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Occupation and risk of lymphoid and myeloid leukaemia in the European Prospective Investigation into Cancer and Nutrition (EPIC)
  1. Fatemeh Saberi Hosnijeh1,2,
  2. Yvette Christopher1,
  3. Petra Peeters3,
  4. Isabelle Romieu4,
  5. Wei Xun5,
  6. Elio Riboli5,
  7. Ole Raaschou-Nielsen6,
  8. Anne Tjønneland6,
  9. Nikolaus Becker7,
  10. Alexandra Nieters8,
  11. Antonia Trichopoulou9,10,
  12. Christina Bamia9,
  13. Philip Orfanos10,
  14. Enrico Oddone11,
  15. Leila Luján-Barroso12,
  16. Miren Dorronsoro13,
  17. Carmen Navarro14,15,
  18. Aurelio Barricarte15,16,
  19. Esther Molina-Montes15,17,
  20. Nick Wareham18,
  21. Paolo Vineis19,
  22. Roel Vermeulen1,3
  1. 1Division Environmental Epidemiology, Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands
  2. 2Zanjan University of Medical Science, Zanjan, Iran
  3. 3Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands
  4. 4International Agency for Research on Cancer (IARC-WHO), Lyon, France
  5. 5Division of Epidemiology, Public Health and Primary Care Faculty of Medicine Imperial College, London, UK
  6. 6Danish Cancer Society Research Center, Copenhagen, Denmark
  7. 7Division of Cancer Epidemiology, DKFZ Heidelberg, Heidelberg, Germany
  8. 8Centre of Chronic Immunodeficiency, University of Freiburg, Heidelberg, Germany
  9. 9Department of Hygiene, Epidemiology and Medical Statistics, WHO Collaborating Center for Food and Nutrition Policies, University of Athens Medical School, Athens, Greece
  10. 10Hellenic Health Foundation, Athens, Greece
  11. 11Environmental Epidemiology and Cancer Registry Unit, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy
  12. 12Unit of Nutrition, Environment and Cancer, Catalan Institute of Oncology (ICO), Barcelona, Spain
  13. 13Public Health Division of Gipuzkoa, Basque Regional Health Department and Biodonostia/Ciberesp, San Sebastian, Spain
  14. 14Department of Epidemiology, Murcia Regional Health Authority, Murica, Spain
  15. 15CIBER Epidemiología y Salud Pública (CIBERESP), Granada, Spain
  16. 16Navarre Public Health Institute, Pamplona, Spain
  17. 17Andalusian School of Public Health, Granada, Spain
  18. 18Epidemiology Unit, Medical Research Council, Cambridge, UK
  19. 19Imperial College School of Public Health, London, UK
  1. Correspondence to Dr Roel Vermeulen, Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Jenalaan 18D, PO Box 80178, Utrecht 3508 TD, The Netherlands; r.c.h.vermeulen{at}


Objectives Established risk factors for leukaemia do not explain the majority of leukaemia cases. Previous studies have suggested the importance of occupation and related exposures in leukaemogenesis. We evaluated possible associations between job title and selected hazardous agents and leukaemia in the European Prospective Investigation into Cancer and Nutrition.

Methods The mean follow-up time for 241 465 subjects was 11.20 years (SD 2.42 years). During the follow-up period, 477 incident cases of myeloid and lymphoid leukaemia occurred. Data on 52 occupations considered a priori to be at high risk of developing cancer were collected through standardised questionnaires. Occupational exposures were estimated by linking the reported occupations to a job exposure matrix. Cox proportional hazard models were used to explore the association between occupation and related exposures and risk of leukaemia.

Results The risk of lymphoid leukaemia significantly increased for working in chemical laboratories (HR 8.35, 95% CI 1.58 to 44.24), while the risk of myeloid leukaemia increased for working in the shoe or other leather goods industry (HR 2.54, 95% CI 1.28 to 5.06). Exposure-specific analyses showed a non-significant increased risk of myeloid leukaemias for exposure to benzene (HR 1.15, 95% CI 0.75 to 1.40; HR=1.60, 95% CI 0.95 to 2.69 for the low and high exposure categories, respectively). This association was present both for acute and chronic myeloid leukaemia at high exposure levels. However, numbers were too small to reach statistical significance.

Conclusions Our findings suggest a possible role of occupational exposures in the development of both lymphoid and myeloid leukaemia. Exposure to benzene seemed to be associated with both acute and chronic myeloid leukaemia.

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