Are occupational, hobby, or lifestyle exposures associated with Philadelphia chromosome positive chronic myeloid leukaemia?
J Björka, M Albina, H Welindera, H Tinnerberga, N Mauritzsonb, T Kauppinenc, U Strömberga, B Johanssond, R Billströmb, Z Mikoczya, T Ahlgrene, P-G Nilssonb, F Mitelmand, L Hagmara
a Department of
Occupational and Environmental Medicine, Lund University Hospital,
SE-221 85 Lund, Sweden, b Department of Internal
Medicine, Division of Hematology, Lund, Sweden, c Finnish Institute of Occupational Health,
Helsinki, Finland, d Department
of Clinical Genetics, Lund, Sweden, e Division of Hematology, Malmö
University Hospital, Sweden
Correspondence to: Dr J Björk jonas.bjork{at}ymed.lu.se
Accepted 4 July 2001
OBJECTIVES
To
investigate a broad range of occupational, hobby, and lifestyle
exposures, suggested as risk factors for Philadelphia chromosome positive (Ph+) chronic myeloid leukaemia (CML).
METHODSA case-control
study, comprising 255 Ph+CML patients from southern Sweden and matched
controls, was conducted. Individual data on work tasks, hobbies, and
lifestyle exposures were obtained by telephone interviews. Occupational
hygienists assessed occupational and hobby exposures for each subject
individually. Also, occupational titles were obtained from national
registries, and group level exposurethat is, the exposure proportion
for each occupational titlewas assessed with a job exposure matrix.
The effects of 11 exposures using individual data and two exposures
using group data (organic solvents and animal dust) were estimated.
RESULTSFor the
individual data on organic solvents, an effect was found for moderate
or high intensity of exposure (odds ratio (OR) 3.4, 95% confidence
interval (95% CI) 1.1 to 11) and for long duration (15-20 years) of
exposure (OR 2.1, 95% CI 1.1 to 4.0). By contrast, the group data
showed no association (OR 0.69, 95% CI 0.27 to 1.8; moderate or high
intensity versus no exposure). For extremely low frequency
electromagnetic fields (EMFs), only individual data were available. An
association with long occupational exposure to EMFs was found (OR 2.3, 95% CI 1.2 to 4.5). However, no effect of EMF intensity was indicated.
No significant effects of benzene, gasoline or diesel, or tobacco
smoking were found. OR estimates below unity were suggested for
personal use of hair dye and for agricultural exposures.
CONCLUSIONSAssociations
between exposure to organic solvents and EMFs, and Ph+CML were
indicated but were not entirely consistent.
Keywords: risk factors; epidemiology; case-control study
© 2001 by Occupational and Environmental Medicine
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