Occupational exposures and malignant lymphoma
1995 (English)Doctoral thesis, comprehensive summary (Other academic)
The incidence of malignant lymphoma, especially non-Hodgkin's lymphoma (NHL) has increased over the last few decades. This statement is true despite the fact that methods for diagnosing malignant lymphoma has changed and misclassification has been a problem. In the present series of investigations, various occupational and non-occupational exposures were studied as possible determinants of malignant lymphomas, i.e. both Hodgkin's disease (HD) and NHL.
Two questionnaireMbased case-referent studies were performed in the central part of Sweden. It was noted that exposure to solvents and to phenoxy herbicides involved increased risks for HD and NHL, whereas farming was not associated with an increased risk for NHL. Exposure to wood might also appem·ed as a determinant of risk.
A pooled analysis of the two case-referent studies was performed to focus on biological interactions and rare exposmes. The analyses included three steps: ascertaining Mantel-Haenszel odds ratios (MHOR) stratified on age and gender, calculating logistic odds ratios (LOR) and determining biological interactions. Occupational exposure to various solvents, e.g. white spirit (MHOR 2.6), thinner (MHOR 1. 9), gasoline (MHOR 1.9) and aviation gasoline (.MHOR 3.5), was found to be connected with increased risks. Moreover, paper pulp workers and painters appeared with increased risks (MHOR 2.4 and 2.5, respectively). When confounding also from other exposures not only age and gender was considered, occupational exposure to plastic and rubber chemicals (LOR 2.2), phenoxy herbicides (LOR 2.6) and wood preservatives (LOR 2.6) showed increased risks. Lrunberjacking was also associated with an increased risk (LOR 1. 7), whereas no clearly increased risk was connected with exposure to dry wood among carpenters and cabinet-makers (LOR 1.1 ). A synergistic effect was found for combined exposures to solvents and phenoxy herbicides and to solvents and rubber and plastic chemicals.
Pulp and paper mill workers were investigated by using the registers of deaths and burials. Several causes of death were considered, and malignant lymphoma mortality was found to be doubled.
As most of the studies had included only living subjects, a study was performed in order to evaluate the potential bias of incomplete ascertainment of cases. No bias could be verified in this respect.
Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 1995. , 53 p.
Linköping University Medical Dissertations, ISSN 0345-0082 ; 475
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:liu:diva-28624Local ID: 13780ISBN: 91-7871-329-3OAI: oai:DiVA.org:liu-28624DiVA: diva2:249435
1995-12-19, Administrationsbyggnadens aula, Universitetssjukhuset, Linköping, 09:00 (Swedish)
Papers, included in the Ph.D. thesis, are not registered and included in the posts from 1999 and backwards.2009-10-092009-10-092012-07-16Bibliographically approved