Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA.
Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, NC, USA.
Environ Int. 2019 Apr;125:229-235. doi: 10.1016/j.envint.2019.01.066. Epub 2019 Feb 2.
Epidemiologic studies suggest an increased risk of leukemia among individuals occupationally exposed to some organochlorine (OC) compounds. Associations between serum OC pesticide and polychlorinated biphenyl (PCB) levels and risk of acute myeloid leukemia (AML), the most common subtype of acute leukemia in adult populations, have not been evaluated prospectively in the general population.
We evaluated the risk of AML in relation to pre-diagnostic serum levels of OC pesticides and PCBs in a case-control study nested within the Janus Serum Bank Cohort.
Janus is a large population-based cohort containing biologic samples collected beginning in the early 1970s from ~318,000 individuals in Norway. Serum levels of 11 OC pesticides or their metabolites and 34 PCB congeners were measured in 56 AML cases and 288 controls. Conditional logistic regression was conducted to evaluate associations between lipid-adjusted serum OC levels and risk of AML.
Higher serum levels of total chlordane/heptachlor metabolites were associated with AML risk (3rd vs. 1st tertile odds ratio (OR) = 2.26, 95% confidence interval (CI) = 0.91-5.63; p = 0.11). Significant exposure-response associations were observed for levels of heptachlor epoxide (3rd vs. 1st tertile OR = 2.85, 95% CI = 1.05-7.73; p = 0.02) and dieldrin (3rd vs. 1st tertile OR = 2.71, 95% CI = 1.07-6.83; p = 0.03). No significant exposure-response associations with AML risk were observed for total DDT or individual isomers and derivatives. Higher serum levels of p,p'-DDT showed a non-significant increase in risk, but the exposure-response became attenuated when co-adjusting for heptachlor epoxide or dieldrin levels. Serum PCB levels were not significantly associated with AML risk.
Our data suggest that higher serum levels of dieldrin and metabolites derived from chlordane/heptachlor are associated with risk of AML in the general Norwegian population, based on samples collected on average ~17 years before diagnosis. Further research in populations with historically high or recent exposure to DDT is warranted to assess the association with AML risk with body burden of specific DDT isomers and derivatives.
流行病学研究表明，职业接触某些有机氯化合物（OC）的个体患白血病的风险增加。血清 OC 农药和多氯联苯（PCB）水平与急性髓系白血病（AML）风险之间的关联尚未在普通人群中进行前瞻性评估，AML 是成人人群中最常见的急性白血病亚型。
我们在 Janus 血清库队列中进行的病例对照研究中，评估了预诊断血清 OC 农药和 PCB 水平与 AML 风险之间的关系。
Janus 是一个大型基于人群的队列，包含 1970 年代初从挪威约 318000 个人中采集的生物样本。在 56 例 AML 病例和 288 例对照中测量了 11 种 OC 农药或其代谢物和 34 种 PCB 同系物的血清水平。采用条件逻辑回归评估脂质调整后的血清 OC 水平与 AML 风险之间的关系。
总氯丹/七氯代谢物血清水平较高与 AML 风险相关（第 3 与第 1 三分位比值比（OR）=2.26，95%置信区间（CI）=0.91-5.63；p=0.11）。对于七氯环氧化物（第 3 与第 1 三分位 OR=2.85，95%CI=1.05-7.73；p=0.02）和狄氏剂（第 3 与第 1 三分位 OR=2.71，95%CI=1.07-6.83；p=0.03）水平，观察到显著的暴露-反应关系。总滴滴涕或单个异构体和衍生物与 AML 风险无显著暴露-反应关系。较高的血清 p,p'-滴滴涕水平显示出非显著的风险增加，但当共同调整七氯环氧化物或狄氏剂水平时，暴露-反应减弱。血清 PCB 水平与 AML 风险无显著相关性。
基于平均约 17 年前采集的样本，我们的数据表明，在挪威普通人群中，血清中较高的狄氏剂和氯丹/七氯衍生代谢物水平与 AML 风险相关。需要在历史上或最近有滴滴涕高暴露人群中进行进一步研究，以评估特定滴滴涕异构体和衍生物的体内负荷与 AML 风险的关联。
