A case-control study of aplastic anaemia: occupational exposures. The French Cooperative Group for Epidemiological Study of Aplastic Anaemia.

BACKGROUND

Based on the national register of new cases of aplastic anaemia (AA) begun in France in 1984, a case-control study was conducted to explore the aetiology of the disease.

METHODS

Cases were all included in the French national register of AA. Two different groups of controls were derived with individual matching; one group from hospitalized patients in the same hospital; the other group from neighbours named by the case. A 15-year occupational history was collected through interview and then grouped into exposure categories by jobs done for one year or more. The study included 98 cases, 181 hospitalized controls, and 72 neighbours aged 18-70 years.

RESULTS

No differences appeared between the cases and both groups of controls relative to any group of occupation investigated. However, a borderline non-significant small excess for exposure to pesticides was observed among the cases when compared to hospitalized controls. Whatever the control group, no association was found between AA and exposure to solvents, ionizing radiation, fuel, oils and grease. A positive relationship between exposure to glues and AA was observed, as well as a trend towards an increased risk after exposure to paints.

CONCLUSIONS

This large-scale case-control study confirmed the vanishing role of previously known toxic substances in the aetiology of AA. However, a higher proportion of AA patients reported exposure to paints and to glues, a relationship which needs further investigation because of the diversity of compounds included in these products.