Skip to main content
Occupational and Environmental Medicine logoLink to Occupational and Environmental Medicine
. 2001 Nov;58(11):722–727. doi: 10.1136/oem.58.11.722

Are occupational, hobby, or lifestyle exposures associated with Philadelphia chromosome positive chronic myeloid leukaemia?

J Bjork 1, M Albin 1, H Welinder 1, H Tinnerberg 1, N Mauritzson 1, T Kauppinen 1, U Stromberg 1, B Johansson 1, R Billstrom 1, Z Mikoczy 1, T Ahlgren 1, P Nilsson 1, F Mitelman 1, L Hagmar 1
PMCID: PMC1740065  PMID: 11600728

Abstract

OBJECTIVES—To investigate a broad range of occupational, hobby, and lifestyle exposures, suggested as risk factors for Philadelphia chromosome positive (Ph+) chronic myeloid leukaemia (CML).
METHODS—A case-control study, comprising 255 Ph+CML patients from southern Sweden and matched controls, was conducted. Individual data on work tasks, hobbies, and lifestyle exposures were obtained by telephone interviews. Occupational hygienists assessed occupational and hobby exposures for each subject individually. Also, occupational titles were obtained from national registries, and group level exposure—that is, the exposure proportion for each occupational title—was assessed with a job exposure matrix. The effects of 11 exposures using individual data and two exposures using group data (organic solvents and animal dust) were estimated.
RESULTS—For the individual data on organic solvents, an effect was found for moderate or high intensity of exposure (odds ratio (OR) 3.4, 95% confidence interval (95% CI) 1.1 to 11) and for long duration (15-20 years) of exposure (OR 2.1, 95% CI 1.1 to 4.0). By contrast, the group data showed no association (OR 0.69, 95% CI 0.27 to 1.8; moderate or high intensity versus no exposure). For extremely low frequency electromagnetic fields (EMFs), only individual data were available. An association with long occupational exposure to EMFs was found (OR 2.3, 95% CI 1.2 to 4.5). However, no effect of EMF intensity was indicated. No significant effects of benzene, gasoline or diesel, or tobacco smoking were found. OR estimates below unity were suggested for personal use of hair dye and for agricultural exposures.
CONCLUSIONS—Associations between exposure to organic solvents and EMFs, and Ph+CML were indicated but were not entirely consistent.


Keywords: risk factors; epidemiology; case-control study

Full Text

The Full Text of this article is available as a PDF (159.1 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Ahlbom A., Day N., Feychting M., Roman E., Skinner J., Dockerty J., Linet M., McBride M., Michaelis J., Olsen J. H. A pooled analysis of magnetic fields and childhood leukaemia. Br J Cancer. 2000 Sep;83(5):692–698. doi: 10.1054/bjoc.2000.1376. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Albin M., Björk J., Welinder H., Tinnerberg H., Mauritzson N., Johansson B., Billström R., Strömberg U., Mikoczy Z., Ahlgren T. Acute myeloid leukemia and clonal chromosome aberrations in relation to past exposure to organic solvents. Scand J Work Environ Health. 2000 Dec;26(6):482–491. doi: 10.5271/sjweh.572. [DOI] [PubMed] [Google Scholar]
  3. Björk J., Albin M., Mauritzson N., Strömberg U., Johansson B., Hagmar L. Smoking and acute myeloid leukemia: associations with morphology and karyotypic patterns and evaluation of dose-response relations. Leuk Res. 2001 Oct;25(10):865–872. doi: 10.1016/s0145-2126(01)00048-0. [DOI] [PubMed] [Google Scholar]
  4. Björk J., Albin M., Mauritzson N., Strömberg U., Johansson B., Hagmar L. Smoking and myelodysplastic syndromes. Epidemiology. 2000 May;11(3):285–291. doi: 10.1097/00001648-200005000-00010. [DOI] [PubMed] [Google Scholar]
  5. Blair A., White D. W. Leukemia cell types and agricultural practices in Nebraska. Arch Environ Health. 1985 Jul-Aug;40(4):211–214. doi: 10.1080/00039896.1985.10545920. [DOI] [PubMed] [Google Scholar]
  6. Bouyer J., Dardenne J., Hémon D. Performance of odds ratios obtained with a job-exposure matrix and individual exposure assessment with special reference to misclassification errors. Scand J Work Environ Health. 1995 Aug;21(4):265–271. doi: 10.5271/sjweh.36. [DOI] [PubMed] [Google Scholar]
  7. Bouyer J., Hémon D. Comparison of three methods of estimating odds ratios from a job exposure matrix in occupational case-control studies. Am J Epidemiol. 1993 Feb 15;137(4):472–481. doi: 10.1093/oxfordjournals.aje.a116696. [DOI] [PubMed] [Google Scholar]
  8. Brownson R. C., Novotny T. E., Perry M. C. Cigarette smoking and adult leukemia. A meta-analysis. Arch Intern Med. 1993 Feb 22;153(4):469–475. [PubMed] [Google Scholar]
  9. Doll R. Cancers weakly related to smoking. Br Med Bull. 1996 Jan;52(1):35–49. doi: 10.1093/oxfordjournals.bmb.a011531. [DOI] [PubMed] [Google Scholar]
  10. Doll R., Peto R. Mortality in relation to smoking: 20 years' observations on male British doctors. Br Med J. 1976 Dec 25;2(6051):1525–1536. doi: 10.1136/bmj.2.6051.1525. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Dosemeci M., Wacholder S., Lubin J. H. Does nondifferential misclassification of exposure always bias a true effect toward the null value? Am J Epidemiol. 1990 Oct;132(4):746–748. doi: 10.1093/oxfordjournals.aje.a115716. [DOI] [PubMed] [Google Scholar]
  12. Floderus B, Persson T, Stenlund C. Magnetic-field Exposures in the Workplace: Reference Distribution and Exposures in Occupational Groups. Int J Occup Environ Health. 1996 Jul;2(3):226–238. doi: 10.1179/oeh.1996.2.3.226. [DOI] [PubMed] [Google Scholar]
  13. Gentile G., Mele A., Monarco B., Vitale A., Pulsoni A., Visani G., Castelli G., Rapicetta M., Verani P., Martino P. Hepatitis B and C viruses, human T-cell lymphotropic virus types I and II, and leukemias: a case-control study. The Italian Leukemia Study Group. Cancer Epidemiol Biomarkers Prev. 1996 Mar;5(3):227–230. [PubMed] [Google Scholar]
  14. Hayes R. B., Yin S. N., Dosemeci M., Li G. L., Wacholder S., Travis L. B., Li C. Y., Rothman N., Hoover R. N., Linet M. S. Benzene and the dose-related incidence of hematologic neoplasms in China. Chinese Academy of Preventive Medicine--National Cancer Institute Benzene Study Group. J Natl Cancer Inst. 1997 Jul 16;89(14):1065–1071. doi: 10.1093/jnci/89.14.1065. [DOI] [PubMed] [Google Scholar]
  15. Kauppinen T., Toikkanen J., Pukkala E. From cross-tabulations to multipurpose exposure information systems: a new job-exposure matrix. Am J Ind Med. 1998 Apr;33(4):409–417. doi: 10.1002/(sici)1097-0274(199804)33:4<409::aid-ajim12>3.0.co;2-2. [DOI] [PubMed] [Google Scholar]
  16. Keller-Byrne J. E., Khuder S. A., Schaub E. A. Meta-analysis of leukemia and farming. Environ Res. 1995 Oct;71(1):1–10. doi: 10.1006/enrs.1995.1060. [DOI] [PubMed] [Google Scholar]
  17. Kheifets L. I., Afifi A. A., Buffler P. A., Zhang Z. W., Matkin C. C. Occupational electric and magnetic field exposure and leukemia. A meta-analysis. J Occup Environ Med. 1997 Nov;39(11):1074–1091. doi: 10.1097/00043764-199711000-00008. [DOI] [PubMed] [Google Scholar]
  18. Mauritzson N., Johansson B., Albin M., Billström R., Ahlgren T., Mikoczy Z., Nilsson P. G., Hagmar L., Mitelman F. A single-center population-based consecutive series of 1500 cytogenetically investigated adult hematological malignancies: karyotypic features in relation to morphology, age and gender. Eur J Haematol. 1999 Feb;62(2):95–102. doi: 10.1111/j.1600-0609.1999.tb01728.x. [DOI] [PubMed] [Google Scholar]
  19. McKinney P. A., Roberts B. E., O'Brien C., Bird C. C., Richards I. D., Alexander F., Cartwright R. A. Chronic myeloid leukaemia in Yorkshire: a case control study. Acta Haematol. 1990;83(1):35–38. doi: 10.1159/000205160. [DOI] [PubMed] [Google Scholar]
  20. Mele A., Szklo M., Visani G., Stazi M. A., Castelli G., Pasquini P., Mandelli F. Hair dye use and other risk factors for leukemia and pre-leukemia: a case-control study. Italian Leukemia Study Group. Am J Epidemiol. 1994 Mar 15;139(6):609–619. doi: 10.1093/oxfordjournals.aje.a117050. [DOI] [PubMed] [Google Scholar]
  21. Pedersen-Bjergaard J., Brøndum-Nielsen K., Karle H., Johansson B. Chemotherapy-related - late occurring - Philadelphia chromosome in AML, ALL and CML. Similar events related to treatment with DNA topoisomerase II inhibitors? Leukemia. 1997 Sep;11(9):1571–1574. doi: 10.1038/sj.leu.2400769. [DOI] [PubMed] [Google Scholar]
  22. Raabe G. K., Wong O. Leukemia mortality by cell type in petroleum workers with potential exposure to benzene. Environ Health Perspect. 1996 Dec;104 (Suppl 6):1381–1392. doi: 10.1289/ehp.961041381. [DOI] [PMC free article] [PubMed] [Google Scholar]
  23. Sandler D. P. Recent studies in leukemia epidemiology. Curr Opin Oncol. 1995 Jan;7(1):12–18. [PubMed] [Google Scholar]
  24. Sawyers C. L. Chronic myeloid leukemia. N Engl J Med. 1999 Apr 29;340(17):1330–1340. doi: 10.1056/NEJM199904293401706. [DOI] [PubMed] [Google Scholar]
  25. Siegel M. Smoking and leukemia: evaluation of a causal hypothesis. Am J Epidemiol. 1993 Jul 1;138(1):1–9. doi: 10.1093/oxfordjournals.aje.a116772. [DOI] [PubMed] [Google Scholar]

Articles from Occupational and Environmental Medicine are provided here courtesy of BMJ Publishing Group

RESOURCES