Table 7.

Cohort studies of formaldehyde exposures and exposures and lymphohematopoietic malignancies

Authors (Years), Country	Cohort description Type of analysis (cohort size)	Exposure assessment	Results SMR or PMR (95% CI)
Walrath et al. (1983), USA [39]	Embalmers and funeral directors, PMR/PCMR (1132 white men); 1925–80	Time since first license, age at first license	LHM 25 deaths PMR 1.21 Leukemia 12 deaths PCMR 1.19 Myeloid leukemia 6 deaths PCMR 1.5
Walrath et al. (1984), USA [40]	Embalmers, PMR/PCMR(1007 white men)	Duration	LHM 19 deaths PCMR 1.22 Leukemia 12 deaths PCMR 1.40 Myeloid leukemia 6 deaths PCMR 1.50
Levine et al. (1984), Canada [41]	Embalmers, SMR(1413 men); 1950–77	None	LHM 8 deaths SMR 1.23 (0.53–2.43) Leukemia 4 deaths SMR 1.60 (0.44–4.10)
Stroup et al. (1986), USA [42]	Anatomists, SMR (2239 men); 1925–79	Duration	LHM 18 deaths SMR 1.2 (0.7–2.0) Lymphoma 2 deaths SMR 0.7 (0.1–2.5) Leukemia 10 deaths SMR 1.5 (0.7–2.7) CML 3 deaths SMR 8.8 (1.8–25.5) Other lymphoma 6 deaths SMR 2.0 (0.7–4.4)
Logue et al. (1986), USA [43]	Pathologists, SMR (5585 men); 1962–77	None	LHM SMR 0.48 Leukemia SMR 1.06
Hayes et al. (1990), USA [44]	Embalmers/funeral directors, PMR(3649 white men, 397 non-white men); 1975–85	None	LHM 100 deaths PMR 1.31 (1.06–1.59) (White) 15 deaths PMR 2.41 (1.35–3.97) (Non-white) Myeloid leukemia 23 deaths PMR 1.61 (1.02–2.41) (White) 1 death PMR 1.06 (0.02–5.93) (Non-white) Other unspecified leukemia 17 deaths PMR 2.08 (1.21–3.34) (White) 3 deaths PMR 4.92 (1.01–14.36) (Non-white)
Hall et al. (1991), UK [45]	Pathologists; SMR; 4512 (data presented for 3872, 802 women, 3069 men); 1974–87	None	LHM 10 deaths SMR 1.44 (0.69–2.65) Hodgkin lymphoma 1 death SMR 1.21 (0.03–6.71) Leukemia 10 deaths SMR 1.5 (0.7–2)
Hauptmann et al. (2003), USA [46]	The cohort composed of 10 plants of manufacture of or using by the National Cancer Institute during 1966–1994; Standardized mortality (25,619 workers; 22,493 men, 3126 women) and Relative risks	Duration; quantitative estimates of cumulative, average and highest peak exposure	Peak exposure (ppm) LHM 2.0–3.9 RR 1.71 (1.14–2.58) ≥4 RR 1.87 (1.27–2.75) (p-trend, 0.002) Leukemia 2.0–3.9 RR 2.04 (1.04–4.01) ≥4 RR 2.46 (1.31–4.62) (p-trend, 0.004) Myeloid leukemia ≥4 RR 3.46 (1.27–9.43) (p-trend, 0.009)
Freeman et al. (2009), USA [47]	Update of Hauptmann et al.(2003); 1966–2004	Duration; quantitative estimates of cumulative, average and highest peak exposure	Peak exposure (ppm) LHM ≥4 RR 1.37 (1.03–1.81) (p-trend, 0.02) Hodgkin lymphoma 2.0–3.9 RR 3.30 (1.04–10.50) ≥4 RR 3.96 (1.31–12.02) (p-trend, 0.01)
Checkoway et al. (2015), USA [48]	Re-analyses of Freeman et al. (2009), Analysis of full cohort (n = 25,619) and workers employed 1 year or longer (n = 16,306); Cox proportional hazards analyses; 1966–2004	Duration; quantitative estimates of cumulative, average and highest peak exposure	Worked ≥1 year, Peak Exposure (ppm) Hodgkin lymphoma ≥2.0–< 4 HR 3.50 (1.06–11.56) ≥4 HR 5.13 (1.67–15.77) (p-trend, 0.003) All leukemia ≥2.0–< 4 HR 2.46 (1.29–4.67) ≥ HR 2.45 (1.32–4.52) (p-trend, 0.002)
Coggon et al. (2003), UK [23]	Garment industry; Standardized Mortality (11,039 workers), 1955–1998	Duration, time since first exposure, year of first exposure	LHM 59 deaths SMR 0.97 (0.74–1.26) Leukemia 24 deaths SMR 1.09 (0.70–1.62) Myeloid leukemia 15 death SMR 1.44 (0.80–2.37)
Coggon et al. (2014), UK [24]	Update of Pinkerton et al., (2004). (11,043 workers), 1955–2008		LHM 107 deaths SMR 1.11 (0.91–1.34) Leukemia 36 deaths SMR 1.04 (0.73–1.44) Myeloid leukemia 21 death SMR 1.28 (0.79–1.96)
Pinkerton et al. (2004), USA [25]	Chemical ctories that used or produced Formaldehyde; Standardized mortality (14,014 men); 1941–2000	Level of exposure (background, low, moderate, high); among highly exposed, time period and duration of exposure	Leukemia All subjects 31 deaths SMR 0.91 (0.62–1.29) High exposure 9 deaths SMR 0.71 (0.31–1.39)
Meyers et al. (2013), USA [26]	Update of Coggon et al., (2003). (14,008 men); 1941–2012	Level of exposure (background, low, moderate, high); among highly exposed, time period and duration of exposure	Leukemia All subjects 36 deaths SMR 1.02 (0.77–1.33) High exposure 13 deaths SMR 0.82 (0.44–1.41)

SMR, Standardized mortality ratio; LHM, Lymphohematopoietic malignancies

SMR, Standardized mortality ratio; PMR, Proportionate mortality ratio; PCMR, Proportionate cancer mortality ratio; LHM, Lymphohematopoietic malignancies; CML, Chronic myeloid leukemia

RR, Relative risk; LHM, Lymphohematopoietic malignancies; HR, Hazard ratio