title: Occupation, exposure to chemicals, sensitizing agents, and risk of multiple myeloma in Sweden.
abstract: BACKGROUND
  This study sought to identify occupations with high incidence of multiple myeloma and to investigate possible excess risk associated with occupational exposure to chemicals and sensitizing agents in Sweden.
  
  
  METHODS
  A historical cohort of 2,992,166 workers was followed up (1971--1989) through record linkage with the National Cancer and Death Registries. For each job category, age and period standardized incidence ratios and age and period adjusted relative risks of multiple myeloma were calculated using Poisson models. Exposure to chemicals and to sensitizing agents was also assessed using two job-exposure matrices. Men and women were analyzed separately.
  
  
  RESULTS
  During follow-up, 3,127 and 1,282 myelomas were diagnosed in men and women, respectively. In men, excess risk was detected among working proprietors, agricultural, horticultural and forestry enterprisers, bakers and pastry cooks, dental technicians, stone cutters/carvers, and prison/reformatory officials. In women, this excess was observed among attendants in psychiatric care, metal workers, bakers and pastry cooks, and paper/paperboard product workers. Workers, particularly bakers and pastry cooks, exposed to high molecular weight sensitizing agents registered an excess risk of over 40% across the sexes. Occasional, although intense, exposure to pesticides was also associated with risk of myeloma in our cohort.
  
  
  CONCLUSIONS
  Our study supports a possible etiologic role for farming and use of pesticides in myeloma risk. The high incidence found in both female and male bakers and pastry cooks has not been described previously. Further research is required to assess the influence of high molecular weight sensitizing agents on risk of multiple myeloma.
authors.affiliation: CIBER en Epidemiología y Salud Pública, CIBERESP, Spain. vicarvajal@isciii.es
authors.forename: Virginia
authors.initials: V
authors.lastname: Lope
authors.forename: Beatriz
authors.initials: B
authors.lastname: Pérez-Gómez
authors.forename: Nuria
authors.initials: N
authors.lastname: Aragonés
authors.forename: Gonzalo
authors.initials: G
authors.lastname: López-Abente
authors.forename: Per
authors.initials: P
authors.lastname: Gustavsson
authors.forename: Nils
authors.initials: N
authors.lastname: Plato
authors.forename: Jan-Paul
authors.initials: JP
authors.lastname: Zock
authors.forename: Marina
authors.initials: M
authors.lastname: Pollán
mesh_terms: D000328:Adult; D015331:Cohort Studies; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000139:chemically induced* / Q000453:epidemiology*; D009784:Occupational Diseases / Q000139:chemically induced* / Q000453:epidemiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D016012:Poisson Distribution; D012042:Registries; D012306:Risk; D013548:Sweden / Q000453:epidemiology