title: Occupational exposure to trichloroethylene and risk of non-Hodgkin lymphoma and its major subtypes: a pooled InterLymph [correction of IinterLlymph] analysis.
abstract: OBJECTIVE
  We evaluated the association between occupational exposure to trichloroethylene (TCE) and risk of non-Hodgkin lymphoma (NHL) in a pooled analysis of four international case-control studies.
  
  
  METHODS
  Overall, the pooled study population included 3788 NHL cases and 4279 controls. Risk of NHL and its major subtypes associated with TCE exposure was calculated with unconditional logistic regression and polytomous regression analysis, adjusting by age, gender and study.
  
  
  RESULTS
  Risk of follicular lymphoma (FL), but not NHL overall or other subtypes, increased by probability (p=0.02) and intensity level (p=0.04), and with the combined analysis of four exposure metrics assumed as independent (p=0.004). After restricting the analysis to the most likely exposed study subjects, risk of NHL overall, FL and chronic lymphocytic leukaemia (CLL) were elevated and increased by duration of exposure (p=0.009, p=0.04 and p=0.01, respectively) and with the combined analysis of duration, frequency and intensity of exposure (p=0.004, p=0.015 and p=0.005, respectively). Although based on small numbers of exposed, risk of all the major NHL subtypes, namely diffuse large B-cell lymphoma, FL and CLL, showed increases in risk ranging 2-3.2-fold in the highest category of exposure intensity. No significant heterogeneity in risk was detected by major NHL subtypes or by study.
  
  
  CONCLUSIONS
  Our pooled analysis apparently supports the hypothesis of an increase in risk of specific NHL subtypes associated with occupational exposure to TCE.
authors.affiliation: Department of Public Health, Clinical and Molecular Medicine, Occupational Health Section, University of Cagliari, Monserrato, Italy.
authors.forename: P
authors.initials: P
authors.lastname: Cocco
authors.forename: R
authors.initials: R
authors.lastname: Vermeulen
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authors.lastname: Flore
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authors.lastname: Nonne
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authors.initials: M
authors.lastname: Campagna
authors.forename: M
authors.initials: M
authors.lastname: Purdue
authors.forename: A
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authors.lastname: Blair
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authors.lastname: Monnereau
authors.forename: L
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authors.lastname: Orsi
authors.forename: J
authors.initials: J
authors.lastname: Clavel
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authors.lastname: Becker
authors.forename: S
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authors.lastname: de Sanjosé
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authors.lastname: Foretova
authors.forename: A
authors.initials: A
authors.lastname: Staines
authors.forename: M
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authors.lastname: Maynadié
authors.forename: A
authors.initials: A
authors.lastname: Nieters
authors.forename: L
authors.initials: L
authors.lastname: Miligi
authors.forename: A
authors.initials: A
authors.lastname: 't Mannetje
authors.forename: A
authors.initials: A
authors.lastname: Kricker
authors.forename: P
authors.initials: P
authors.lastname: Brennan
authors.forename: P
authors.initials: P
authors.lastname: Boffetta
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authors.lastname: Lan
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authors.initials: N
authors.lastname: Rothman
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000139:chemically induced*; D008224:Lymphoma, Follicular / Q000139:chemically induced*; D016403:Lymphoma, Large B-Cell, Diffuse / Q000139:chemically induced*; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced*; D016273:Occupational Exposure / Q000009:adverse effects*; D012044:Regression Analysis; D012307:Risk Factors; D014241:Trichloroethylene / Q000633:toxicity*
chemical_list: D014241:Trichloroethylene