Talibov Madar, Auvinen Anssi, Weiderpass Elisabete, Hansen Johnni, Martinsen Jan-Ivar, Kjaerheim Kristina, Tryggvadottir Laufey, Pukkala Eero
Faculty of Social Sciences, University of Tampere, Tampere, Finland.
Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
Int J Cancer. 2017 Sep 15;141(6):1140-1147. doi: 10.1002/ijc.30814. Epub 2017 Jun 15.
The aim of this study was to assess the effect of occupational solvent exposure on the risk of adult chronic lymphocytic leukemia (CLL). The current case-control study was nested in the Nordic Occupational Cancer Study (NOCCA) cohort. 20,615 CLL cases diagnosed in 1961-2005 in Finland, Iceland, Norway, and Sweden, and 103,075 population-based controls matched by year of birth, sex, and country were included. Occupational histories for cases and controls were obtained from census records in 1960, 1970, 1980/1981, and 1990. Exposure to selected solvents was estimated by using the NOCCA job-exposure matrix (NOCCA-JEM). Odds ratios (OR) and 95% confidence intervals (95% CI) were estimated by using conditional logistic regression models. Overall, nonsignificant CLL risk elevations were observed for methylene chloride, perchloroethylene, and 1,1,1-trichloroethane. Compared to unexposed, significantly increased risks were observed for cumulative perchloroethylene exposure ≤13.3 ppm-years (OR = 1.85, 95% CI 1.16-2.96) and average life-time perchloroethylene exposure ≤2.5 ppm (1.61, 95% CI 1.01-2.56) among women, and cumulative methylene chloride exposure ≤12.5 ppm-years (OR = 1.19, 95% CI 1.01-1.41) and 12.5-74.8 ppm-years (OR = 1.23, 95% CI 1.01-1.51) among men in an analysis with 5 years lag-time, though without dose-response pattern. Decreased CLL risk was observed for aliphatic and alicyclic hydrocarbon solvents and toluene. This study did not support associations for solvent exposure and CLL. Observed weak associations for methylene chloride, perchloroethylene, 1,1,1-trichloroethane exposures, aliphatic and alicyclic hydrocarbons and toluene were not consistent across sexes, and showed no gradient with amount of exposure.
本研究的目的是评估职业性接触溶剂对成人慢性淋巴细胞白血病（CLL）风险的影响。当前的病例对照研究嵌套于北欧职业癌症研究（NOCCA）队列中。纳入了1961年至2005年在芬兰、冰岛、挪威和瑞典诊断出的20615例CLL病例，以及按出生年份、性别和国家匹配的103075名基于人群的对照。病例和对照的职业史来自1960年、1970年、1980/1981年和1990年的人口普查记录。使用NOCCA工作接触矩阵（NOCCA-JEM）估计对选定溶剂的接触情况。使用条件逻辑回归模型估计比值比（OR）和95%置信区间（95%CI）。总体而言，观察到二氯甲烷、全氯乙烯和1,1,1-三氯乙烷的CLL风险升高不显著。与未接触者相比，在一项有5年滞后时间的分析中，女性累积全氯乙烯接触量≤13.3 ppm-年（OR = 1.85，95%CI 1.16 - 2.96）和平均终身全氯乙烯接触量≤2.5 ppm（1.61，95%CI 1.01 - 2.56）时，风险显著增加；男性累积二氯甲烷接触量≤12.5 ppm-年（OR = 1.19，95%CI 1.01 - 1.41）和12.5 - 74.8 ppm-年（OR = 1.23，95%CI 1.01 - 1.51）时，风险显著增加，不过没有剂量反应模式。观察到脂肪族和脂环族烃类溶剂以及甲苯的CLL风险降低。本研究不支持溶剂接触与CLL之间的关联。观察到的二氯甲烷、全氯乙烯、1,1,1-三氯乙烷接触、脂肪族和脂环族烃类以及甲苯之间的微弱关联在性别上不一致，且未显示出接触量的梯度关系。
