title: A hospital-based case control study of aplastic anemia in Shanghai, China.
abstract: We report results of a hospital-based case control study of 137 consecutive patients diagnosed with aplastic anemia (AA) in participating hospitals over a 4-year period. Diagnoses were made by a single laboratory, subjects were age- and gender-matched to two controls and interviewed concerning previous disease, work histories and exposures to potential etiologic agents. Analysis was conducted on two distinct subgroups: severe aplastic anemia (SAA) and moderate aplastic anemia (MAA). In univariate regression models, the strongest associations were observed for exposure to benzene and SAA (OR=3.12, 95% CI=1.12-8.65) and life on a farm and MAA (OR=3.08, 95% CI=1.44-6.56). Benzene exposure did not show a strong dose-response relationship with either subtype. When accounting for all of the potential confounders we considered in conditional regression models, the previous relationships persisted. Other explanatory variables included hair-dye use for MAA and farm exposures, such as livestock for SAA, although most of these additional variables fell just short of statistical significance. Adjusted R-squared values were only 10% for each subtype, leaving 90% of AA occurrence unexplained. Our results suggest that: (a) benzene exposure is more strongly related to SAA than MAA, (b) farm and livestock exposures are related to both forms of AA, confirming some previous results, and (c) a large percentage of AA remains unexplained, which may indicate that individual susceptibility has a major influence on AA occurrence.
authors.affiliation: Fudan-Cinpathogen Clinical and Molecular Research Center, Institutes of Biomedical Sciences, Fudan University, Shanghai, China.
authors.forename: Sherilyn A
authors.initials: SA
authors.lastname: Gross
authors.forename: Richard D
authors.initials: RD
authors.lastname: Irons
authors.forename: A Robert
authors.initials: AR
authors.lastname: Schnatter
authors.forename: John
authors.initials: J
authors.lastname: Ryder
authors.forename: Xiao Qin
authors.initials: XQ
authors.lastname: Wang
authors.forename: G Bruce
authors.initials: GB
authors.lastname: Copley
authors.forename: Thomas W
authors.initials: TW
authors.lastname: Armstrong
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000741:Anemia, Aplastic / Q000175:diagnosis* / Q000453:epidemiology* / Q000209:etiology / Q000473:pathology; D001554:Benzene / Q000009:adverse effects*; D016022:Case-Control Studies; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D055815:Young Adult
chemical_list: D001554:Benzene