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Occupational Exposure to Immunologically Active Agents and Risk for Lymphoma

¹ Respiratory and Environmental Health Research Unit, Municipal Institute of Medical Research; ² Hematologia Oncologica and ³ Epidemiology and Cancer Registry, Catalan Institute of Oncology, Barcelona, Spain; ⁴ Department of Pathology, Hospital Verge de la Cinta, Tortosa, Spain; ⁵ Department of Pathology, Hospital Ramon y Cajal, Universidad de Alcalá, Madrid, Spain; ⁶ University of British Columbia, Vancouver, British Columbia, Canada; and ⁷ Jonsson Comprehensive Cancer Center, David Geffen School of Medicine at University of California at Los Angeles, Los Angeles, California

Requests for reprints: Silvia de Sanjose, Servei d'Epidemiologia & Registre del Cancer, Institut Catala d'Oncologia, Gran Via Km 2.7, 08907 L'Hospitalet, Barcelona, Spain. Phone: 34-93-260-7812; Fax: 34-93-260-7787. E-mail: s.sanjose{at}ico.scs.es

Objectives: We evaluated whether occupational exposure to high molecular weight agents that are associated with asthma and that act predominantly through an immunoglobulin E (IgE)–dependent hypersensitivity mechanism is also associated with risk for specific lymphoma types.

Methods: The Spanish lymphoma case-control study includes 519 newly diagnosed cases of lymphoid neoplasms and 554 hospital controls ages 20 to 80 years. Lymphomas were histologically or cytologically confirmed and classified according to the WHO classification. Lifetime occupational exposure to seven high molecular weight agents such as latex was evaluated through an asthma-specific job-exposure matrix and validated by an industrial hygienist. Odds ratios (OR) and 95% confidence intervals (95% CI) were adjusted for age, sex, hospital, and occupational exposures.

Results: Subjects exposed to high molecular weight agents had an increased risk for Hodgkin's lymphoma (OR, 2.27; 95% CI, 0.93-5.50), particularly nodular sclerosis (OR, 3.22; 95% CI, 1.14-9.09). ORs did not increase with duration of exposure to these agents. Exposure to high molecular weight agents was not associated with risk of other B-cell lymphomas; for most specific subcategories of B-cell lymphoma, ORs were below unity. A slightly increased OR (95% CI) was seen for mycosis fungoides [1.60 (0.53-4.84)], although overall there was no increased risk for T-cell lymphomas.

Conclusions: Exposure to immunologically active agents among clinically immunocompetent subjects was associated with risk for Hodgkin's lymphoma.

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