzene, toluene, xylene, styrene). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using conditional logistic regression analysis, adjusted for smoking (in pack years) and alcohol consumption. To increase the statistical power, patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression analysis. Results We observed a statistically significant association between high exposure to chlorinated hydrocarbons and malignant lymphoma (Odds ratio = 2.1; 95% confidence interval 1.1–4.3). In the analysis of lymphoma subentities, a pronounced risk elevation was found for follicular lymphoma and marginal zone lymphoma. When specific substances were considered, the association between trichloroethylene and malignant lymphoma was of borderline statistical significance. Aromatic hydrocarbons were not significantly associated with the lymphoma diagnosis. Conclusion In accordance with the literature, this data point to a potential etiologic role of chlorinated hydrocarbons (particularly trichloroethylene) and malignant lymphoma. Chlorinated hydrocarbons might affect specific lymphoma subentities differentially. Our study does not support a strong association between aromatic hydrocarbons (benzene, toluene, xylene, or styrene) and the diagnosis of a malignant lymphoma.
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Affiliation(s)
- Andreas Seidler
- Federal Institute of Occupational Safety and Health (BAuA), Berlin, Germany
| | - Matthias Möhner
- Federal Institute of Occupational Safety and Health (BAuA), Berlin, Germany
| | - Jürgen Berger
- Department of Medical Informatics, University Medical Center Hamburg-Eppendorf, Germany
| | - Birte Mester
- Institute of Occupational Medicine, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
- Bremen Institute for Prevention Research and Social Medicine, Bremen, Germany
| | - Evelin Deeg
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Gine Elsner
- Institute of Occupational Medicine, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany
| | - Alexandra Nieters
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
| | - Nikolaus Becker
- German Cancer Research Center (DKFZ), Division of Cancer Epidemiology, Heidelberg, Germany
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Weihkopf T, Becker N, Nieters A, Mester B, Deeg E, Elsner G, Blettner M, Seidler A. Sun exposure and malignant lymphoma: A population-based case–control study in Germany. Int J Cancer 2007; 120:2445-51. [PMID: 17311289 DOI: 10.1002/ijc.22492] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Although some causes for malignant lymphoma are known their etiology is not well understood so far. We analyze the relationship between sun exposure and malignant lymphoma in a multicenter, population-based case-control study. Patients with malignant lymphoma (n = 710, 18-80 years) were prospectively recruited in 6 study regions in Germany. For each case, a gender, region and age-matched control was drawn from population-registers. In personal interviews, lifetime holidays spent in sunny climate, outdoor leisure activities and sunbed or sunlamp use were recorded. On basis of job task-specific supplementary questionnaires, an occupational physician assessed the cumulative working time outside. Odds ratios (OR) and 95%-confidence-intervals (CI) were calculated using conditional logistic regression analysis, adjusted for smoking and alcohol consumption. To increase statistical power, patients with specific lymphoma subentities were additionally compared with the entire control group using unconditional logistic regression. We observed a reduced overall lymphoma risk among subjects having spent vacations at sunny climates or frequently used sunbeds or sunlamps. The analysis of lymphoma subentities revealed similar results with the exception of T-NHL and follicular lymphoma which were positively associated with outdoor leisure activities. While cumulative working time outside appeared unrelated to NHL overall and most subentities, it was negatively associated with follicular lymphoma and weakly positively to HL. This data suggest that exposure to natural and artificial ultraviolet radiation may reduce the OR for lymphoma in this study population.
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Affiliation(s)
- Thomas Weihkopf
- Institute of Medical Biostatistics, Epidemiology and Informatics, Johannes-Gutenberg University, Mainz, Germany.
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Abstract
Commentary on the paper by Mester et al (see page 17)
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Affiliation(s)
- A Blair
- National Cancer Institute, Executive Plaza South, Room 8118, Bethesda, MD 20892, USA.
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