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Occupational risk factors for non‐Hodgkin's lymphoma: A population‐based case–control study in Northern Germany
Author(s) -
Richardson David B.,
Terschüren Claudia,
Hoffmann Wolfgang
Publication year - 2008
Publication title -
american journal of industrial medicine
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.7
H-Index - 104
eISSN - 1097-0274
pISSN - 0271-3586
DOI - 10.1002/ajim.20552
Subject(s) - medicine , odds ratio , population , confidence interval , risk factor , non hodgkin's lymphoma , lymphoma , environmental health
Objectives To identify occupational factors associated with non‐Hodgkin's lymphoma (NHL). Methods A population‐based case–control study was conducted in which incident cases of high‐malignancy NHL (NHL high ), low‐malignancy NHL (NHL low ), and chronic lymphocytic leukemia (CLL) were ascertained during the period 1986–1998 among men and women aged 15–75 years residing in six German counties; controls were drawn from population registries. Occupational histories were collected and agent‐specific exposures were estimated via a job‐exposure‐matrix. Odds ratios were estimated by conditional logistic regression. Results A total of 858 cases were included in these analyses. Agricultural workers [odds ratio (OR) = 2.67, 95% confidence interval (CI): 0.99, 7.21) and farmers (OR = 1.98, 95% CI: 0.98, 3.98] had elevated risk of NHL high . Risk of NHL low was elevated among agricultural workers (OR = 2.46, 95% CI: 1.17, 5.16), and among blacksmiths, toolmakers, and machine tool operators (OR = 3.12, 95% CI: 1.31, 7.47). Workers in sales and construction had elevated risks of NHL high and NHL low . Exposure to arsenic compounds, chlorophenols, diesel fuel, herbicides, nitrites/nitrates/nitrosamines, and organic dusts were associated with NHL high and NHL low , while exhibiting little association with CLL. A positive monotonic trend in NHL low risk across tertiles of cumulative diesel fuel exposure was observed [ P ‐value for test of linear trend ( P ) = 0.03]. Conclusions These findings provide insights into several potential occupational risk factors for NHL and suggest some specific occupational agents for further investigation. Am. J. Ind. Med. 51:258–268, 2008. © 2008 Wiley‐Liss, Inc.