379 Occupational exposure to trichloroethylene and risk of non-Hodgkin lymphoma and its major subtypes: a pooled interlymph analysis

Abstract

Objectives To test the association between occupational exposure to trichloroethylene (TCE) and risk of non Hodgkin lymphoma (NHL), we conducted a pooled analysis of four international case-control studies. Methods Studies were selected which included state-of-the art retrospective assessment of occupational exposure to TCE and histological information on lymphoma subtype. Overall, the pooled study population included 3788 NHL cases and 4279 controls. Summary indicators of exposure were harmonised across studies. We conducted unconditional logistic regression analysis to test the association between the harmonised TCE exposure estimates and NHL and its major subtypes, adjusting by age, gender, and study. Results Among the total study population, risk of follicular lymphoma, but not NHL overall or other subtypes, increased by probability (p = 0.02) and intensity level (p = 0.04) of TCE exposure. When the analysis was restricted to subjects most likely exposed to TCE, risk of NHL overall (p = 0.009), follicular lymphoma (p = 0.04), and chronic lymphocytic leukaemia (CLL) (p = 0.01) showed a linear increase by duration of exposure. No heterogeneity in NHL risk associated with high probability of exposure to TCE (all intensity levels combined) was detected. Conclusion With due caution because of several limitations, our pooled analysis supports the hypothesis of an increased risk of NHL, and particularly of the follicular lymphoma and CLL subtypes, associated with occupational exposure to TCE.

Medical History, Lifestyle, Family History, and Occupational Risk Factors for Peripheral T-Cell Lymphomas: The InterLymph Non-Hodgkin Lymphoma Subtypes Project

“…Based on our data, we observed an increase in risk of PTCL and, specifically, ALCL, for textile workers. Exposures related to textile work include: dust, endotoxin (a bacterial contaminant of raw cotton fiber and cotton dust), assorted dyes, and chemicals such as trichloroethylene, which has previously been linked to lymphoma risk (33)(34)(35)(36)(37)(38). We also report that electrical fitters had increased odds of developing ALCL and angioimmunoblastic lymphoma.…”

Analysis of 153 115 patients with hematological malignancies refines the spectrum of familial risk

“…3 Aside from exposure to DNA-damaging agents and the association between Epstein-Barr virus (EBV), HIV, human T-cell lymphotropic virus (HTLV), and Helicobacter pylori with specific lymphoma subtypes, the etiological basis of most hematological malignancies is poorly understood. [4][5][6][7][8][9][10][11][12][13][14] Epidemiological observational studies and reports of families segregating hematological malignancies over the years have supported the role of inherited factors in disease etiology. [15][16][17][18] Direct evidence for predisposition to hematological tumors is provided by the increased risk associated with a number of rare inherited syndromes 19 (eg, Fanconi anemia, 20 Diamond-Blackfan anemia, 21 and dyskeratosis congenita 22 ), as well as rare germline mutations in a number of genes causing Mendelian susceptibility (ANKRD26, 23 CEBPA, 24 DDX41, 25 ELANE, 26 ETV6, 27 GATA2, 28 HAX1, 29 RUNX1, 30 SAMD9, 31 SAMD9L, 32 SRP72, 33 and LSD1 34 ).…”

A systematic review and meta-analysis of occupational exposures and risk of follicular lymphoma

“…4). Exposure was either self-reported or based on employment records; three studies used a solvent JEM (Barry et al 2011;Blair et al 1993;Tranah et al 2009) and one study used a trichloroethylene JEM (Cocco et al 2013). The point estimates reported by most studies were greater than one, with wide confidence intervals due to small numbers of exposed cases.…”