Occupational Exposure to Solvents and Risk of Non-Hodgkin Lymphoma in Connecticut Women

doi:10.1093/aje/kwn300

American Journal of Epidemiology Advance Access originally published online on December 4, 2008
American Journal of Epidemiology 2009 169(2):176-185; doi:10.1093/aje/kwn300

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American Journal of Epidemiology © The Author 2008. Published by the Johns Hopkins Bloomberg School of Public Health. All rights reserved. For permissions, please e-mail: journals.permissions@oxfordjournals.org.

ORIGINAL CONTRIBUTIONS

Occupational Exposure to Solvents and Risk of Non-Hodgkin Lymphoma in Connecticut Women

Rong Wang, Yawei Zhang, Qing Lan, Theodore R. Holford, Brian Leaderer, Shelia Hoar Zahm, Peter Boyle, Mustafa Dosemeci, Nathaniel Rothman, Yong Zhu, Qin Qin and Tongzhang Zheng

Correspondence to Dr. Tongzhang Zheng, Yale School of Public Health, 60 College Street, LEPH 427, P.O. Box 208034, New Haven, CT 06520-8034 (e-mail: tongzhang.zheng{at}yale.edu).

Received for publication December 3, 2007. Accepted for publication August 26, 2008.

A population-based case-control study involving 601 incidentcases of non-Hodgkin lymphoma (NHL) and 717 controls was conductedin 1996–2000 among Connecticut women to examine associationswith exposure to organic solvents. A job-exposure matrix wasused to assess occupational exposures. Increased risk of NHLwas associated with occupational exposure to chlorinated solvents(odds ratio (OR) = 1.4, 95% confidence interval (CI): 1.1, 1.8)and carbon tetrachloride (OR = 2.3, 95% CI: 1.3, 4.0). Thoseever exposed to any organic solvent in work settings had a borderlineincreased risk of NHL (OR = 1.3, 95% CI: 1.0, 1.6); moreover,a significantly increased risk was observed for those with averageprobability of exposure to any organic solvent at medium-highlevel (OR = 1.5, 95% CI: 1.1, 1.9). A borderline increased riskwas also found for ever exposure to formaldehyde (OR = 1.3,95% CI: 1.0, 1.7) in work settings. Risk of NHL increased withincreasing average intensity (P = 0.01), average probability(P < 0.01), cumulative intensity (P = 0.01), and cumulativeprobability (P < 0.01) level of organic solvent and withaverage probability level (P = 0.02) and cumulative intensitylevel of chlorinated solvent (P = 0.02). Analyses by NHL subtypeshowed a risk pattern for diffuse large B-cell lymphoma similarto that for overall NHL, with stronger evidence of an associationwith benzene exposure. Results suggest an increased risk ofNHL associated with occupational exposure to organic solventsfor women.

case-control studies; lymphoma, non-Hodgkin; risk factors; solvents

Abbreviations: CI, confidence interval; DLBCL, diffuse large B-cell lymphoma; NHL, non-Hodgkin lymphoma; OR, odds ratio

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