Program in Epidemiology, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA.
Occup Environ Med. 2011 Jun;68(6):391-9. doi: 10.1136/oem.2009.054809. Epub 2010 Sep 10.
Few studies have examined whether exposure to chlorinated solvents is associated with multiple myeloma. We evaluated associations between multiple myeloma and occupational exposure to six chlorinated solvents: 1,1,1-trichloroethane, trichloroethylene (TCE), methylene chloride (DCM), perchloroethylene, carbon tetrachloride and chloroform.
In-person interviews obtained occupational histories and information on jobs with likely solvent exposure. We assigned exposure metrics of probability, frequency, intensity and confidence using job-exposure matrices modified by job-specific questionnaire information. We used logistic regression to estimate ORs and 95% CIs for associations between multiple myeloma and ever exposure to each, and any, chlorinated solvent and analysed whether associations varied by duration and cumulative exposure. We also considered all occupations that were given the lowest confidence scores as unexposed and repeated all analyses.
Risk of multiple myeloma was elevated for subjects ever exposed to 1,1,1-trichloroethane (OR (95% CI): 1.8 (1.1 to 2.9)). Ever exposure to TCE or DCM also entailed elevated, but not statistically significant, risks of multiple myeloma; these became statistically significant when occupations with low confidence scores were considered unexposed (TCE: 1.7 (1.0 to 2.7); DCM: 2.0 (1.2 to 3.2)). Increasing cumulative exposure to perchloroethylene was also associated with increasing multiple myeloma risk. We observed non-significantly increased multiple myeloma risks with exposure to chloroform; however, few subjects were exposed.
Evidence from this relatively large case-control study suggests that exposures to certain chlorinated solvents may be associated with increased incidence of multiple myeloma; however, the study is limited by relatively low participation (52%) among controls.
鲜有研究探讨接触氯化溶剂是否与多发性骨髓瘤相关。我们评估了六种氯化溶剂（1,1,1-三氯乙烷、三氯乙烯（TCE）、二氯甲烷（DCM）、四氯乙烯、四氯化碳和氯仿）的职业暴露与多发性骨髓瘤之间的关系。
通过面对面访谈获得职业史和可能存在溶剂暴露的工作信息。我们使用职业暴露矩阵，并结合工作特异性调查问卷信息，对暴露概率、频率、强度和置信度进行赋值。我们使用逻辑回归估计多发性骨髓瘤与每种氯化溶剂以及任何氯化溶剂的暴露之间的比值比（OR）和 95%置信区间（CI），并分析关联是否因暴露持续时间和累积暴露量而有所差异。我们还考虑了所有置信度评分最低的职业为未暴露，并重复了所有分析。
与从未接触过 1,1,1-三氯乙烷的个体相比，曾接触过 1,1,1-三氯乙烷的个体多发性骨髓瘤的发病风险升高（OR（95%CI）：1.8（1.1 至 2.9））。曾接触 TCE 或 DCM 的个体也存在多发性骨髓瘤发病风险升高的趋势，但无统计学意义；当置信度评分较低的职业被视为未暴露时，这种趋势变得具有统计学意义（TCE：1.7（1.0 至 2.7）；DCM：2.0（1.2 至 3.2））。四氯乙烯的累积暴露量增加也与多发性骨髓瘤风险增加相关。我们观察到接触氯仿与多发性骨髓瘤风险呈非显著增加趋势；然而，接触氯仿的个体较少。
这项相对较大的病例对照研究提供了证据表明，接触某些氯化溶剂可能与多发性骨髓瘤发病率增加相关；然而，该研究受到对照组参与率相对较低（52%）的限制。
