Richardson David B, Terschüren Claudia, Hoffmann Wolfgang
Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
Am J Ind Med. 2008 Apr;51(4):258-68. doi: 10.1002/ajim.20552.
To identify occupational factors associated with non-Hodgkin's lymphoma (NHL).
A population-based case-control study was conducted in which incident cases of high-malignancy NHL (NHL(high)), low-malignancy NHL (NHL(low)), and chronic lymphocytic leukemia (CLL) were ascertained during the period 1986-1998 among men and women aged 15-75 years residing in six German counties; controls were drawn from population registries. Occupational histories were collected and agent-specific exposures were estimated via a job-exposure-matrix. Odds ratios were estimated by conditional logistic regression.
A total of 858 cases were included in these analyses. Agricultural workers [odds ratio (OR) = 2.67, 95% confidence interval (CI): 0.99, 7.21) and farmers (OR = 1.98, 95% CI: 0.98, 3.98] had elevated risk of NHL(high). Risk of NHL(low) was elevated among agricultural workers (OR = 2.46, 95% CI: 1.17, 5.16), and among blacksmiths, toolmakers, and machine tool operators (OR = 3.12, 95% CI: 1.31, 7.47). Workers in sales and construction had elevated risks of NHL(high) and NHL(low). Exposure to arsenic compounds, chlorophenols, diesel fuel, herbicides, nitrites/nitrates/nitrosamines, and organic dusts were associated with NHL(high) and NHL(low), while exhibiting little association with CLL. A positive monotonic trend in NHL(low) risk across tertiles of cumulative diesel fuel exposure was observed [P-value for test of linear trend (P) = 0.03].
These findings provide insights into several potential occupational risk factors for NHL and suggest some specific occupational agents for further investigation.
确定与非霍奇金淋巴瘤（NHL）相关的职业因素。
开展一项基于人群的病例对照研究，在1986年至1998年期间，对居住在德国六个县的15至75岁男女中的高恶性NHL（NHL(高)）、低恶性NHL（NHL(低)）和慢性淋巴细胞白血病（CLL）的新发病例进行确诊；对照从人口登记处选取。收集职业史，并通过工作暴露矩阵估计特定接触剂的暴露情况。通过条件逻辑回归估计比值比。
这些分析共纳入858例病例。农业工人[比值比（OR）=2.67，95%置信区间（CI）：0.99，7.21]和农民（OR =1.98，95% CI：0.98，3.98）患NHL(高)的风险升高。农业工人（OR =2.46，95% CI：1.17，5.16）以及铁匠、工具制造工人和机床操作员（OR =3.12，95% CI：1.31，7.47）患NHL(低)的风险升高。销售和建筑行业的工人患NHL(高)和NHL(低)的风险升高。接触砷化合物、氯酚、柴油、除草剂、亚硝酸盐/硝酸盐/亚硝胺和有机粉尘与NHL(高)和NHL(低)相关，而与CLL的关联较小。在累积柴油暴露三分位数中，观察到NHL(低)风险呈正单调趋势[线性趋势检验的P值（P）=0.03]。
这些发现为NHL的几种潜在职业风险因素提供了见解，并提示了一些特定职业接触剂以供进一步研究。
