title: Occupation and risk of lymphoid and myeloid leukaemia in the European Prospective Investigation into Cancer and Nutrition (EPIC).
abstract: OBJECTIVE
  Established risk factors for leukaemia do not explain the majority of leukaemia cases. Previous studies have suggested the importance of occupation and related exposures in leukaemogenesis. We evaluated possible associations between job title and selected hazardous agents and leukaemia in the European Prospective Investigation into Cancer and Nutrition.
  
  
  METHODS
  The mean follow-up time for 241 465 subjects was 11.20 years (SD 2.42 years). During the follow-up period, 477 incident cases of myeloid and lymphoid leukaemia occurred. Data on 52 occupations considered a priori to be at high risk of developing cancer were collected through standardised questionnaires. Occupational exposures were estimated by linking the reported occupations to a job exposure matrix. Cox proportional hazard models were used to explore the association between occupation and related exposures and risk of leukaemia.
  
  
  RESULTS
  The risk of lymphoid leukaemia significantly increased for working in chemical laboratories (HR 8.35, 95% CI 1.58 to 44.24), while the risk of myeloid leukaemia increased for working in the shoe or other leather goods industry (HR 2.54, 95% CI 1.28 to 5.06). Exposure-specific analyses showed a non-significant increased risk of myeloid leukaemias for exposure to benzene (HR 1.15, 95% CI 0.75 to 1.40; HR=1.60, 95% CI 0.95 to 2.69 for the low and high exposure categories, respectively). This association was present both for acute and chronic myeloid leukaemia at high exposure levels. However, numbers were too small to reach statistical significance.
  
  
  CONCLUSIONS
  Our findings suggest a possible role of occupational exposures in the development of both lymphoid and myeloid leukaemia. Exposure to benzene seemed to be associated with both acute and chronic myeloid leukaemia.
authors.affiliation: Division Environmental Epidemiology, Institute for Risk Assessment Sciences, Utrecht, The Netherlands.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Saberi Hosnijeh
authors.forename: Yvette
authors.initials: Y
authors.lastname: Christopher
authors.forename: Petra
authors.initials: P
authors.lastname: Peeters
authors.forename: Isabelle
authors.initials: I
authors.lastname: Romieu
authors.forename: Wei
authors.initials: W
authors.lastname: Xun
authors.forename: Elio
authors.initials: E
authors.lastname: Riboli
authors.forename: Ole
authors.initials: O
authors.lastname: Raaschou-Nielsen
authors.forename: Anne
authors.initials: A
authors.lastname: Tjønneland
authors.forename: Nikolaus
authors.initials: N
authors.lastname: Becker
authors.forename: Alexandra
authors.initials: A
authors.lastname: Nieters
authors.forename: Antonia
authors.initials: A
authors.lastname: Trichopoulou
authors.forename: Christina
authors.initials: C
authors.lastname: Bamia
authors.forename: Philip
authors.initials: P
authors.lastname: Orfanos
authors.forename: Enrico
authors.initials: E
authors.lastname: Oddone
authors.forename: Leila
authors.initials: L
authors.lastname: Luján-Barroso
authors.forename: Miren
authors.initials: M
authors.lastname: Dorronsoro
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Aurelio
authors.initials: A
authors.lastname: Barricarte
authors.forename: Esther
authors.initials: E
authors.lastname: Molina-Montes
authors.forename: Nick
authors.initials: N
authors.lastname: Wareham
authors.forename: Paolo
authors.initials: P
authors.lastname: Vineis
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
mesh_terms: D000208:Acute Disease; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D005060:Europe / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D007945:Leukemia, Lymphoid / Q000453:epidemiology / Q000209:etiology*; D007951:Leukemia, Myeloid / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009784:Occupational Diseases / Q000209:etiology*; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations / Q000145:classification*; D011446:Prospective Studies; D012307:Risk Factors