Miligi Lucia, Costantini Adele Seniori, Benvenuti Alessandra, Kriebel David, Bolejack Vanessa, Tumino Rosario, Ramazzotti Valerio, Rodella Stefania, Stagnaro Emanuele, Crosignani Paolo, Amadori Dino, Mirabelli Dario, Sommani Letizia, Belletti Isabella, Troschel Loredana, Romeo Luciano, Miceli Giuseppe, Tozzi Giulio Andrea, Mendico Igino, Vineis Paolo
Istituto Toscano Tumori, Unit of Environmental and Occupational Epidemiology, Centre for Study and Prevention of Cancer, Via di S. Salvi 12, 50135 Florence, Italy.
Epidemiology. 2006 Sep;17(5):552-61. doi: 10.1097/01.ede.0000231279.30988.4d.
A number of studies have shown possible associations between occupational exposures, particularly solvents, and lymphomas. The present investigation aimed to evaluate the association between exposure to solvents and lymphomas (Hodgkin and non-Hodgkin) in a large population-based, multicenter, case-control study in Italy.
All newly diagnosed cases of malignant lymphoma in men and women age 20 to 74 years in 1991-1993 were identified in 8 areas in Italy. The control group was formed by a random sample of the general population in the areas under study stratified by sex and 5-year age groups. We interviewed 1428 non-Hodgkin lymphoma cases, 304 Hodgkin disease cases, and 1530 controls. Experts examined the questionnaire data and assessed a level of probability and intensity of exposure to a range of chemicals.
Those in the medium/high level of exposure had an increased risk of non-Hodgkin lymphoma with exposure to toluene (odds ratio = 1.8; 95% confidence interval = 1.1-2.8), xylene 1.7 (1.0-2.6), and benzene 1.6 (1.0-2.4). Subjects exposed to all 3 aromatic hydrocarbons (benzene, toluene, and xylene; medium/high intensity compared with none) had an odds ratio of 2.1 (1.1-4.3). We observed an increased risk for Hodgkin disease for those exposed to technical solvents (2.7; 1.2-6.5) and aliphatic solvents (2.7; 1.2-5.7).
This study suggests that aromatic and chlorinated hydrocarbons are a risk factor for non-Hodgkin lymphomas, and provides preliminary evidence for an association between solvents and Hodgkin disease.
多项研究表明职业暴露，尤其是溶剂暴露，与淋巴瘤之间可能存在关联。本调查旨在通过意大利一项基于人群的大型多中心病例对照研究，评估溶剂暴露与淋巴瘤（霍奇金淋巴瘤和非霍奇金淋巴瘤）之间的关联。
在意大利的8个地区识别出1991 - 1993年期间所有新诊断的年龄在20至74岁的男性和女性恶性淋巴瘤病例。对照组由所研究地区按性别和5岁年龄组分层的普通人群随机样本组成。我们对1428例非霍奇金淋巴瘤病例、304例霍奇金病病例和1530名对照进行了访谈。专家检查了问卷数据，并评估了接触一系列化学物质的可能性水平和强度。
中/高暴露水平人群接触甲苯时患非霍奇金淋巴瘤的风险增加（比值比 = 1.8；95%置信区间 = 1.1 - 2.8），接触二甲苯时为1.7（1.0 - 2.6），接触苯时为1.6（1.0 - 2.4）。接触所有3种芳烃（苯、甲苯和二甲苯；中/高强度与无接触相比）的受试者比值比为2.1（1.1 - 4.3）。我们观察到接触工业溶剂（2.7；1.2 - 6.5）和脂肪族溶剂（2.7；1.2 - 5.7）的人患霍奇金病的风险增加。
本研究表明芳烃和氯代烃是非霍奇金淋巴瘤的一个风险因素，并为溶剂与霍奇金病之间的关联提供了初步证据。
