Pasqualetti P, Casale R, Collacciani A, Colantonio D
Dipartimento di Medicina Interna e Sanità Publica, Università degli Studi di L'Aquila.
Med Lav. 1990 Jul-Aug;81(4):308-19.
The incidence of multiple myeloma is increasing in western countries, and several environmental and occupational risk factors have been suggested to explain this trend. A case-control study was conducted in order to investigate the relationship between occupation, exposure to chemicals, and risk of multiple myeloma. A total of 170 cases of multiple myeloma, 98 males and 72 females, aged 43-84 (mean age = 67 D.S. = 10), and 170 matched hospital controls (mean age = 68 D.S. = 9) were identified for the years 1970-1988. All subjects were interviewed about socioeconomic status, current or previous occupation, and if they had ever been exposed to one or more of a list of toxic substances. Exposure were grouped in 21 risk categories. Poor socioeconomic status was associated with a significant risk for multiple myeloma (OR = 2.8; 95% Confidence Interval: 1.61-3.05), as well as agricultural work (OR = 2.71; 95% CI: 1.87-4.42), and work in industry (OR = 3.20; 95% CI: 2.00-5.75). Regarding toxic substance exposure, a significant association was found for asbestos (OR = 4.00; 95% CI: 2.02-8.05), mineral oils (OR = 3.00; 95% CI: 1.98-5.08), pesticides (OR = 2.83; 95% CI: 1.87-4.78), and radiation (OR = 9.00; 95% CI: 0.81-21.73). No significant association was demonstrated for alcohol intake and tobacco smoking. High odds ratios were also found for fertilizers, paints, cosmetics and/or hairdressing products, and dust. These findings agree with previously reported studies, suggesting a relationship between some occupational exposures and the risk of multiple myeloma. The data, however, require clarification in prospective, larger, population-based studies.
西方国家多发性骨髓瘤的发病率正在上升，有人提出一些环境和职业风险因素来解释这一趋势。为了调查职业、化学物质暴露与多发性骨髓瘤风险之间的关系，开展了一项病例对照研究。在1970年至1988年期间，共确定了170例多发性骨髓瘤病例，其中男性98例，女性72例，年龄在43至84岁之间（平均年龄 = 67岁，标准差 = 10），以及170名匹配的医院对照者（平均年龄 = 68岁，标准差 = 9）。所有受试者都接受了关于社会经济地位、当前或以前职业的访谈，以及他们是否曾接触过一系列有毒物质中的一种或多种。暴露被分为21个风险类别。社会经济地位低下与多发性骨髓瘤的显著风险相关（比值比 = 2.8；95%置信区间：1.61 - 3.05），农业工作（比值比 = 2.71；95%置信区间：1.87 - 4.42）和工业工作（比值比 = 3.20；95%置信区间：2.00 - 5.75）也是如此。关于有毒物质暴露，发现石棉（比值比 = 4.00；95%置信区间：2.02 - 8.05）、矿物油（比值比 = 3.00；95%置信区间：1.98 - 5.08）、农药（比值比 = 2.83；95%置信区间：1.87 - 4.78）和辐射（比值比 = 9.00；95%置信区间：0.81 - 21.73）存在显著关联。未发现酒精摄入和吸烟有显著关联。在肥料、油漆、化妆品和/或美发产品以及粉尘方面也发现了高比值比。这些发现与先前报道的研究一致，表明某些职业暴露与多发性骨髓瘤风险之间存在关联。然而，这些数据需要在前瞻性、更大规模的基于人群的研究中加以澄清。
