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Review
Occupational trichloroethylene exposure and risk of lymphatic and haematopoietic cancers: a meta-analysis
  1. Sara Karami1,
  2. Bryan Bassig1,
  3. Patricia A Stewart2,3,
  4. Kyoung-Mu Lee3,4,
  5. Nathaniel Rothman1,
  6. Lee E Moore1,
  7. Qing Lan1
  1. 1Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
  2. 2Stewart Exposure Assessments, LLC, Arlington, Virginia, USA
  3. 3Formerly of the Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
  4. 4Department of Environmental Health, Korea National Open University, Seoul, Korea
  1. Correspondence to Dr Sara Karami and Dr Lee E Moore, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, Department of Health and Human Services, National Cancer Institute, National Institutes of Health, 6120 Executive Blvd, EPS 8102, Rockville, MD 20852, USA; moorele{at}mail.nih.gov

Abstract

The carcinogenic potential of trichloroethylene (TCE) continues to generate much controversy, even after the US Environmental Protection Agency raised its classification to ‘carcinogenic to humans’. We conducted a meta-analysis of published cohort and case–control studies exploring occupational TCE exposure in relation to five different lymphatic and haematopoietic cancers: non-Hodgkin's lymphoma (NHL, N=24), Hodgkin's lymphoma (HL, N=13), multiple myeloma (MM, N=11), leukaemia (N=12) and chronic/small lymphocytic leukaemia (CLL/SLL, N=7).  Studies published between 1950 and 2011 were identified through a PubMed Medline search. All studies included in analyses were classified as those that assessed either occupational TCE exposure specifically (‘TCE-exposure’ studies) or a broader classification of all chlorinated solvents (‘chlorinated solvent-exposure’ studies).  A significantly raised summary estimate for NHL was seen for all cohort and case–control ‘TCE-exposure’ studies combined (N=19; relative risk (RR)=1.32, 95% CI 1.14 to 1.54; I2=25.20; p-heterogeneity=0.12) and for cohort ‘TCE-exposure’ studies (N=10; RR=1.52, 95% CI 1.29 to 1.79; I2=7.09; p-heterogeneity=0.63). A non-significant but raised summary estimate was seen for NHL case–control ‘TCE-exposure’ studies. No significant association with NHL risk was detected overall for any ‘chlorinated solvent-exposure’ studies. Summary estimates for occupational TCE exposure were not associated with risk of HL, MM, leukaemia or CLL/SLL.  Our updated meta-analysis of NHL, which incorporates new analytical results from three cohort and four case–control studies, supports an association between occupational TCE exposure and NHL.

https://doi.org/10.1136/oemed-2012-101212

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