Objectives Evidence suggests that certain occupations and related exposures may increase the risk of malignant lymphoma. Farming, printing and paper industry, wood processing, meat handling and processing, welding, shoe and leather manufacturing and teaching profession are among the categories that have been implicated in previous studies. The relationship between occupation and malignant lymphoma has been investigated in a large European prospective study.
Methods We investigated occupational risks for lymphomas in the European Prospective Investigation into Cancer and Nutrition (EPIC). The mean follow-up time for 348 555 subjects was 9 years (SD: 2 years). The analysis was based on 866 and 48 newly diagnosed cases of non-Hodgkin's lymphoma (NHL) and Hodgkin's lymphoma (HL). These were identified in the EPIC subcohorts with occupational data. Data on 52 occupations were collected through standardised questionnaires. Cox proportional hazard models were used to explore the association between occupation and risk of malignant lymphoma.
Results The following occupations were positively associated with malignant NHL after adjustment for study centre, age, sex, socioeconomic status (SES), smoking and alcohol: butchers (HR=1.53, 95% CI 1.05 to 2.48, including multiple myeloma/plasmacytoma; HR=1.30, 95% CI 1.00 to 2.66, excluding multiple myeloma/plasmacytoma) and car repair workers (HR=1.50, 95% CI 1.01 to 2.00, including multiple myeloma/plasmacytoma; HR=1.51, 95% CI 1.01 to 2.31, excluding multiple myeloma/plasmacytoma). HL was associated with gasoline station occupation (HR=4.59, 95% CI 1.08 to 19.6).
Conclusion The findings in this current study of a higher risk of NHL among car repair workers and butchers and a higher risk of HL among gasoline station workers suggest a possible role from occupationally related exposures, such as solvents and zoonotic viruses, as risk factors for malignant lymphoma.
- longitudinal studies
- animal workers
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Funding Europe Against Cancer Program of the European Commission (SANCO), Deutsche Krebshilfe Deutsches Krebsforschungszentrum German Federal Ministry of Education and Research, Danish Cancer Society Health Research Fund (FIS) of the Spanish Ministry of Health Spanish Regional Governments of Andalucia, Asturias, Basque Country, Murcia and Navarra Grant ISCIII, Red de Centros RCESP, C03/09, Spain Cancer Research, United Kingdom Stroke Association, United Kingdom British Heart Foundation, United Kingdom Department of Health, United Kingdom Food Standards Agency, United Kingdom Wellcome Trust, United Kingdom Greek Ministry of Education and Ministry of Health Italian Association for Research on Cancer (AIRC), Italian National Research Council Dutch Ministry of Public Health, Welfare and Sports, World Cancer Research Fund, Swedish Cancer Society, Swedish Scientific Council Regional Government of Skåne, Sweden Norwegian Cancer Society Research Council of Norway. Other funders: Wellcome Trust.
Competing interests None.
Patient consent Obtained.
Ethics approval This study was conducted with the approval of the IARC ethical committee and all the local IRBs.
Provenance and peer review Not commissioned; externally peer reviewed.