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Odutola MK, Benke G, Fritschi L, Giles GG, van Leeuwen MT, Vajdic CM. A systematic review and meta-analysis of occupational exposures and risk of follicular lymphoma. ENVIRONMENTAL RESEARCH 2021; 197:110887. [PMID: 33607095 DOI: 10.1016/j.envres.2021.110887] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2020] [Revised: 02/03/2021] [Accepted: 02/10/2021] [Indexed: 06/12/2023]
Abstract
BACKGROUND The etiology of follicular lymphoma (FL), a common non-Hodgkin lymphoma subtype, is largely unknown. OBJECTIVE We performed a systematic review and meta-analysis of observational studies examining the relationship between occupational exposures and FL risk. METHODS We searched Ovid MEDLINE, Ovid EMBASE, and Web of Science for eligible observational studies examining job titles or occupational exposures prior to January 1, 2020. We performed a narrative synthesis and used random-effects models to generate meta-estimates of relative risk (RR) with 95% confidence intervals (95%CI) for exposures reported by three or more studies. RESULTS Fifty-eight studies were eligible. Ten cohort and 37 case-control studies quantified FL risk in relation to any exposure to one or more occupational groups or agents. Eight cohort and 19 case-control studies examined dose-response relationships. We found evidence of a positive association with increasing plasma concentration of dichlorodiphenyldichloroethylene (DDE; meta-RR = 1.51, 95%CI = 0.99, 2.31; I2 = 0.0%) and polychlorinated biphenyls (PCBs; meta-RR = 1.47, 95%CI = 0.97, 2.24; I2 = 8.6%). We observed a positive association with exposure to any solvent (meta-RR = 1.16, 95%CI = 1.00, 1.34; I2 = 0.0%) and chlorinated solvents (meta-RR = 1.35, 95%CI = 1.09, 1.68; I2 = 0.0%). Single studies reported a significant positive dose-response association for exposure to any pesticide, hexachlorobenzene, any organophosphate, diazinon, metolachlor, carbaryl, lindane, trichloroethylene, oils/greases, and extremely low-frequency magnetic fields. Job title-only analyses suggested increased risk for medical doctors and spray painters, and decreased risk for bakers and teachers. Overall, studies demonstrated low risk of bias, but most studies examined small numbers of exposed cases. CONCLUSIONS Current evidence indicates a positive association between FL and occupational exposure to DDE, PCBs, any solvent and chlorinated solvents. Our findings may help guide policies and practices on the safe use of solvents and inform models of lymphomagenesis. Future studies with larger sample sizes and comprehensive quantitative exposure measures may elucidate other avoidable carcinogenic exposures.
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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
| | - Geza Benke
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Lin Fritschi
- School of Public Health, Curtin University, Perth, Western Australia, Australia
| | - Graham G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia; Cancer Epidemiology and Intelligence Division, Cancer Council Victoria, Melbourne, Australia; Precision Medicine, School of Clinical Sciences at Monash Health Monash University, Melbourne, Australia
| | - Marina T van Leeuwen
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Claire M Vajdic
- Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia.
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Chen D, Grimsrud TK, Langseth H, Barr DB, Bassig BA, Blair A, Cantor KP, Gammon MD, Lan Q, Rothman N, Engel LS. Prediagnostic serum concentrations of organochlorine pesticides and non-Hodgkin lymphoma: A nested case-control study in the Norwegian Janus Serum Bank Cohort. ENVIRONMENTAL RESEARCH 2020; 187:109515. [PMID: 32445944 PMCID: PMC9278122 DOI: 10.1016/j.envres.2020.109515] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/18/2019] [Revised: 04/03/2020] [Accepted: 04/09/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Much of the marked increase in incidence of non-Hodgkin lymphoma (NHL) over the past few decades remains unexplained. Organochlorines, including organochlorine pesticides (OCPs), have been implicated as possible contributors to the increase, but the evidence is inconsistent. OBJECTIVES To investigate the relation between pre-diagnostic levels of OCPs and risk of NHL in a case-control study nested within the population-based Janus Serum Bank Cohort in Norway. METHODS Prediagnostic concentrations of 11 OCPs or OCP metabolites were measured in baseline blood samples collected between 1972 and 1978 from 190 cases and 190 controls matched on sex, county, age at blood draw, and date of blood draw. We conducted conditional logistic regression to estimate adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for each quartile of lipid-corrected OCP/metabolite relative to the lowest quartile. RESULTS We observed non-significantly elevated ORs across quartiles of β-hexachlorocyclohexane compared to the lowest quartile (OR range: 1.40-1.82) although with no apparent monotonic exposure-response relationship. We also found an inverse association between risk of NHL and o,p'-DDT (OR for Q4 vs. Q1 = 0.44, 95% CI: 0.19, 1.01; p-trend = 0.05). In analyses stratified by age at blood collection and duration of follow-up, several other analytes, primarily chlordane-related compounds, showed inverse associations among younger participants or those with longer follow-up time between blood draw and NHL diagnosis. CONCLUSIONS We found only limited evidence of positive association between selected OCPs and development of NHL.
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Affiliation(s)
- Dazhe Chen
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Tom K Grimsrud
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Hilde Langseth
- Department of Research, Cancer Registry of Norway, Institute of Population-Based Cancer Research, Oslo, Norway
| | - Dana B Barr
- Department of Environmental Health, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Bryan A Bassig
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, MD, USA
| | - Aaron Blair
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, MD, USA
| | - Kenneth P Cantor
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, MD, USA
| | - Marilie D Gammon
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | - Qing Lan
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, MD, USA
| | - Nathaniel Rothman
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Department of Health and Human Services, Rockville, MD, USA
| | - Lawrence S Engel
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina Chapel Hill, Chapel Hill, NC, USA.
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Occupational and environmental exposure to polychlorinated biphenyls and risk of non-Hodgkin lymphoma: a systematic review and meta-analysis of epidemiology studies. Eur J Cancer Prev 2019; 28:441-450. [DOI: 10.1097/cej.0000000000000463] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Klil-Drori AJ, Kleinstern G, Seir RA, Choshen-Cohen L, Abdeen Z, Hussein E, Aqel M, Göen T, Perlman R, Ben-Yehuda D, Paltiel O. Serum organochlorines and non-Hodgkin lymphoma: A case-control study in Israeli Jews and Palestinians. CHEMOSPHERE 2018; 213:395-402. [PMID: 30241084 DOI: 10.1016/j.chemosphere.2018.09.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 09/11/2018] [Accepted: 09/12/2018] [Indexed: 06/08/2023]
Abstract
Associations of organochlorine (OC) pesticides and polychlorinated biphenyls (PCBs) with non-Hodgkin lymphoma are controversial. We compared serum levels of 6 OC pesticides and 38 PCBs in Israeli Jews (IJ) and Palestinian Arabs (PA) and assessed possible associations with B-cell non-Hodgkin lymphoma (B-NHL). Ninety B-NHL cases (50 IJ and 40 PA) and 120 controls (65 IJ and 55 PA) were included. Median concentrations of analytes in controls were compared across ethnic groups using quantile regression, adjusting for age and sex. We used logistic regression to derive odds ratios (OR) and 95% confidence intervals (CI) for detectable analytes and B-NHL, adjusting for age, ethnic group, faming and body mass index. Median values of PCBs and dichlorodiphenyldichloroethylene (DDE) were higher in IJ vs PA controls (P = 0.0007), as were several PCBs (74, 99, 118, 138, 146, 153, 156, 163, 170, and 180). Overall, OC pesticide and PCB exposures were comparable with reports from high-income countries. B-NHL was associated with PCB 146 (OR 1.70, 95% CI: 1.02, 2.83), PCB 156 (OR 1.75, 95% CI: 1.06, 2.89), and high-chlorinated PCBs (OR 1.55, 95% CI: 1.00, 2.40) in all study subjects. These associations were robust in quantile as well as sensitivity analyses. An association of DDE with B-NHL was noted in PA (OR 1.72, 95% CI: 1.07, 2.77), but not in IJ (OR 0.87, 95% CI: 0.59, 1.27). Although high-chlorinated PCB concentrations did not indicate high exposure levels, our findings indicate that B-NHL may be associated with this exposure.
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Affiliation(s)
- Adi J Klil-Drori
- Center for Clinical Epidemiology, Lady Davis Institute, Jewish General Hospital, Montreal, Quebec, Canada.
| | - Geffen Kleinstern
- Braun School of Public Health, Hadassah-Hebrew University, Jerusalem, Israel; Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Rania Abu Seir
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel; Faculty of Health Professions, Dept. of Medical Laboratory Sciences, Al-Quds University, Abu Deis, West Bank, Israel
| | - Lotan Choshen-Cohen
- Braun School of Public Health, Hadassah-Hebrew University, Jerusalem, Israel
| | - Ziad Abdeen
- Al-Quds Nutrition and Health Research Institute, Al-Quds University, Abu Deis, West Bank, Israel
| | - Elyan Hussein
- Department of Hematology, Beit Jala Hospital, West Bank, Israel
| | - Mohammad Aqel
- Augusta Victoria Hospital, Jerusalem, West Bank, Israel
| | - Thomas Göen
- Institute and Outpatient Clinic of Occupational, Social and Environmental Medicine, University of Erlangen-Nuremberg, Erlangen, Germany
| | - Riki Perlman
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Dina Ben-Yehuda
- Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Ora Paltiel
- Braun School of Public Health, Hadassah-Hebrew University, Jerusalem, Israel; Department of Hematology, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
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5
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Hanchette C, Zhang CH, Schwartz GG. Ovarian Cancer Incidence in the U.S. and Toxic Emissions from Pulp and Paper Plants: A Geospatial Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081619. [PMID: 30065203 PMCID: PMC6122072 DOI: 10.3390/ijerph15081619] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Revised: 07/19/2018] [Accepted: 07/26/2018] [Indexed: 12/02/2022]
Abstract
Ovarian cancer is the fifth leading cause of female cancer mortality in the U.S. and accounts for five percent of all cancer deaths among women. No environmental risk factors for ovarian cancer have been confirmed. We previously reported that ovarian cancer incidence rates at the state level were significantly correlated with the extent of pulp and paper manufacturing. We evaluated that association using county-level data and advanced geospatial methods. Specifically, we investigated the relationship of spatial patterns of ovarian cancer incidence rates with toxic emissions from pulp and paper facilities using data from the Environmental Protection Agency’s Toxic Release Inventory (TRI). Geospatial analysis identified clusters of counties with high ovarian cancer incidence rates in south-central Iowa, Wisconsin, New York, Pennsylvania, Alabama, and Georgia. A bivariate local indicator of spatial autocorrelation (LISA) analysis confirmed that counties with high ovarian cancer rates were associated with counties with large numbers of pulp and paper mills. Regression analysis of state level data indicated a positive correlation between ovarian cancer and water pollutant emissions. A similar relationship was identified from the analysis of county-level data. These data support a possible role of water-borne pollutants from pulp and paper mills in the etiology of ovarian cancer.
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Affiliation(s)
- Carol Hanchette
- Department of Geography and Geosciences, University of Louisville, 2301 S 3rd Street, Louisville, KY 40292-0001, USA.
| | - Charlie H Zhang
- Department of Geography and Geosciences, University of Louisville, 2301 S 3rd Street, Louisville, KY 40292-0001, USA.
| | - Gary G Schwartz
- Department of Population Health, School of Medicine & Health Sciences, University of North Dakota, 1301 N Columbia Rd., Stop 9037, Grand Forks, ND 58202-9037, USA.
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Ghosh S, Loffredo CA, Mitra PS, Trnovec T, Palkovicova Murinova L, Sovcikova E, Hoffman EP, Makambi KH, Dutta SK. PCB exposure and potential future cancer incidence in Slovak children: an assessment from molecular finger printing by Ingenuity Pathway Analysis (IPA®) derived from experimental and epidemiological investigations. ENVIRONMENTAL SCIENCE AND POLLUTION RESEARCH INTERNATIONAL 2018; 25:16493-16507. [PMID: 29143255 PMCID: PMC5953777 DOI: 10.1007/s11356-017-0149-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/08/2017] [Accepted: 09/07/2017] [Indexed: 05/20/2023]
Abstract
The risk of cancer due to PCB exposure in humans is highly debated. In eastern Slovakia, high exposure of the population to organochlorines (especially PCBs) was associated with various disease and disorder pathways, viz., endocrine disruption, metabolic disorder & diabetes, and cancer, thereby disturbing several cellular processes, including protein synthesis, stress response, and apoptosis. We have evaluated a Slovak cohort (45-month children, at lower and higher levels of PCB exposure from the environment) for disease and disorder development to develop early disease cancer biomarkers that could shed new light on possible mechanisms for the genesis of cancers under such chemical exposures, and identify potential avenues for prevention.Microarray studies of global gene expression were conducted from the 45-month-old children on the Affymetrix platform followed by Ingenuity Pathway Analysis (IPA®) to associate the affected genes with their mechanistic pathways. High-throughput qRT-PCR TaqMan low-density array (TLDA) was performed to further validate the selected genes on the whole blood cells of the most highly exposed children from the study cohort (n = 71). TP53, MYC, BCL2, and LRP12 differential gene expressions suggested strong relationships between potential future tumor promotion and PCB exposure in Slovak children. The IPA analysis further detected the most important signaling pathways, including molecular mechanism of cancers, prostate cancer signaling, ovarian cancer signaling, P53 signaling, oncostatin M signaling, and their respective functions (viz., prostate cancer, breast cancer, progression of tumor, growth of tumor, and non-Hodgkin's disease). The results suggest that PCB exposures, even at the early age of these children, may have lifelong consequences for the future development of chronic diseases.
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Affiliation(s)
- Somiranjan Ghosh
- Molecular Genetics Laboratory, Department of Biology, Howard University, 415 College Street, NW, Room 408, EE Just Hall, Washington, DC, 20059, USA.
- Department of Pediatrics and Child Health, College of Medicine, Howard University, Washington, DC, 20059, USA.
| | - Christopher A Loffredo
- Departments of Oncology and of Biostatistics, Georgetown University, Washington, DC, 20057, USA
| | - Partha S Mitra
- Molecular Genetics Laboratory, Department of Biology, Howard University, 415 College Street, NW, Room 408, EE Just Hall, Washington, DC, 20059, USA
| | - Tomas Trnovec
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Lubica Palkovicova Murinova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Eva Sovcikova
- Department of Environmental Medicine, Faculty of Public Health, Slovak Medical University, Bratislava, Slovak Republic
| | - Eric P Hoffman
- School of Pharmacy and Pharmaceutical Science, Binghamton University, State University of New York, Binghamton, NY, 13902, USA
| | - Kepher H Makambi
- Department of Biostatistics, Bioinformatics, and Biomathematics, Georgetown University, Washington, DC, 20057, USA
| | - Sisir K Dutta
- Molecular Genetics Laboratory, Department of Biology, Howard University, 415 College Street, NW, Room 408, EE Just Hall, Washington, DC, 20059, USA
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7
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Zani C, Ceretti E, Covolo L, Donato F. Do polychlorinated biphenyls cause cancer? A systematic review and meta-analysis of epidemiological studies on risk of cutaneous melanoma and non-Hodgkin lymphoma. CHEMOSPHERE 2017; 183:97-106. [PMID: 28535466 DOI: 10.1016/j.chemosphere.2017.05.053] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2017] [Revised: 04/20/2017] [Accepted: 05/09/2017] [Indexed: 05/20/2023]
Abstract
In 2015 a IARC Working Group upgraded the classification of PCBs to Group 1 "Carcinogenic to humans", also on the basis of evidence from epidemiological studies showing an excess risk for melanoma. Increased risks for non-Hodgkin lymphoma (NHL) and breast cancer were also reported though the evidence was limited. However, some recent reviews of studies on PCB exposure and risk of cancer provided discrepant findings. Therefore, we re-evaluated the association between exposure to PCBs and risk of melanoma and NHL by a systematic review and meta-analysis. We retrieved 11 independent cohort studies on occupationally exposed workers. About half of them showed increased standardized mortality or incidence ratios (SMRs or SIRs) for melanoma and none for NHL. The pooled SMRs were 1.32 (95% CI: 1.05-1.64) for melanoma and 0.94 (0.73-1.23) for NHL. Among population-based cohort and case-control studies with individual measures of PCB exposure, one only study was carried out on PCB exposure and melanoma, showing an odds ratio (OR) of 6.0 (2.0-18.2) for the highest compared to lowest quartile of PCB distribution. 13 cohort and case-control studies evaluated the association between NHL and PCB concentration in blood or subcutaneous fat, with summary OR = 1.5 (1.1-1.7) for the highest vs lowest quantile of PCB distribution. However, two cohort studies on people intoxicated by rice oil containing PCBs found no excess of deaths for skin cancer and inconsistent results for NHL. In conclusion, these findings do not provide a strong evidence that PCB exposure can increase the risk of melanoma and NHL in humans.
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Affiliation(s)
- Claudia Zani
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy.
| | - Elisabetta Ceretti
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Loredana Covolo
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
| | - Francesco Donato
- Department of Medical and Surgical Specialities, Radiological Sciences and Public Health, University of Brescia, Viale Europa 11, 25123, Brescia, Italy
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8
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Kelly RS, Kiviranta H, Bergdahl IA, Palli D, Johansson AS, Botsivali M, Vineis P, Vermeulen R, Kyrtopoulos SA, Chadeau-Hyam M. Prediagnostic plasma concentrations of organochlorines and risk of B-cell non-Hodgkin lymphoma in envirogenomarkers: a nested case-control study. Environ Health 2017; 16:9. [PMID: 28202064 PMCID: PMC5312563 DOI: 10.1186/s12940-017-0214-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2016] [Accepted: 02/07/2017] [Indexed: 05/05/2023]
Abstract
BACKGROUND Evidence suggests a largely environmental component to non-Hodgkin's lymphoma (NHL). Persistent organic pollutants (POPs) including polychlorinated biphenyls (PCBs), DDE and HCB have been repeatedly implicated, but the literature is inconsistent and a causal relationship remains to be determined. METHODS The EnviroGenoMarkers study is nested within two prospective cohorts EPIC-Italy and the Northern Sweden Health and Disease Study. Six PCB congeners, DDE and HCB were measured in blood plasma samples provided at recruitment using gas-chromatography mass spectrometry. During 16 years follow-up 270 incident cases of B-cell NHL (including 76 cases of multiple myeloma) were diagnosed. Cases were matched to 270 healthy controls by centre, age, gender and date of blood collection. Cases were categorised into ordered quartiles of exposure for each POP based on the distribution of exposure in the control population. Logistic regression was applied to assess the association with risk, multivariate and stratified analyses were performed to identify confounders or effect modifiers. RESULTS The exposures displayed a strong degree of correlation, particularly amongst those PCBs with similar degrees of chlorination. There was no significant difference (p < 0.05) in median exposure levels between cases and controls for any of the investigated exposures. However under a multivariate model PCB138, PCB153, HCB and DDE displayed significant inverse trends (Wald test p-value <0.05). Under stratified analyses these were determined to be driven by males and by the Diffuse Large B-Cell Lymphoma subtype. When considering those in the highest levels of exposure (>90th percentile) the association was null for all POPs CONCLUSION: We report no evidence that a higher body burden of PCBs, DDE or HCB increased the risk of subsequent NHL diagnosis. Significantly inverse associations were noted for males with a number of the investigated POPs. We hypothesize these unexpected relationships may relate to the subtype composition of our population, effect modification by BMI or other unmeasured confounding. This study provides no additional support for the previously observed role of PCBs, DDE and HCB as risk factors for NHL.
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Affiliation(s)
- Rachel S. Kelly
- Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical School, 181 Longwood Avenue, Boston, MA 02115 USA
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Hannu Kiviranta
- National Institute for Health and Welfare Chemicals and Health Unit, Neulanen Research Centre, Neulaniementie 4, FI-70210 Kuopio, Finland
| | - Ingvar A. Bergdahl
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | | | - Maria Botsivali
- National Hellenic Research Foundation, Institute of Biology, Pharmaceutical Chemistry and Biotechnology, Athens, Greece
| | - Paolo Vineis
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- HuGeF Foundation, Turin, Italy
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
| | - Soterios A. Kyrtopoulos
- National Hellenic Research Foundation, Institute of Biology, Pharmaceutical Chemistry and Biotechnology, Athens, Greece
| | - Marc Chadeau-Hyam
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
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Birmann BM, Barnard ME, Bertrand KA, Bao Y, Crous-Bou M, Wolpin BM, De Vivo I, Tworoger SS. Nurses' Health Study Contributions on the Epidemiology of Less Common Cancers: Endometrial, Ovarian, Pancreatic, and Hematologic. Am J Public Health 2016; 106:1608-15. [PMID: 27459458 PMCID: PMC4981809 DOI: 10.2105/ajph.2016.303337] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/19/2016] [Indexed: 01/05/2023]
Abstract
OBJECTIVES To review the contributions of the Nurses' Health Study (NHS) to epidemiologic knowledge of endometrial, ovarian, pancreatic, and hematologic cancers. METHODS We reviewed selected NHS publications from 1976 to 2016, including publications from consortia and other pooled studies. RESULTS NHS studies on less common cancers have identified novel risk factors, such as a reduced risk of endometrial cancer in women of advanced age at last birth, and have clarified or prospectively confirmed previously reported associations, including an inverse association between tubal ligation and ovarian cancer. Through biomarker research, the NHS has furthered understanding of the pathogenesis of rare cancers, such as the role of altered metabolism in pancreatic cancer risk and survival. NHS investigations have also demonstrated the importance of the timing of exposure, such as the finding of a positive association of early life body fatness, but not of usual adult body mass index, with non-Hodgkin lymphoma risk. CONCLUSIONS Evidence from the NHS has informed prevention strategies and contributed to improved survival from less common but often lethal malignancies, including endometrial, ovarian, pancreatic, and hematologic cancers.
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Affiliation(s)
- Brenda M Birmann
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
| | - Mollie E Barnard
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
| | - Kimberly A Bertrand
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
| | - Ying Bao
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
| | - Marta Crous-Bou
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
| | - Brian M Wolpin
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
| | - Immaculata De Vivo
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
| | - Shelley S Tworoger
- Brenda M. Birmann, Ying Bao, Marta Crous-Bou, Immaculata De Vivo, and Shelley S. Tworoger are with the Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA. Mollie E. Barnard is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston. Kimberly A. Bertrand is with the Slone Epidemiology Center, Boston University, Boston. Brian M. Wolpin is with the Department of Medical Oncology, Dana-Farber Cancer Institute and Harvard Medical School
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Luo D, Zhou T, Tao Y, Feng Y, Shen X, Mei S. Exposure to organochlorine pesticides and non-Hodgkin lymphoma: a meta-analysis of observational studies. Sci Rep 2016; 6:25768. [PMID: 27185567 PMCID: PMC4869027 DOI: 10.1038/srep25768] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2016] [Accepted: 04/22/2016] [Indexed: 01/09/2023] Open
Abstract
Growing evidence indicates that exposure to organochlorine pesticides (OCPs) could increase non-Hodgkin lymphoma (NHL) risk. However, results from epidemiological studies investigating this association remain controversial. We thus conducted a meta-analysis to quantitatively evaluate the association between OCP exposure and NHL risk. Relevant publications were searched in PubMed, Web of Science, and Embase and identified according to the inclusion criteria. Thirteen studies (6 nested case-control, 1 case-cohort, and 6 case-control) were selected for this meta-analysis. We used odds ratios (ORs) with 95% confidence intervals (CIs) to estimate the relationship between OCPs exposure and NHL risk. The summary OR for included studies was 1.40 (95% CI 1.27 to 1.56). No overall significant heterogeneity in the OR was observed (Ph = 0.253, I(2) = 12.6%). Furthermore, OR estimates in subgroup analyses were discussed, and strong associations were observed for dichlorodiphenyldichloroethylene (DDE, OR = 1.38, 95% CI 1.14 to 1.66), hexachlorocyclohexane (HCH, OR = 1.42, 95% CI 1.08 to 1.87), chlordane (OR = 1.93, 95% CI 1.51 to 2.48), and hexachlorobenzene (HCB, OR = 1.54, 95% CI 1.20 to 1.99). This meta-analysis had suggested that total OCPs of interest was significantly positively associated with NHL risk.
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Affiliation(s)
- Dan Luo
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Tingting Zhou
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Yun Tao
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Yaqian Feng
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Xiaoli Shen
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China
| | - Surong Mei
- State Key Laboratory of Environment Health (Incubation), Key Laboratory of Environment and Health, Ministry of Education, Key Laboratory of Environment and Health (Wuhan), Ministry of Environmental Protection, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China
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Somers EC, Ganser MA, Warren JS, Basu N, Wang L, Zick SM, Park SK. Mercury Exposure and Antinuclear Antibodies among Females of Reproductive Age in the United States: NHANES. ENVIRONMENTAL HEALTH PERSPECTIVES 2015; 123:792-8. [PMID: 25665152 PMCID: PMC4529012 DOI: 10.1289/ehp.1408751] [Citation(s) in RCA: 50] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2014] [Accepted: 02/04/2015] [Indexed: 05/03/2023]
Abstract
BACKGROUND Immune dysregulation associated with mercury has been suggested, although data in the general population are lacking. Chronic exposure to low levels of methylmercury (organic) and inorganic mercury is common, such as through fish consumption and dental amalgams. OBJECTIVE We examined associations between mercury biomarkers and antinuclear antibody (ANA) positivity and titer strength. METHODS Among females 16-49 years of age (n = 1,352) from the National Health and Nutrition Examination Survey (NHANES) 1999-2004, we examined cross-sectional associations between mercury and ANAs (indirect immunofluorescence; cutoff ≥ 1:80). Three biomarkers of mercury exposure were used: hair (available 1999-2000) and total blood (1999-2004) predominantly represented methylmercury, and urine (1999-2002) represented inorganic mercury. Survey statistics were used. Multivariable modeling adjusted for several covariates, including age and omega-3 fatty acids. RESULTS Sixteen percent of females were ANA positive; 96% of ANA positives had a nuclear speckled staining pattern. Geometric mean (geometric SD) mercury concentrations were 0.22 (0.03) ppm in hair, 0.92 (0.05) μg/L blood, and 0.62 (0.04) μg/L urine. Hair and blood, but not urinary, mercury were associated with ANA positivity (sample sizes 452, 1,352, and 804, respectively), after adjusting for confounders: for hair, odds ratio (OR) = 4.10 (95% CI: 1.66, 10.13); for blood, OR = 2.32 (95% CI: 1.07, 5.03) comparing highest versus lowest quantiles. Magnitudes of association were strongest for high-titer (≥ 1:1,280) ANA: hair, OR = 11.41 (95% CI: 1.60, 81.23); blood, OR = 5.93 (95% CI: 1.57, 22.47). CONCLUSIONS Methylmercury, at low levels generally considered safe, was associated with subclinical autoimmunity among reproductive-age females. Autoantibodies may predate clinical disease by years; thus, methylmercury exposure may be relevant to future autoimmune disease risk.
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Affiliation(s)
- Emily C Somers
- Department of Internal Medicine, University of Michigan, Ann Arbor, Michigan, USA
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Wang SS, Flowers CR, Kadin ME, Chang ET, Hughes AM, Ansell SM, Feldman AL, Lightfoot T, Boffetta P, Melbye M, Lan Q, Sampson JN, Morton LM, Zhang Y, Weisenburger DD. Medical history, lifestyle, family history, and occupational risk factors for peripheral T-cell lymphomas: the InterLymph Non-Hodgkin Lymphoma Subtypes Project. J Natl Cancer Inst Monogr 2015; 2014:66-75. [PMID: 25174027 DOI: 10.1093/jncimonographs/lgu012] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Accounting for 10%-15% of all non-Hodgkin lymphomas in Western populations, peripheral T-cell lymphomas (PTCL) are the most common T-cell lymphoma but little is known about their etiology. Our aim was to identify etiologic risk factors for PTCL overall, and for specific PTCL subtypes, by analyzing data from 15 epidemiologic studies participating in the InterLymph Consortium. METHODS A pooled analysis of individual-level data for 584 histologically confirmed PTCL cases and 15912 controls from 15 case-control studies conducted in Europe, North America, and Australia was undertaken. Data collected from questionnaires were harmonized to permit evaluation of a broad range of potential risk factors. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using logistic regression. RESULTS Risk factors associated with increased overall PTCL risk with a P value less than .05 included: a family history of hematologic malignancies (OR = 1.92, 95% CI = 1.30 to 2.84); celiac disease (OR = 17.8, 95% CI = 8.61 to 36.79); eczema (OR = 1.41, 95% CI = 1.07 to 1.85); psoriasis (OR = 1.97, 95% CI = 1.17 to 3.32); smoking 40 or more years (OR = 1.92, 95% CI = 1.41 to 2.62); and employment as a textile worker (ever) (OR = 1.58, 95% CI = 1.05 to 2.38) and electrical fitter (ever) (OR = 2.89, 95% CI = 1.41 to 5.95). Exposures associated with reduced overall PTCL risk included a personal history of allergies (OR = 0.69, 95% CI = 0.54 to 0.87), alcohol consumption (ever) (OR = 0.64, 95% CI = 0.49 to 0.82), and having ever lived or worked on a farm (OR = 0.72, 95% CI = 0.55% to 0.95%). We also observed the well-established risk elevation for enteropathy-type PTCL among those with celiac disease in our data. Conclusions Our pooled analyses identified a number of new potential risk factors for PTCL and require further validation in independent series.
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Affiliation(s)
- Sophia S Wang
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW).
| | - Christopher R Flowers
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Marshall E Kadin
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Ellen T Chang
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Ann Maree Hughes
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Stephen M Ansell
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Andrew L Feldman
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Tracy Lightfoot
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Paolo Boffetta
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Mads Melbye
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Qing Lan
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Joshua N Sampson
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Lindsay M Morton
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Yawei Zhang
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
| | - Dennis D Weisenburger
- Department of Cancer Etiology, Beckman Research Institute of the City of Hope, Duarte, CA (SSW); Winship Cancer Institute, Emory University, Atlanta, GA (CRF); Department of Dermatology, Boston University, Boston, MA, Roger Williams Medical Center, Providence, RI (MEK); Health Sciences Practice, Exponent, Inc., Menlo Park, CA, Department of Health Research and Policy, Stanford University School of Medicine, Stanford, CA (ETC); National Centre for Epidemiology and Population Health, The Australian National University, Canberra, Australia (AMH); Department of Health Sciences Research, Mayo Clinic, Rochester, MN (SMA); Department of Laboratory Medicine and Pathology, Mayo Clinic Cancer Center, Rochester, MN (ALF); Epidemiology and Cancer Statistics Group, Department of Health Sciences, University of York, York, UK (TL); Tisch Cancer Institute, Mount Sinai School of Medicine, New York, NY (PB); Department of Epidemiology Research, Statens Serum Institut, Copenhagen, Denmark (MM); Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD (QL, JNS, LMM); Department of Environmental Health Sciences, Yale School of Public Health, New Haven, CT (YZ); Department of Pathology, City of Hope National Medical Center, Duarte, CA (DDW)
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Mortality among capacitor workers exposed to polychlorinated biphenyls (PCBs), a long-term update. Int Arch Occup Environ Health 2014; 88:85-101. [DOI: 10.1007/s00420-014-0940-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2013] [Accepted: 03/13/2014] [Indexed: 01/25/2023]
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Yildirim M, Karakilinc H, Yildiz M, Kurtoglu E, Dilli UD, Goktas S, Demirpence O, Kaya V. Non-Hodgkin lymphoma and pesticide exposure in Turkey. Asian Pac J Cancer Prev 2014; 14:3461-3. [PMID: 23886128 DOI: 10.7314/apjcp.2013.14.6.3461] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Non-Hodgkin lymphoma (NHL) is a solid tumour of lymphocytes, important elements in the immune system. According to 2006 data, in Turkey the incidence was 6.5 per 100,000 in males, and 4.4 in females. The relationship between the use of pesticides and development of NHL has been extensively investigated in many studies, and it has been demonstrated that the risk of NHL is increased by exposure to such compounds. Antalya is a region of intensive agricultural activity. In this study, the relationship between the incidence of lymphoma in Antalya and the amount of pesticides employed was investigated. MATERIALS AND METHODS The study used data from 1995 to 2010 on the patients from the databank of TR Ministry of Health, Antalya Provincial Health Directorate, Cancer Registration Center and the patients who were histopathologically diagnosed with NHL during these years. RESULTS The relationship between the amount of pesticide used and the incidence was studied with the Spearman correlation analysis and the p value was found as 0.05. The correlation coefficient was 0.497. An increase in the NHL incidence over the years was identified, with a 2.42-fold increment found from 1995 to 2005 and a 2.77 fold elevation from 1995 to 2010. The use of pesticides increased 1.89 fold over the same period. CONCLUSIONS Our study investigated the relationship of the pesticides used with NHL patients diagnosed during the same year. Since the time elapsing after exposure to pesticides until the development of cancer is not clear, no comparison can be made at present. We believe that the increase in use of pesticides since 1995 may be associated with the increase in the incidence of NHLand therefore that further studies on the issue including measurements of serum pesticide levels, are required.
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Affiliation(s)
- Mustafa Yildirim
- Department of Medical Oncology, Ministry of Health Batman Regional Govermant Hospital, Batman, Turkey.
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15
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Kelly RS, Lundh T, Porta M, Bergdahl IA, Palli D, Johansson AS, Botsivali M, Vineis P, Vermeulen R, Kyrtopoulos SA, Chadeau-Hyam M. Blood erythrocyte concentrations of cadmium and lead and the risk of B-cell non-Hodgkin's lymphoma and multiple myeloma: a nested case-control study. PLoS One 2013; 8:e81892. [PMID: 24312375 PMCID: PMC3842971 DOI: 10.1371/journal.pone.0081892] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2013] [Accepted: 10/17/2013] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Cadmium (Cd) and lead (Pb) are hypothesised to be risk factors for non-Hodgkin's lymphoma (NHL), a group of haematological malignancies with a suspected environmental aetiology. Within the EnviroGenoMarkers study we utilised pre-diagnostic erythrocyte concentrations of Cd and Pb to determine whether exposure was associated with risk of B-cell NHL and multiple myeloma. METHODS 194 incident cases of B-cell NHL and 76 cases of multiple myeloma diagnosed between 1990 and 2006 were identified from two existing cohorts; EPIC-Italy and the Northern Sweden Health and Disease Study. Cases were matched to healthy controls by centre, age, gender and date of blood collection. Cd and Pb were measured in blood samples provided at recruitment using inductively coupled plasma-mass spectrometry. Logistic regression was applied to assess the association with risk. Analyses were stratified by cohort and gender and by subtype where possible. RESULTS There was little evidence of an increased risk of B-cell NHL or multiple myeloma with exposure to Cd (B-cell NHL: OR 1.09 95%CI 0.61, 1.93, MM: OR 1.16 95% CI: 0.40, 3.40 ) or Pb (B-cell NHL: 0.93 95% CI 0.43, 2.02, multiple myeloma: OR 1.63 95%CI 0.45, 5.94) in the total population when comparing the highest to the lowest quartile of exposure. However, gender and cohort specific differences in results were observed. In females the risk of B-cell NHL was more than doubled in those with a body burden of Cd >1 µg/L (OR 2.20 95%CI; 1.04, 4.65). CONCLUSIONS This nested case-control study does not support a consistent positive association between Cd or Pb and NHL, but there is some indication of a gender specific effect suggesting further research is warranted.
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Affiliation(s)
- Rachel S. Kelly
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
| | - Thomas Lundh
- Department of Occupational and Environmental Medicine, Lund University Hospital, Lund, Sweden
| | - Miquel Porta
- Hospital del Mar Research Institute - IMIM, CIBER Epidemiología y Salud Pública (CIBERESP) and Universitat Autònoma de Barcelona, Barcelona, Catalonia, Spain
| | - Ingvar A. Bergdahl
- Occupational and Environmental Medicine, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Domenico Palli
- Molecular and Nutritional Epidemiology Unit, Cancer Prevention and Research Institute (ISPO), Florence, Italy
| | | | - Maria Botsivali
- National Hellenic Research Foundation, Institute of Biology, Pharmaceutical Chemistry and Biotechnology, Athens, Greece
| | - Paolo Vineis
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
- HuGeF Foundation, Turin, Italy
| | - Roel Vermeulen
- Institute for Risk Assessment Sciences, Division of Environmental Epidemiology, Utrecht University, Utrecht, The Netherlands
| | - Soterios A. Kyrtopoulos
- National Hellenic Research Foundation, Institute of Biology, Pharmaceutical Chemistry and Biotechnology, Athens, Greece
| | - Marc Chadeau-Hyam
- Medical Research Council-Health Protection Agency Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom
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16
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Alavanja MCR, Ross MK, Bonner MR. Increased cancer burden among pesticide applicators and others due to pesticide exposure. CA Cancer J Clin 2013; 63:120-42. [PMID: 23322675 DOI: 10.3322/caac.21170] [Citation(s) in RCA: 187] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
A growing number of well-designed epidemiological and molecular studies provide substantial evidence that the pesticides used in agricultural, commercial, and home and garden applications are associated with excess cancer risk. This risk is associated both with those applying the pesticide and, under some conditions, those who are simply bystanders to the application. In this article, the epidemiological, molecular biology, and toxicological evidence emerging from recent literature assessing the link between specific pesticides and several cancers including prostate cancer, non-Hodgkin lymphoma, leukemia, multiple myeloma, and breast cancer are integrated. Although the review is not exhaustive in its scope or depth, the literature does strongly suggest that the public health problem is real. If we are to avoid the introduction of harmful chemicals into the environment in the future, the integrated efforts of molecular biology, pesticide toxicology, and epidemiology are needed to help identify the human carcinogens and thereby improve our understanding of human carcinogenicity and reduce cancer risk.
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Affiliation(s)
- Michael C R Alavanja
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, North Bethesda, MD 20892, USA.
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17
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Wu H, Bertrand KA, Choi AL, Hu FB, Laden F, Grandjean P, Sun Q. Persistent organic pollutants and type 2 diabetes: a prospective analysis in the nurses' health study and meta-analysis. ENVIRONMENTAL HEALTH PERSPECTIVES 2013; 121:153-61. [PMID: 23131992 PMCID: PMC3569682 DOI: 10.1289/ehp.1205248] [Citation(s) in RCA: 129] [Impact Index Per Article: 11.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2012] [Accepted: 11/05/2012] [Indexed: 05/17/2023]
Abstract
BACKGROUND Prospective data regarding persistent organic pollutants (POPs) and risk of type 2 diabetes (T2D) are limited, and the results for individual POPs are not entirely consistent across studies. OBJECTIVES We prospectively examined plasma POP concentrations in relation to incident T2D and summarized existing evidence in a meta-analysis. METHODS Plasma polychlorinated biphenyls (PCBs), dichlorodiphenyltrichloroethane (DDT), dichlorodiphenyldichloroethylene (DDE), and hexachlorobenzene (HCB) concentrations were measured in 1,095 women who were free of diabetes at blood draw in 1989-1990 and participated in two case-control studies in the Nurses' Health Study. We identified 48 incident T2D cases through 30 June 2008. We conducted a literature search in PubMed and EMBASE through December 2011 to identify prospective studies on POPs in relation to diabetes. We used a fixed-effects model to summarize results. RESULTS After multivariable adjustment, plasma HCB concentration was positively associated with incident T2D [pooled odds ratio (OR) 3.59 (95% CI: 1.49, 8.64, ptrend = 0.003) comparing extreme tertiles]. Other POPs were not significantly associated with diabetes. After pooling our results with those of six published prospective studies that included 842 diabetes cases in total, we found that HCB and total PCBs both were associated with diabetes: the pooled ORs were 2.00 (95% CI: 1.13, 3.53; I2 = 21.4%, pheterogeneity = 0.28) and 1.70 (95% CI: 1.28, 2.27; I2 = 16.3%, pheterogeneity = 0.30) for HCB and total PCBs, respectively. CONCLUSIONS These findings support an association between POP exposure and the risk of T2D.
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Affiliation(s)
- Hongyu Wu
- Department of Nutrition, Harvard School of Public Health, Boston, Massachusetts 02115, USA
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18
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Zani C, Toninelli G, Filisetti B, Donato F. Polychlorinated biphenyls and cancer: an epidemiological assessment. JOURNAL OF ENVIRONMENTAL SCIENCE AND HEALTH. PART C, ENVIRONMENTAL CARCINOGENESIS & ECOTOXICOLOGY REVIEWS 2013; 31:99-144. [PMID: 23672403 DOI: 10.1080/10590501.2013.782174] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/22/2023]
Abstract
Polychlorinated biphenyls (PCBs) are toxic and persistent chemicals produced between 1930s and 1980s primarily for insulating fluids in heavy-duty electrical equipment in power plants, industries, and large buildings. They persist in the environment and accumulate in plants and animals, and have been classified as probable carcinogens to humans. We performed a systematic review and meta-analysis of scientific literature on the relationship between PCB exposure and human cancer. Two cohorts of people highly exposed to PCBs through ingestion of contaminated rice oil and some cohorts of occupationally exposed workers failed to show a definite increase in total cancer mortality and provided inconsistent results regarding single cancers. Several cohort and case-control studies investigated the association between PCBs and specific cancers, showing an association between PCB serum levels and non-Hodgkin lymphomas (NHL), with a summary odds ratio of 1.5 (95% confidence interval: 1.1-1.7), but no consistent results for the other cancer sites and types. In conclusion, this review provides some evidence for the role of PCBs in the development of NHL, although the inconsistent results of studies performed on highly polluted people and occupationally exposed workers do not allow a firm conclusion to be drawn.
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Affiliation(s)
- Claudia Zani
- Institute of Hygiene, Epidemiology and Public Health, University of Brescia, Italy.
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19
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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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20
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Kramer S, Hikel SM, Adams K, Hinds D, Moon K. Current status of the epidemiologic evidence linking polychlorinated biphenyls and non-hodgkin lymphoma, and the role of immune dysregulation. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:1067-75. [PMID: 22552995 PMCID: PMC3440083 DOI: 10.1289/ehp.1104652] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2011] [Accepted: 05/02/2012] [Indexed: 05/08/2023]
Abstract
BACKGROUND Although case-control studies conducted to date have largely affirmed the relationship between polychlorinated biphenyls (PCBs) and non-Hodgkin lymphoma (NHL), occupational cohort studies of PCB-exposed workers have been generally interpreted as negative, thereby raising doubts about a potential causal association. A common theme of immune dysregulation unifies many of NHL's strongest risk factors, and several authors have posited that subclinical immune dysregulation may increase NHL risk by decreasing host resistance, reducing control of cellular proliferation and differentiation, and diminishing tumor surveillance mechanisms. OBJECTIVES The goals of this review were a) to evaluate the epidemiological research examining the association between PCB exposure and NHL and discuss the contribution to the weight of evidence of case-control studies and occupational cohort studies; and b) to summarize the evidence for immune dysregulation as a means by which PCBs may cause NHL. METHODS We performed a literature search using PubMed and seven additional online biomedical and toxicological referencing libraries to identify literature published through August 2011. DISCUSSION AND CONCLUSIONS Overall, we conclude that the weight of evidence supports a causal role of PCBs in lymphomagenesis. The strongest epidemiological evidence for the relationship between PCBs and NHL comes from case-control studies conducted among the general population. Epidemiological and toxicological data demonstrating immunosuppressive and inflammatory effects of PCBs further contribute to the weight of evidence by providing a plausible explanation for how PCBs can cause NHL through immune dysregulation.
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Affiliation(s)
- Shira Kramer
- Epidemiology International, Hunt Valley, Maryland, USA.
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21
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Freeman MD, Kohles SS. Plasma levels of polychlorinated biphenyls, non-Hodgkin lymphoma, and causation. JOURNAL OF ENVIRONMENTAL AND PUBLIC HEALTH 2012; 2012:258981. [PMID: 22577404 PMCID: PMC3346688 DOI: 10.1155/2012/258981] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 11/09/2011] [Indexed: 11/18/2022]
Abstract
Polychlorinated biphenyls (PCBs) are synthetic chlorinated hydrocarbons that have extensively polluted the environment and bioaccumulated in the food chain. PCBs have been deemed to be probable carcinogens by the Environmental Protection Agency, and exposure to high levels of PCBs has been consistently linked to increased risk of non-Hodgkin lymphoma (NHL). In the present article we present a forensic epidemiologic evaluation of the causal relationship between NHL and elevated PCB levels via application of the Bradford-Hill criteria. Included in the evaluation is a meta-analysis of the results of previously published case-control studies in order to assess the strength of association between NHL and PCBs, resulting in an odds ratio in which the lowest percentile PCB concentration (quartile, quintile, or tertile) has been compared with the highest percentile concentration in the study groups. The weight-adjusted odds ratio for all PCB congeners was 1.43 with a 95% confidence interval of 1.31 to 1.55, indicating a statistically significant causal association with NHL. Because of the lack of an unexposed comparison group, a rationale for the use of a less than 2.0 relative risk causal contribution threshold is presented herein, including an ecologic analysis of NHL incidence and PCB accumulation (as measured by sales volume) over time. The overall results presented here indicate a strong general causal association between NHL and PCB exposure.
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Affiliation(s)
- Michael D. Freeman
- Department of Public Health and Preventive Medicine, Oregon Health & Science University School of Medicine, 1234 SW 18th Avenue, Suite 102, Portland, OR 97205, USA
| | - Sean S. Kohles
- Regenerative Bioengineering Laboratory, Department of Mechanical & Materials Engineering, Portland State University, 1930 SW 4th Avenue, Suite 400, Portland, OR 97201, USA
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Ultraviolet exposure and non-Hodgkin's lymphoma: beneficial and adverse effects? Cancer Causes Control 2012; 23:653-5; author reply 657-8. [PMID: 22367726 DOI: 10.1007/s10552-012-9929-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2011] [Accepted: 02/15/2012] [Indexed: 10/28/2022]
Abstract
Studies of risk of non-Hodgkin's lymphoma have found both direct and inverse correlations with respect to solar ultraviolet (UV) doses. Reduced risk is generally found in midlatitudes, while increased risk is generally found at higher latitudes. It is suggested that reduced risk arises from vitamin D production from UVB irradiance, while increased risk arises from immunosuppression associated with UVA irradiance. The ratio of UVA to UVB increases with increasing latitude.
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Bräuner EV, Sørensen M, Gaudreau E, LeBlanc A, Eriksen KT, Tjønneland A, Overvad K, Raaschou-Nielsen O. A prospective study of organochlorines in adipose tissue and risk of non‑Hodgkin lymphoma. ENVIRONMENTAL HEALTH PERSPECTIVES 2012; 120:105-11. [PMID: 22328999 PMCID: PMC3261942 DOI: 10.1289/ehp.1103573] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2011] [Accepted: 08/26/2011] [Indexed: 05/22/2023]
Abstract
BACKGROUND Exposure to organochlorines has been examined as a potential risk factor for non-Hodgkin lymphoma (NHL), with inconsistent results that may be related to limited statistical power or to imprecise exposure measurements. OBJECTIVE Our purpose was to examine associations between organochlorine concentrations in prediagnostic adipose tissue samples and the risk of NHL. METHODS We conducted a case–cohort study using a prospective Danish cohort of 57,053 persons enrolled between 1993 and 1997. Within the cohort we identified 256 persons diagnosed with NHL in the population-based nationwide Danish Cancer Registry and randomly selected 256 subcohort persons. We measured concentrations of 8 pesticides and 10 polychlorinated biphenyl (PCB) congeners in adipose tissue collected upon enrollment. Associations between the 18 organochlorines and NHL were analyzed in Cox regression models, adjusting for body mass index. RESULTS Incidence rate ratios and confidence intervals (CIs) for interquartile range increases in concentrations of dichlorodiphenyltrichlorethane (DDT), cis-nonachlor, and oxychlordane were 1.35 (95% CI: 1.10, 1.66), 1.13 (95% CI: 0.94, 1.36), and 1.11 (95% CI: 0.89, 1.38), respectively, with monotonic dose–response trends for DDT and cis-nonachlor based on categorical models. The relative risk estimates were higher for men than for women. In contrast, no clear association was found between NHL and PCBs. CONCLUSION We found a higher risk of NHL in association with higher adipose tissue levels of DDT, cis-nonachlor, and oxychlordane, but no association with PCBs. This is the first study of organochlorines and NHL using prediagnostic adipose tissue samples in the exposure assessment and provides new environmental health evidence that these organochlorines contribute to NHL risk.
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Abstract
INTRODUCTION: Despite decades of intensive research, Non-Hodgkin Lymphoma (NHL) remains poorly understood and is largely incurable. NHL is a heterogeneous group of malignancies with multiple subtypes, each of which has distinct morphologic, immunophenotypic, and clinical features. Identifying the risk factors for NHL may improve our understanding of the underlying biological mechanisms and have an impact on clinical practice. AREAS COVERED: This article provides a review of several aspects of NHL, including epidemiology and subtype classification, clinical, environmental, genetic, and genomic risk factors identified for etiology and prognosis, and available statistical and bioinformatics tools for identification of genetic and genomic risk factors from the analysis of high-throughput studies. EXPERT OPINION: Multiple clinical and environmental risk factors have been identified. However, they have failed to provide practically effective prediction. Genetic and genomic risk factors identified from high-throughput studies have suffered a lack of reproducibility. The identification of genetic/genomic risk factors demands innovative statistical and bioinformatics tools. Although multiple analysis methods have been developed, there is still room for improvement. There is a critical need for well-designed, prospective, large-scale pangenomic studies.
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Affiliation(s)
- Yawei Zhang
- School of Public Health, Yale University, 60 College ST, New Haven, CT 06520, USA
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25
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Maifredi G, Donato F, Magoni M, Orizio G, Gelatti U, Maiolino P, Zani C, Vassallo F, Scarcella C. Polychlorinated biphenyls and non-Hodgkin's lymphoma: a case-control study in Northern Italy. ENVIRONMENTAL RESEARCH 2011; 111:254-259. [PMID: 21238956 DOI: 10.1016/j.envres.2010.12.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/24/2008] [Revised: 12/13/2010] [Accepted: 12/20/2010] [Indexed: 05/30/2023]
Abstract
BACKGROUND Polychlorinated biphenyls (PCBs) have been hypothesized to increase the risk of non-Hodgkin lymphoma (NHL), although conclusive evidence is still lacking. High levels of PCBs were found in soil in some areas close to a PCB-producing factory in Brescia, North Italy. We conducted a population-based case-control study among residents of the town to investigate the possible association between PCB pollution and NHL in this area. METHODS We included both incident and deceased NHL cases, and a random sample of the town residents as controls, frequency matched to cases as regards age and gender. Exposure to PCBs was estimated on the basis of the lifetime residential history of cases and controls in four different areas of the town-A, B and C (polluted areas) and D (control area). RESULTS A total of 495 cases (287 incident cases) and 1467 controls were enrolled. Positive associations were found between NHL and having resided for at least 10 years in the area A, the most polluted area (odds ratio, OR=1.8; p=0.02) and for having resided in any of the polluted areas considered together (A+B+C) (OR=1.4; p=0.08). However, no associations were evident for having resided 20 years or longer in the polluted areas or when analyzing the association with each subject's main residence in his/her lifetime. CONCLUSION This study provides some evidence for an association between PCB exposure and NHL, though results should be considered with caution in the absence of individual biological measures of exposure.
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Affiliation(s)
- Giovanni Maifredi
- Institute of Hygiene, Epidemiology and Public Health, Department of Experimental and Applied Medicine, University of Brescia, Viale Europa 11, 25123 Brescia, Italy
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