title: Blood erythrocyte concentrations of cadmium and lead and the risk of B-cell non-Hodgkin's lymphoma and multiple myeloma: a nested case-control study.
abstract: BACKGROUND
  Cadmium (Cd) and lead (Pb) are hypothesised to be risk factors for non-Hodgkin's lymphoma (NHL), a group of haematological malignancies with a suspected environmental aetiology. Within the EnviroGenoMarkers study we utilised pre-diagnostic erythrocyte concentrations of Cd and Pb to determine whether exposure was associated with risk of B-cell NHL and multiple myeloma.
  
  
  METHODS
  194 incident cases of B-cell NHL and 76 cases of multiple myeloma diagnosed between 1990 and 2006 were identified from two existing cohorts; EPIC-Italy and the Northern Sweden Health and Disease Study. Cases were matched to healthy controls by centre, age, gender and date of blood collection. Cd and Pb were measured in blood samples provided at recruitment using inductively coupled plasma-mass spectrometry. Logistic regression was applied to assess the association with risk. Analyses were stratified by cohort and gender and by subtype where possible.
  
  
  RESULTS
  There was little evidence of an increased risk of B-cell NHL or multiple myeloma with exposure to Cd (B-cell NHL: OR 1.09 95%CI 0.61, 1.93, MM: OR 1.16 95% CI: 0.40, 3.40 ) or Pb (B-cell NHL: 0.93 95% CI 0.43, 2.02, multiple myeloma: OR 1.63 95%CI 0.45, 5.94) in the total population when comparing the highest to the lowest quartile of exposure. However, gender and cohort specific differences in results were observed. In females the risk of B-cell NHL was more than doubled in those with a body burden of Cd >1 µg/L (OR 2.20 95%CI; 1.04, 4.65).
  
  
  CONCLUSIONS
  This nested case-control study does not support a consistent positive association between Cd or Pb and NHL, but there is some indication of a gender specific effect suggesting further research is warranted.
authors: Medical Research Council-Health Protection Agency Centre for Environment and Health, Department of Epidemiology and Biostatistics, Imperial College London, London, United Kingdom.
authors: Rachel S
authors: RS
authors: Kelly
authors: Thomas
authors: T
authors: Lundh
authors: Miquel
authors: M
authors: Porta
authors: Ingvar A
authors: IA
authors: Bergdahl
authors: Domenico
authors: D
authors: Palli
authors: Ann-Sofie
authors: AS
authors: Johansson
authors: Maria
authors: M
authors: Botsivali
authors: Paolo
authors: P
authors: Vineis
authors: Roel
authors: R
authors: Vermeulen
authors: Soterios A
authors: SA
authors: Kyrtopoulos
authors: Marc
authors: M
authors: Chadeau-Hyam
mesh_terms: D002104:Cadmium / Q000097:blood*; D016022:Case-Control Studies; D015331:Cohort Studies; D004781:Environmental Exposure; D004912:Erythrocytes / Q000378:metabolism*; D005260:Female; D006801:Humans; D007558:Italy; D007854:Lead / Q000097:blood*; D016393:Lymphoma, B-Cell / Q000097:blood*; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000097:blood*; D012307:Risk Factors; D013548:Sweden
chemical_list: D002104:Cadmium; D007854:Lead