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Occupational exposure to extremely low-frequency magnetic fields and follicular lymphoma risk: a family case–control study
  1. Michael K Odutola1,
  2. Marina T van Leeuwen1,
  3. Fiona J Bruinsma2,3,
  4. Geza Benke4,
  5. Michelle C Turner5,6,7,
  6. Judith Trotman8,
  7. Jennifer Turner9,10,
  8. John F Seymour11,
  9. H Miles Prince12,
  10. Samuel T Milliken13,
  11. Campbell Tiley14,
  12. Mark Hertzberg15,
  13. Fernando Roncolato16,
  14. Stephen Opat17,
  15. Robert Lindeman18,
  16. Emma Verner8,
  17. Craig R Underhill19,
  18. Elisabeth Cardis5,6,7,
  19. Graham Giles2,20,
  20. Claire M Vajdic1,21
  1. 1 Centre for Big Data Research in Health, University of New South Wales, Sydney, New South Wales, Australia
  2. 2 Cancer Epidemiology Division, Cancer Council Victoria, Melbourne, Victoria, Australia
  3. 3 Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
  4. 4 School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
  5. 5 ISGlobal, Barcelona Institute for Global Health, Barcelona, Spain
  6. 6 Department of Global Health, Pompeu Fabra University (UPF), Barcelona, Spain
  7. 7 Spanish Consortium for Research and Public Health (CIBERESP), Instituto de Salud Carlos III, Madrid, Spain
  8. 8 Concord Repatriation General Hospital and University of Sydney, Concord, New South Wales, Australia
  9. 9 Anatomical Pathology, Douglass Hanly Moir Pathology, Sydney, New South Wales, Australia
  10. 10 Department of Clinical Medicine, Faculty of Medicine, Health and Human Science, Macquarie University, Sydney, New South Wales, Australia
  11. 11 Royal Melbourne Hospital, Peter MacCallum Cancer Centre and University of Melbourne, Melbourne, Victoria, Australia
  12. 12 Sir Peter MacCallum Department of Oncology, University of Melbourne, Parkville, Victoria, Australia
  13. 13 Haematology Department, St. Vincent’s Hospital, Sydney, New South Wales, Australia
  14. 14 Cancer Day Unit, Gosford Hospital, Gosford, New South Wales, Australia
  15. 15 Department of Haematology, Prince of Wales Hospital and University of New South Wales, Sydney, New South Wales, Australia
  16. 16 Clinical Haematology, St. George Hospital, Kogarah, New South Wales, Australia
  17. 17 Clinical Haematology, Monash Health, Clayton, Victoria, Australia
  18. 18 Clinical Operations, New South Wales Health Pathology, Sydney, New South Wales, Australia
  19. 19 Border Medical Oncology Research Unit, Albury, New South Wales, Australia
  20. 20 Precision Medicine, School of Clinical Sciences at Monash Health, Monash University, Clayton, Victoria, Australia
  21. 21 The Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
  1. Correspondence to Dr Claire M Vajdic, Kirby Institute, University of New South Wales, Sydney, NSW 2052, Australia; claire.vajdic{at}unsw.edu.au

Abstract

Objectives We aimed to examine the relationship between occupational exposure to extremely low-frequency magnetic fields (ELF-MFs) and follicular lymphoma (FL) risk.

Methods We conducted a family case–control study between 2011 and 2016 in Australia and included 681 cases. Controls were either a family member of cases (related (n=294), unrelated (n=179)) or were unrelated recruited for a similarly designed Australian multiple myeloma study (n=711). We obtained detailed job histories using lifetime work calendars. We assigned exposure to ELF-MFs using an enhanced job exposure matrix, with a lag period of 10 years. We examined associations with FL risk using logistic regression accounting for relatedness between cases and controls. We performed sensitivity analyses including by control type, by sex, complete case analyses, ELF-MF exposure percentiles in addition to quartiles, ELF-MF exposure in the maximum exposed job, a shorter lag period (1 year) and the cumulative exposure in the most recent time period (1–9 years).

Results We observed no association with the average intensity, duration or lifetime cumulative exposure to occupational ELF-MF exposure in the primary or sensitivity analyses.

Conclusions Our findings do not support an association between occupational ELF-MF exposure and FL risk. Although the inclusion of family members as part of the larger control group may have biased our risk estimates towards the null, findings were similar in sensitivity analyses restricted to cases and unrelated controls. Further research incorporating enhanced exposure assessment to ELF-MF is warranted to inform occupational safety regulations and any potential role in lymphomagenesis.

  • radiation, nonionizing
  • epidemiology
  • occupational health
  • public health
  • risk assessment

Data availability statement

Data are available upon reasonable request. Approval by all relevant human research ethics committees will be required.

https://doi.org/10.1136/oemed-2023-108949

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    Data availability statement

    Data are available upon reasonable request. Approval by all relevant human research ethics committees will be required.

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    Footnotes

    • Twitter @clairevajdic

    • Contributors MKO, MTvL, GB, GG and CMV were responsible for conceptualisation of the study. CMV, JTr, JTu, JFS, HMP, STM, CT, MH, FR, SO, RL, EV and CRU were responsible for data collection. MKO was responsible for data management, analysis and write-up under the supervision of MTvL and CMV. MKO was responsible for preparation of the first draft of the manuscript. MKO, MTvL, FJB, GB, MCT, JTr, JTu, JFS, HMP, STM, CT, MH, FR, SO, RL, EV, CRU, EC, GG and CMV interpreted the data and contributed to and reviewed the manuscript. CMV is responsible for the overall content as the guarantor.

    • Funding This study was supported by the National Health and Medical Research Council of Australia (ID 1006707). The National Health and Medical Research Council also supported MTvL (ID 1012141). MKO is supported by an International Postgraduate Award Scholarship through the Australian Government Research Training Program (ID 5188838) and a Cancer Institute NSW Translational Cancer Research Network PhD Scholarship Top-up award. MCT is funded by a Ramón y Cajal fellowship (RYC-2017-01892) from the Spanish Ministry of Science, Innovation and Universities and co-funded by the European Social Fund. ISGlobal acknowledges support from the Spanish Ministry of Science and Innovation through the 'Centro de Excelencia Severo Ochoa 2019–2023' Program (CEX2018-000806-S), and support from the Generalitat de Catalunya through the CERCA Program. The INTEROCC Study was supported by the NIH (grant no. 1R01CA124759).

    • Competing interests None declared.

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

    • Supplemental material This content has been supplied by the author(s). It has not been vetted by BMJ Publishing Group Limited (BMJ) and may not have been peer-reviewed. Any opinions or recommendations discussed are solely those of the author(s) and are not endorsed by BMJ. BMJ disclaims all liability and responsibility arising from any reliance placed on the content. Where the content includes any translated material, BMJ does not warrant the accuracy and reliability of the translations (including but not limited to local regulations, clinical guidelines, terminology, drug names and drug dosages), and is not responsible for any error and/or omissions arising from translation and adaptation or otherwise.