Schenk M, Purdue M P, Colt J S, Hartge P, Blair A, Stewart P, Cerhan J R, De Roos A J, Cozen W, Severson R K
Department of Family Medicine and Public Health Sciences, Karmanos Cancer Institute, Wayne State University, Detroit, Michigan 48201, USA.
Occup Environ Med. 2009 Jan;66(1):23-31. doi: 10.1136/oem.2007.036723. Epub 2008 Sep 19.
To identify occupations and industries associated with non-Hodgkin's lymphoma (NHL) in a large population-based, case-control study in the USA.
Cases (n = 1189) of histologically confirmed malignant NHL ages 20-74 were prospectively identified in four geographic areas covered by the National Cancer Institute SEER Program. Controls (n = 982) were selected from the general population by random digit dialling (<65 years of age) and from residents listed in Medicare files (65-74 years of age). Odds ratios and 95% confidence intervals for occupations and industries were calculated by unconditional logistic regression analyses, adjusting for age, gender, ethnicity and study centre. Further analyses stratified for gender and histological subtype were also performed.
Risk of NHL was increased for a few occupations and industries. Several white collar occupations, with no obvious hazardous exposures, had elevated risks, including purchasing agents and buyers, religious workers, physical therapists and information clerks. Occupations with excesses that may have exposures of interest include launderers and ironers, service occupations, food/beverage preparation supervisors, hand packers and packagers, roofing and siding, leather and leather products, transportation by air, nursing and personal care facilities, and specialty outpatient clinics. Significantly decreased risks of NHL were found for a number of occupations and industries including post-secondary teachers and chemical and allied products.
The results of this study suggest that several occupations and industries may alter the risk of NHL. Our results support previously reported increased risks among farmers, printers, medical professionals, electronic workers and leather workers. These findings should be evaluated further in larger studies that have the power to focus on specific exposures and histological subtypes of NHL.
在美国一项基于人群的大型病例对照研究中,确定与非霍奇金淋巴瘤(NHL)相关的职业和行业。
在国家癌症研究所监测、流行病学和最终结果(SEER)项目覆盖的四个地理区域,前瞻性地确定了1189例组织学确诊的20 - 74岁恶性NHL病例。通过随机数字拨号从一般人群中选取年龄小于65岁的对照(n = 982),从医疗保险档案中列出的居民中选取年龄在65 - 74岁的对照。通过无条件逻辑回归分析计算职业和行业的优势比及95%置信区间,并对年龄、性别、种族和研究中心进行调整。还进行了按性别和组织学亚型分层的进一步分析。
少数职业和行业的NHL风险增加。一些无明显有害暴露的白领职业风险升高,包括采购代理和采购员、宗教工作者、物理治疗师和信息员。可能存在感兴趣暴露的职业中风险过高的包括洗衣工和熨烫工、服务职业、食品/饮料制备主管、手工包装工和包装工、屋顶和壁板行业、皮革及皮革制品行业、航空运输业、护理和个人护理机构以及专科门诊诊所。在许多职业和行业中发现NHL风险显著降低,包括高等教育教师以及化学及相关产品行业。
本研究结果表明,一些职业和行业可能改变NHL的风险。我们的结果支持先前报道的农民、印刷工、医疗专业人员、电子工人和皮革工人中风险增加的情况。这些发现应在更大型的研究中进一步评估,这些研究有能力聚焦于NHL的特定暴露和组织学亚型。