Population-based research on occupational and environmental factors for leukemia and non-Hodgkin's lymphoma: The Northern Germany Leukemia and Lymphoma Study (NLL)

ArticleinAmerican Journal of Industrial Medicine 51(4):246-57 · April 2008with14 Reads
Impact Factor: 1.74 · DOI: 10.1002/ajim.20551 · Source: PubMed

The Northern Germany Leukemia and Lymphoma Study (NLL) is a population-based study designed to provide a quantitative basis for investigations into occupational and environmental risk factors for leukemia and lymphoma. All incident cases of leukemia and lymphoma diagnosed between 1/1/1986 and 12/31/1998 in six counties in Northern Germany were actively ascertained. Controls were selected from population registries. Use of pesticides, sources of food supply, time spent at home and work, medical and family history were assessed via face-to-face interview. This self-reported information was used in conjunction with direct environmental measurements of pesticides in household dust and electromagnetic fields (EMFs). In addition, geographical information system (GIS) data were used to derive estimates of environmental exposure to pesticides, EMFs associated with transmission lines, and ionizing radiation from routine nuclear power reactor operations. Occupational exposure assessment was based on lifetime work history. For each job, information on branch of industry, company, job description, and duration of employment were ascertained. Fourteen hundred thirty cases and 3041 controls were recruited. Lifetime residential and workplace histories totaled 49,628 addresses. Occupational exposure to pesticides was reported by 15% of the male participants (women: 16%). Four percent of the men (women: 8%) were occupationally exposed to ionizing radiation for >or=1 year over their lifetime. Sixty four percent of the participants had lived in the vicinity (20 km) of a nuclear power plant in operation. The NLL illustrates the successful application of innovative methods to simultaneously assess occupational and environmental risk factors for leukemia and lymphoma including radiological hazards, pesticides, and EMFs.

    • "So the standard of radiologic practice in the prevailing period has to be taken into account. Von Boetticher and Hoffmann applied a comprehensive model for retrospective dose assessment to determine lifetime radiation exposure to patients [13]. This model is based on the knowledge that for a given examination at a certain time the dose under ideal conditions is a relative exact quantity. "
    [Show abstract] [Hide abstract] ABSTRACT: Our aim is to evaluate the relevance of different factors influencing lifetime accumulated red bone marrow dose, such as calendar year, age and sex. The lifetime dose was estimated for controls interviewed in person (N = 2811, 37.5% women) of the population-based representative Northern Germany Leukemia and Lymphoma Study. Data were assessed in standardized computer-assisted personal interviews. The calculation of doses is based on a comprehensive quantification model including calendar year, sex, kind of examination, and technical development. In multivariate regression models the annual red bone marrow dose was analyzed depending on age, sex and calendar year to consider simultaneously temporal changes in radiologic practice and individual risk factors. While the number of examinations continuously rises over time, the dose shows two peaks around 1950 and after 1980. Men are exposed to higher doses than woman. Until 1970 traditional examinations like conventional and mass screening examinations caused the main dose. They were then replaced by technically advanced examinations mainly computed tomography and cardiac catheter. The distribution of the red bone marrow dose over lifetime depends highly on the technical standards and radiation protection survey. To a lesser extent it is influenced by age and sex of the subjects. Thus epidemiological studies concerning the assessment of radiation exposure should consider the calendar year in which the examination was conducted.
    Preview · Article · Nov 2013 · PLoS ONE
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    • "Most studies of NHL have been conducted among male farmers and farm workers. There were relatively few studies that focused only on female farmers and farm workers[2122232425] or studies that focused on both male and female farm workers.[89262728] In Canada, incidence rates for NHL have increased modestly in males (0.8%) and have stabilized in females between 1998 and 2007. "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: The objective was to examine the association between non-Hodgkin's lymphoma (NHL) and farming-related activities, gender, pesticides exposure, and exposure to chemicals other than pesticides in Saskatchewan. Materials and Methods: Male and female study participants were taken from two separate case-control studies conducted in Saskatchewan province, Canada. A case was defined as any man or woman aged 19 years and older with a first diagnosis of NHL registered by the Saskatchewan Cancer Agency during the study period. Conditional logistic regression was used to fit the statistical models. Results: Farming exposure and exposure to pesticides-contaminated cloths were related to an increased risk of NHL. Exposure to pesticides was strongly associated with an increased risk of NHL, especially for men. Conclusion: For men, the incidence of NHL was associated with exposure to pesticides after adjusting for other independent predictors.
    No preview · Article · Sep 2013 · Indian Journal of Occupational and Environmental Medicine
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    • "Hoffmann [90] 2008 Case-control study Ionizing radiation, pesticides and EMF 15% of men (16% of women) participants reported occupational exposure to pesticides, 4% (8% women) reported exposure to ionizing radiation (for > 1 year) and 64% of participants reported having lived sometime in their life in the proximity (<20 km) of a nuclear plant. "
    [Show abstract] [Hide abstract] ABSTRACT: Leukemia is a complex disease, which only became better understood during the last decades following the development of new laboratory techniques and diagnostic methods. Despite our improved understanding of the physiology of the disease, little is yet known about the causes of leukemia. A variety of potential risk factors have been suggested so far, including personal habits and lifestyle, and a wide range of occupational or environmental exposures. A causal association with leukemia has only been documented to date for ionizing radiation, benzene and treatment with cytostatic drugs, but there is an ongoing scientific debate on the possible association of leukemia with a number of other work-related hazards. In this article, we have reviewed scientific studies, published over the past 5 years, which investigated potential associations between leukemia and exposure to occupational risk factors. The systematic literature review took place via electronic databases, using specific search criteria, and independent reviewers have further filtered the search results to identify the number of articles, presented in our paper. A large number of studies included in the review referred to the effects of ionizing radiation, where new data suggest that the effects of exposure to small doses of ionizing radiation should probably be reevaluated. Some other works appear to substantiate a potential association of the disease with certain pesticides. Further research is also suggested regarding the role of infectious agents or exposure to certain chemicals like formaldehyde or butadiene in the pathogenesis of leukemia.
    Full-text · Article · May 2013 · Journal of Occupational Medicine and Toxicology
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