title: Asbestos exposure and malignant lymphoma: a multicenter case-control study in Germany and Italy.
abstract: OBJECTIVE
  To analyze the relationship between asbestos exposure and malignant lymphoma in a multicenter case-control study conducted in Germany and Italy according to a common core protocol.
  
  
  METHODS
  Male and female patients with malignant lymphoma (n = 1,034) between 18 and 80 years of age were prospectively recruited in six study areas in Germany (Ludwigshafen/Upper Palatinate, Heidelberg/Rhine-Neckar-County, Würzburg/Lower Frankonia, Hamburg, Bielefeld/East Westphalia, and Munich) and in two study areas in Sardinia, Italy (Cagliari and Nuoro provinces). A total of 1,173 population control subjects were drawn from population registers. In a structured personal interview, we elicited a complete occupational history, including every occupational period that lasted at least 1 year. On the basis of job task-specific supplementary questionnaires, trained experts assessed the exposure to asbestos. As a measure of cumulative asbestos exposure on a time by intensity scale, fiber-years were calculated. 12 cases (1.2%) and 12 control subjects (1.0%) had a cumulative asbestos exposure of more than 2.6 fiber-years (highest exposure category according to the 90th percentile of exposed control subjects). Odds ratios (OR) and 95% confidence intervals (CI) were calculated using unconditional logistic regression analysis adjusted for age, sex and study region. Patients with specific lymphoma sub-entities were additionally compared with the entire control group.
  
  
  RESULTS
  We observed no statistically significant association between cumulative asbestos exposure and the risk of any lymphoma subtype. An elevated risk was found for the association between exposure to more than 2.6 fiber-years and multiple myeloma (OR = 6.0; 95% CI 1.4-25.1); however, numbers were small (n = 3 cases, all of them from Italy; n = 12 control subjects).
  
  
  CONCLUSIONS
  Our study does not support an association between asbestos exposure and risk of malignant lymphoma.
authors.affiliation: Federal Institute of Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany. seidler.andreas@baua.bund.de
authors.forename: Andreas
authors.initials: A
authors.lastname: Seidler
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Becker
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nieters
authors.forename: Rolf
authors.initials: R
authors.lastname: Arhelger
authors.forename: Birte
authors.initials: B
authors.lastname: Mester
authors.forename: Karin
authors.initials: K
authors.lastname: Rossnagel
authors.forename: Evelin
authors.initials: E
authors.lastname: Deeg
authors.forename: Gine
authors.initials: G
authors.lastname: Elsner
authors.forename: Massimo
authors.initials: M
authors.lastname: Melis
authors.forename: Simonetta
authors.initials: S
authors.lastname: Sesler
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Avataneo
authors.forename: Michele
authors.initials: M
authors.lastname: Meloni
authors.forename: Pierluigi
authors.initials: P
authors.lastname: Cocco
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001194:Asbestos / Q000633:toxicity*; D016022:Case-Control Studies; D015984:Causality; D005260:Female; D005858:Germany / Q000453:epidemiology; D006689:Hodgkin Disease / Q000139:chemically induced; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008223:Lymphoma / Q000139:chemically induced*; D016393:Lymphoma, B-Cell / Q000139:chemically induced; D016399:Lymphoma, T-Cell / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects*; D013997:Time Factors; D055815:Young Adult
chemical_list: D001194:Asbestos