Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkin's lymphoma

Catherine L. Callahan, Patricia A. Stewart, Melissa C. Friesen, Sarah Locke, Anneclaire J. De Roos, James R Cerhan, Richard K. Severson, Nathaniel Rothman, Mark P. Purdue

Research output: Contribution to journalArticle

1 Citation (Scopus)

Abstract

Objectives: Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin's lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene. Methods: Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95% CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype. Results: High cumulative hours exposed to carbon tetrachloride was associated with NHL (>520 hours: OR 1.9; 95% Cl 1.0 to 3.6; P trend =0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95% Cl 1.1 to 3.8; P=0.03) and ≥90% exposure probability (OR 2.1; 95% Cl 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95% Cl 1.0- to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95% Cl 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL. Conclusions: This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.

Original languageEnglish (US)
Pages (from-to)415-420
Number of pages6
JournalOccupational and Environmental Medicine
Volume75
Issue number6
DOIs
StatePublished - Jan 1 2018

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Occupational Exposure
Non-Hodgkin's Lymphoma
Carbon Tetrachloride
Trichloroethylene
Tetrachloroethylene
Methylene Chloride
Chloroform
Occupations
Workplace
Case-Control Studies
Interviews
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkin's lymphoma. / Callahan, Catherine L.; Stewart, Patricia A.; Friesen, Melissa C.; Locke, Sarah; De Roos, Anneclaire J.; Cerhan, James R; Severson, Richard K.; Rothman, Nathaniel; Purdue, Mark P.

In: Occupational and Environmental Medicine, Vol. 75, No. 6, 01.01.2018, p. 415-420.

Research output: Contribution to journalArticle

Callahan, CL, Stewart, PA, Friesen, MC, Locke, S, De Roos, AJ, Cerhan, JR, Severson, RK, Rothman, N & Purdue, MP 2018, 'Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkin's lymphoma', Occupational and Environmental Medicine, vol. 75, no. 6, pp. 415-420. https://doi.org/10.1136/oemed-2017-104890
Callahan, Catherine L. ; Stewart, Patricia A. ; Friesen, Melissa C. ; Locke, Sarah ; De Roos, Anneclaire J. ; Cerhan, James R ; Severson, Richard K. ; Rothman, Nathaniel ; Purdue, Mark P. / Case-control investigation of occupational exposure to chlorinated solvents and non-Hodgkin's lymphoma. In: Occupational and Environmental Medicine. 2018 ; Vol. 75, No. 6. pp. 415-420.
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abstract = "Objectives: Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin's lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene. Methods: Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95{\%} CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype. Results: High cumulative hours exposed to carbon tetrachloride was associated with NHL (>520 hours: OR 1.9; 95{\%} Cl 1.0 to 3.6; P trend =0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95{\%} Cl 1.1 to 3.8; P=0.03) and ≥90{\%} exposure probability (OR 2.1; 95{\%} Cl 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95{\%} Cl 1.0- to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95{\%} Cl 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL. Conclusions: This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.",
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AU - Callahan, Catherine L.

AU - Stewart, Patricia A.

AU - Friesen, Melissa C.

AU - Locke, Sarah

AU - De Roos, Anneclaire J.

AU - Cerhan, James R

AU - Severson, Richard K.

AU - Rothman, Nathaniel

AU - Purdue, Mark P.

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N2 - Objectives: Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin's lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene. Methods: Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95% CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype. Results: High cumulative hours exposed to carbon tetrachloride was associated with NHL (>520 hours: OR 1.9; 95% Cl 1.0 to 3.6; P trend =0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95% Cl 1.1 to 3.8; P=0.03) and ≥90% exposure probability (OR 2.1; 95% Cl 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95% Cl 1.0- to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95% Cl 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL. Conclusions: This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.

AB - Objectives: Although many studies have investigated the association between trichloroethylene (TCE) exposure and non-Hodgkin's lymphoma (NHL), less is known about other chlorinated solvents. We extended our previous analysis of occupational TCE exposure in a multicentre population-based case-control study of NHL to investigate associations with five additional chlorinated solvents: 1,1,1,-trichloroethane, carbon tetrachloride, chloroform, methylene chloride and perchloroethylene. Methods: Cases (n=1189) and controls (n=982) provided detailed information on their occupational histories and workplace exposure to chlorinated solvents for selected occupations using job-specific interview modules. An industrial hygienist used this information and a review of the literature to assess occupational exposure to chlorinated solvents. We computed ORs and 95% CIs for different exposure metrics, with the unexposed group as the referent. We also computed ORs by NHL subtype. Results: High cumulative hours exposed to carbon tetrachloride was associated with NHL (>520 hours: OR 1.9; 95% Cl 1.0 to 3.6; P trend =0.04). This association remained after restricting to jobs with high-intensity exposure (OR 2.0; 95% Cl 1.1 to 3.8; P=0.03) and ≥90% exposure probability (OR 2.1; 95% Cl 1.0 to 4.3; P=0.03), adjusting for TCE (OR 2.1; 95% Cl 1.0- to 4.1; P=0.04) and incorporating a 15-year lag (OR 1.9; 95% Cl 1.0 to 3.6; P=0.06). The other evaluated chlorinated solvents were not associated with NHL. Conclusions: This is the first study using high-quality quantitative exposure assessment methods to identify a statistically significant elevated association between occupational exposure to carbon tetrachloride and NHL. Our findings, although limited by a small number of exposed cases, offer evidence that carbon tetrachloride may be a lymphomagen.

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