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The relationship between multiple myeloma and occupational exposure to six chlorinated solvents
  1. Laura S Gold1,2,
  2. Patricia A Stewart3,
  3. Kevin Milliken1,2,
  4. Mark Purdue4,
  5. Richard Severson5,
  6. Noah Seixas6,
  7. Aaron Blair4,
  8. Patricia Hartge4,
  9. Scott Davis1,2,
  10. Anneclaire J De Roos1,2
  1. 1Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
  2. 2Department of Epidemiology, University of Washington School of Public Health, Seattle, Washington, USA
  3. 3Stewart Exposure Assessments LLC, Arlington, Virginia, USA
  4. 4Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
  5. 5Department of Family Medicine and Public Health Sciences, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan USA
  6. 6Department of Environmental and Occupational Health Sciences, University of Washington School of Public Health, Seattle, Washington, USA
  1. Correspondence to Laura Gold, 1100 Fairview Avenue N, PO Box 19024, Seattle, WA 98109, USA; goldl{at}


Objectives Few studies have examined whether exposure to chlorinated solvents is associated with multiple myeloma. We evaluated associations between multiple myeloma and occupational exposure to six chlorinated solvents: 1,1,1-trichloroethane, trichloroethylene (TCE), methylene chloride (DCM), perchloroethylene, carbon tetrachloride and chloroform.

Methods In-person interviews obtained occupational histories and information on jobs with likely solvent exposure. We assigned exposure metrics of probability, frequency, intensity and confidence using job-exposure matrices modified by job-specific questionnaire information. We used logistic regression to estimate ORs and 95% CIs for associations between multiple myeloma and ever exposure to each, and any, chlorinated solvent and analysed whether associations varied by duration and cumulative exposure. We also considered all occupations that were given the lowest confidence scores as unexposed and repeated all analyses.

Results Risk of multiple myeloma was elevated for subjects ever exposed to 1,1,1-trichloroethane (OR (95% CI): 1.8 (1.1 to 2.9)). Ever exposure to TCE or DCM also entailed elevated, but not statistically significant, risks of multiple myeloma; these became statistically significant when occupations with low confidence scores were considered unexposed (TCE: 1.7 (1.0 to 2.7); DCM: 2.0 (1.2 to 3.2)). Increasing cumulative exposure to perchloroethylene was also associated with increasing multiple myeloma risk. We observed non-significantly increased multiple myeloma risks with exposure to chloroform; however, few subjects were exposed.

Conclusions Evidence from this relatively large case-control study suggests that exposures to certain chlorinated solvents may be associated with increased incidence of multiple myeloma; however, the study is limited by relatively low participation (52%) among controls.

  • Multiple myeloma
  • chlorinated solvents
  • 1,1,1-trichloroethane (TCA)
  • trichloroethylene (TCE)
  • methylene chloride (DCM)
  • perchloroethylene (PCE)
  • carbon tetrachloride
  • chloroform
  • epidemiology
  • public health
  • cancer
  • exposure assessment
  • solvents

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  • Funding This research was funded in part by a grant from the National Occupational Research Agenda (NORA).

  • Competing interests None.

  • Ethics approval Approval to conduct research related to this paper was obtained from the Institutional Review Office of the Fred Hutchinson Cancer Research Center.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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