title: Soft tissue sarcoma, non-Hodgkin's lymphoma and chronic lymphocytic leukaemia in workers exposed to phenoxy herbicides: extended follow-up of a UK cohort.
abstract: OBJECTIVE
  To provide further information on the possible carcinogenicity of phenoxy herbicides, and in particular their relationship to soft tissue sarcoma (STS), non-Hodgkin's lymphoma (NHL) and chronic lymphocytic leukaemia (CLL).
  
  
  METHODS
  We extended follow-up to December 2012 for 8036 men employed at five factories in the UK which had manufactured phenoxy herbicides, or in a contract spraying business. Mortality was compared with that for England and Wales by the person-years method. Nested case-control analyses compared men with incident or fatal STS (n=15) or NHL/CLL (n=74) and matched controls (up to 10 per case).
  
  
  RESULTS
  4093 men had died, including 2303 since the last follow-up. Mortality from all causes and all cancers was close to expectation, but an excess of deaths from NHL was observed among men who had worked for ≥1 year in jobs with more than background exposure to phenoxy herbicides (19 deaths, SMR 1.85, 95% CI 1.12 to 2.89). Four deaths from STS occurred among men potentially exposed above background (3.3 expected). In the nested case-control analyses, there were no significantly elevated risks or consistent trends across categories of potential exposure for either STS or NHL/CLL. Among men who had worked for ≥1 year in potentially exposed jobs, the highest OR (for STS) was only 1.30 (95% CI 0.30 to 5.62).
  
  
  CONCLUSIONS
  Our findings are consistent with the current balance of epidemiological evidence. If phenoxy herbicides pose a hazard of either STS or NHL, then any absolute increase in risk is likely to be small.
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: David
authors.initials: D
authors.lastname: Coggon
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Georgia
authors.initials: G
authors.lastname: Ntani
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: E Clare
authors.initials: EC
authors.lastname: Harris
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Nimeshi
authors.initials: N
authors.lastname: Jayakody
authors.affiliation: MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK.
authors.forename: Keith T
authors.initials: KT
authors.lastname: Palmer
mesh_terms: D000328:Adult; D016022:Case-Control Studies; D005260:Female; D005500:Follow-Up Studies; D006540:Herbicides / Q000633:toxicity*; D006801:Humans; D015451:Leukemia, Lymphocytic, Chronic, B-Cell / Q000139:chemically induced* / Q000401:mortality; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced* / Q000401:mortality; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000139:chemically induced* / Q000401:mortality; D016273:Occupational Exposure / Q000009:adverse effects*; D010636:Phenols / Q000633:toxicity; D012509:Sarcoma / Q000139:chemically induced* / Q000401:mortality; D012983:Soft Tissue Neoplasms / Q000139:chemically induced* / Q000401:mortality; D006113:United Kingdom / Q000453:epidemiology
chemical_list: D006540:Herbicides; D010636:Phenols; C042329:phenoxy radical