title: Occupational exposure to extremely low-frequency magnetic fields and electrical shocks and acute myeloid leukemia in four Nordic countries.
abstract: OBJECTIVE
  We studied the association between occupational exposure to extremely low-frequency magnetic fields (ELF-MF) and electrical shocks and acute myeloid leukemia (AML) in the Nordic Occupational Cancer cohort (NOCCA).
  
  
  METHODS
  We included 5,409 adult AML cases diagnosed between 1961 and 2005 in Finland, Iceland, Norway, and Sweden and 27,045 controls matched by age, sex, and country. Lifetime occupational ELF-MF exposure and risk of electrical shocks were assigned to jobs reported in the censuses using job-exposure matrices. We estimated hazard ratios (HRs) and 95 % confidence intervals (95 % CIs) using conditional logistic regression adjusted for concurrent occupational exposures relevant for AML risk (e.g., benzene, ionizing radiation). We conducted sensitivity analyses with different assumptions to assess the robustness of our results.
  
  
  RESULTS
  Approximately 40 % of the subjects were ever occupationally exposed to low levels and 7 % to high levels of ELF-MF, whereas 18 % were ever at low risk and 15 % at high risk of electrical shocks. We did not observe an association between occupational exposure to neither ELF-MF nor electrical shocks and AML. The HR was 0.88 (95 % CI 0.77-1.01) for subjects with high levels of ELF-MF exposure and 0.94 (95 % CI 0.85-1.05) for subjects with high risk of electrical shocks as compared to those with background-level exposure. Results remained materially unchanged in sensitivity analyses with different assumptions.
  
  
  CONCLUSIONS
  Our results do not support an association between occupational ELF-MF or electric shock exposure and AML.
authors.affiliation: School of Health Sciences, University of Tampere, 33014, Tampere, Finland, Madar.Talibov@uta.fi.
authors.forename: Madar
authors.initials: M
authors.lastname: Talibov
authors.forename: Monica
authors.initials: M
authors.lastname: Guxens
authors.forename: Eero
authors.initials: E
authors.lastname: Pukkala
authors.forename: Anke
authors.initials: A
authors.lastname: Huss
authors.forename: Hans
authors.initials: H
authors.lastname: Kromhout
authors.forename: Pauline
authors.initials: P
authors.lastname: Slottje
authors.forename: Jan Ivar
authors.initials: JI
authors.lastname: Martinsen
authors.forename: Kristina
authors.initials: K
authors.lastname: Kjaerheim
authors.forename: Pär
authors.initials: P
authors.lastname: Sparén
authors.forename: Elisabete
authors.initials: E
authors.lastname: Weiderpass
authors.forename: Laufey
authors.initials: L
authors.lastname: Tryggvadottir
authors.forename: Sanni
authors.initials: S
authors.lastname: Uuksulainen
authors.forename: Roel
authors.initials: R
authors.lastname: Vermeulen
mesh_terms: D000328:Adult; D000368:Aged; D004556:Electric Injuries / Q000453:epidemiology*; D005260:Female; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology*; D016015:Logistic Models; D060526:Magnetic Fields; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure; D009790:Occupations; D012306:Risk; D012537:Scandinavian and Nordic Countries / Q000453:epidemiology; D055815:Young Adult