Risk of leukemia and multiple myeloma associated with exposure to benzene and other organic solvents: evidence from the Italian Multicenter Case-control study.
BACKGROUND
While there is a general consensus about the ability of benzene to induce acute myeloid leukemia (AML), its effects on chronic lymphoid leukemia and multiple myeloma (MM) are still under debate. We conducted a population-based case-control study to evaluate the association between exposure to organic solvents and risk of myeloid and lymphoid leukemia and MM.


METHODS
Five hundred eighty-six cases of leukemia (and 1,278 population controls), 263 cases of MM (and 1,100 population controls) were collected. Experts assessed exposure at individual level to a range of chemicals.


RESULTS
We found no association between exposure to any solvent and AML. There were elevated point estimates for the associations between medium/high benzene exposure and chronic lymphatic leukemia (OR = 1.8, 95% CI = 0.9-3.9) and MM (OR = 1.9, 95% CI = 0.9-3.9). Risks of chronic lymphatic leukemia were somewhat elevated, albeit with wide confidence intervals, from medium/high exposure to xylene and toluene as well.


CONCLUSIONS
We did not confirm the known association between benzene and AML, though this is likely explained by the strict regulation of benzene in Italy nearly three decades prior to study initiation. Our results support the association between benzene, xylene, and toluene and chronic lymphatic leukemia and between benzene and MM with longer latencies than have been observed for AML in other studies.
Costantini
Adele Seniori
AS
Unit of Environmental and Occupational Epidemiology, Center for Study and Prevention of Cancer, Florence, Italy. a.seniori@cspo.it
Benvenuti
Alessandra
A
Vineis
Paolo
P
Kriebel
David
D
Tumino
Rosario
R
Ramazzotti
Valerio
V
Rodella
Stefania
S
Stagnaro
Emanuele
E
Crosignani
Paolo
P
Amadori
Dino
D
Mirabelli
Dario
D
Sommani
Letizia
L
Belletti
Isabella
I
Troschel
Loredana
L
Romeo
Luciano
L
Miceli
Giuseppe
G
Tozzi
Giulio Andrea
GA
Mendico
Igino
I
Maltoni
Simona Alberghini
SA
Miligi
Lucia
L
D000328:Adult; D000368:Aged; D001554:Benzene / Q000009:adverse effects*; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007558:Italy; D007945:Leukemia, Lymphoid / Q000139:chemically induced*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects*; D018570:Risk Assessment; D012997:Solvents / Q000009:adverse effects*; D014050:Toluene / Q000009:adverse effects; D014992:Xylenes / Q000009:adverse effects; D055815:Young Adult
D012997:Solvents; D014992:Xylenes; D014050:Toluene; D001554:Benzene