The role of occupational and environmental exposures in the aetiology of acquired severe aplastic anaemia: a case control investigation.
Aplastic anaemia is a rare but serious disorder with a high morbidity and mortality rate. The causes of aplastic anaemia are, for the most part, unknown. We report on the hypothesis that aplastic anaemia may be caused by occupational and/or environmental exposures to certain chemicals. The UK Aplastic Anaemia Study was an interview-based case-control study covering the whole of Great Britain. Those patients diagnosed between 1 July 1993 and 20 October 1997, aged < or =75 years and born and diagnosed in the UK were eligible for the study. Two hundred eligible cases of aplastic anaemia were compared with 387 age- and sex-matched controls. A number of occupational exposures showed increases in risk. In a multivariate model of these exposures the odds ratios (ORs) for solvents/degreasing agents, pesticides and radiation were >2 and statistically significant. Reported chemical treatment of houses within 5 years of diagnosis had a significantly raised risk for adults [OR = 2.51, 95% confidence interval (CI) 1.02-12.01], particularly for woodworm treatment (OR = 5.1, 95% CI 1.5-17.4). This study identified significant risks associated with self-reported exposure to solvents, radiation and pesticides in the workplace. Self-reported chemical treatment of houses was also associated with an increased risk of developing aplastic anaemia, in keeping with previous literature.
Muir
K R
KR
Division of Public Health Medicine and Epidemiology, Medical School, University of Nottingham, Nottingham, UK. kenneth.muir@nottingham.ac.uk
Chilvers
C E D
CE
Harriss
C
C
Coulson
L
L
Grainge
M
M
Darbyshire
P
P
Geary
C
C
Hows
J
J
Marsh
J
J
Rutherford
T
T
Taylor
M
M
Gordon-Smith
E C
EC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000383:Agriculture; D000741:Anemia, Aplastic / Q000139:chemically induced / Q000209:etiology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D003132:Commerce; D004781:Environmental Exposure; D005260:Female; D006686:Hobbies; D006795:Household Products / Q000009:adverse effects; D006801:Humans; D007221:Industry; D007223:Infant; D016015:Logistic Models; D008297:Male; D008503:Medical Staff; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000139:chemically induced / Q000209:etiology*; D016273:Occupational Exposure; D010575:Pesticides / Q000009:adverse effects; D011827:Radiation; D012306:Risk; D012923:Social Class; D012997:Solvents / Q000009:adverse effects
D010575:Pesticides; D012997:Solvents