Asbestos exposure and malignant lymphoma: a multicenter case-control study in Germany and Italy.
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.
Seidler
Andreas
A
Federal Institute of Occupational Safety and Health (BAuA), Nöldnerstr. 40-42, 10317, Berlin, Germany. seidler.andreas@baua.bund.de
Becker
Nikolaus
N
Nieters
Alexandra
A
Arhelger
Rolf
R
Mester
Birte
B
Rossnagel
Karin
K
Deeg
Evelin
E
Elsner
Gine
G
Melis
Massimo
M
Sesler
Simonetta
S
Avataneo
Giuseppe
G
Meloni
Michele
M
Cocco
Pierluigi
P
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
D001194:Asbestos