Chemical exposures and risk of acute myeloid leukemia and myelodysplastic syndromes in a population-based study.
Benzene exposure is one of the few well-established risk factors for myeloid malignancy. Exposure to other chemicals has been inconsistently associated with hematologic malignancies. We evaluated occupational and residential chemical exposures as risk factors for acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS) using population-based data. AML and MDS cases were identified by the Minnesota Cancer Surveillance System. Controls were identified through the Minnesota driver's license/identification card list. Chemical exposures were measured by self-report. Unconditional logistic regression was used to calculate odds ratios (ORs) and 95% confidence intervals (CI). We included 265 MDS cases, 420 AML cases and 1388 controls. We observed significant associations between both MDS and AML and benzene (OR = 1.77, 95% CI 1.19, 2.63 and OR = 2.10, 95% CI 1.35, 3.28, respectively) and vinyl chlorides (OR = 2.05, 95% CI 1.15, 3.63 and OR = 2.81, 95% CI 1.14, 6.92). Exposure to soot, creosote, inks, dyes and tanning solutions and coal dust were associated with AML (range ORs = 2.68-4.03), while no association was seen between these exposures and MDS (range ORs = 0.57-1.68). Pesticides and agricultural chemicals were not significantly associated with AML or MDS. Similar results were observed in analyses stratified by sex. In addition to providing risk estimates for benzene from a population-based sample, we also identified a number of other occupational and residential chemicals that were significantly associated with AML; however, all exposures were reported by only a small percentage of cases (≤10%). While chemical exposures play a clear role in the etiology of myeloid malignancy, these exposures do not account for the majority of cases.
Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN.|Masonic Cancer Center, University of Minnesota, Minneapolis, MN.
Jenny N
JN
Poynter
Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN.
Michaela
M
Richardson
Division of Epidemiology and Clinical Research, Department of Pediatrics, University of Minnesota, Minneapolis, MN.
Michelle
M
Roesler
Department of Internal Medicine, University of New Mexico, Albuquerque, NM.|Division of Epidemiology, Biostatistics, and Preventive Medicine, University of New Mexico, Albuquerque, NM.
Cindy K
CK
Blair
Department of Laboratory Medicine and Pathology, University of Minnesota, Minneapolis, MN.
Betsy
B
Hirsch
Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN.
Phuong
P
Nguyen
Pathology VA Medical Center, Minneapolis, MN.
Adina
A
Cioc
Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, MN.
James R
JR
Cerhan
Blood and Marrow Transplant Program, Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN.
Erica
E
Warlick
D000328:Adult; D000368:Aged; D001554:Benzene / Q000009:adverse effects*; D016022:Case-Control Studies; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006306:Health Surveys; D006801:Humans; D015470:Leukemia, Myeloid, Acute / Q000453:epidemiology* / Q000209:etiology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D008910:Minnesota / Q000453:epidemiology; D009190:Myelodysplastic Syndromes / Q000453:epidemiology* / Q000209:etiology; D016017:Odds Ratio; D012307:Risk Factors; D055815:Young Adult
D001554:Benzene
acute myeloid leukemia; benzene; case-control study; chemical exposures; myelodysplastic syndromes