AMERICAN JOURNAL OF INDUSTRIAL MEDICINE (2008) Risk of Leukemia and Multiple Myeloma Associated With Exposure to Benzene and Other Organic Solvents:Evidence From the Italian Multicenter Case-Control Study beaabneeReeooaen Stefania Rodella,MD,7.8 Emanuele Stag 9 Paolo Crosign Luciano Ro 1 celi Background While there is a general consensus about the ability mia andu 263。 -st cas Results We found no association between exposure to any solvent and AML.Therewere wide confidence intervals.from medium/hih exosure toxlene and tolene as well. Conclusions We did not confirm the known association between benzene and AML I by the strict regulation suppor Med 恤a nal Health and Salety Local Unit,SPre SAL Az.Unita Sanitaria Locale 7 ydh setts,Lo nal Health and Safety Local Unit.SPreSA.L.Az Unita Sanitaria Local 3G oloohes al Ca rch Institute,Genoa ltaly nit of Cancer CPO San Giovanni Battista Hospital of Turin University of p blished online in Wley InterScience ©2008 Viley-Liss.lnc AMERICAN JOURNAL OF INDUSTRIAL MEDICINE (2008) Risk of Leukemia and Multiple Myeloma Associated With Exposure to Benzene and Other Organic Solvents: Evidence From the Italian Multicenter Case–Control Study Adele Seniori Costantini, MD, 1
Alessandra Benvenuti, DSc, 1 Paolo Vineis, MD, 2,3 David Kriebel, DSc, 4 Rosario Tumino, MD, 5 Valerio Ramazzotti, MD, 6 Stefania Rodella, MD, 7,8 Emanuele Stagnaro, MD, 9 Paolo Crosignani, MD, 10 Dino Amadori, MD, 11 Dario Mirabelli, MD, 12 Letizia Sommani, MD, 13 Isabella Belletti, DSc, 10 Loredana Troschel, DSC, 10 Luciano Romeo, MD, 14 Giuseppe Miceli, MD, 15 Giulio Andrea Tozzi, DSc, 16 Igino Mendico, MD, 17 Simona Alberghini Maltoni,1 and Lucia Miligi, DSc1 Background While there is a general consensus about the ability of benzene to induce acute myeloid leukemia (AML), its effects on chronic lymphoid leukemia and multiple myeloma (MM) are still under debate. We conducted a population-based case–control study to evaluate the association between exposure to organic solvents and risk of myeloid and lymphoid leukemia and MM. Methods Five hundred eighty-six cases of leukemia (and 1,278 population controls), 263 cases of MM (and 1,100 population controls) were collected. Experts assessed exposure at individual level to a range of chemicals. Results We found no association between exposure to any solvent and AML. There were elevated point estimates for the associations between medium/high benzene exposure and chronic lymphatic leukemia (OR ¼ 1.8, 95% CI ¼ 0.9–3.9) and MM (OR ¼ 1.9, 95% CI ¼ 0.9–3.9). Risks of chronic lymphatic leukemia were somewhat elevated, albeit with wide confidence intervals, from medium/high exposure to xylene and toluene as well. Conclusions We did not confirm the known association between benzene and AML, though this is likely explained by the strict regulation of benzene in Italy nearly three decades prior to study initiation. Our results support the association between benzene,
2008 Wiley-Liss,Inc. 14Occupational Medicine, Department of Medicine and Public Health, University of Verona, Verona, Italy 15Occupational Health and Safety Local Unit, S.Pre.S.A.L, Az. Unita' Sanitaria Locale 7, Ragusa, Italy 16Occupational Health and Safety Local Unit, S.Pre.S.A.L, Az. Unita' Sanitaria Locale 3 Genoa, Italy 17Health Prevention Department, Az. Unita' Sanitaria Locale, Latina, Italy Contract grant sponsor: U.S. National Cancer Institute; Contract grant number: NCI CA51086; Contract grant sponsor: European Community (Europe against Cancer Pro￾gramme); Contract grant sponsor: Italian Alliance against Cancer (Lega Italiana per la Lotta contro i Tumori). *Correspondence to: Dr. Adele. Seniori Costantini, Unit of Environmental and Occupational Epidemiology, Center for Study and Prevention of Cancer,Via di S. Salvi12, 50135 Florence, Italy. E-mail: a.seniori@cspo.it Accepted 4 April 2008 DOI10.1002/ajim.20592. Published online in Wiley InterScience (www.interscience.wiley.com) 1 Unit of Environmental and Occupational Epidemiology,Center for Study and Prevention of Cancer, Florence, Italy 2 University of Turin,Turin, Italy 3 Imperial College London, London, UK 4 Department of Work Environment, University of Massachusetts, Lowell, Massachusetts 5 RegistroTumori Azienda Ospedaliera ‘‘Civile
M.P. Arezzo’’ Ragusa, Italy 6 Servizio Integrato di Epidemiologia e Sistemi Informativi, National Cancer Institute, Istituto Regina Elena, Rome, Italy 7 Agenzia Regionale di Sanita' Florence, Italy 8 Az. Ospedaliera,Verona, Italy 9 Environmental Epidemiology Unit, National Cancer Research Institute, Genoa, Italy 10Epidemiology Unit, National Cancer Institute, Milan, Italy 11Medical Oncology Department,Pierantoni Hospital, Istituto Oncologico Romagnolo, Forl|', Italy12Unit of Cancer Epidemiology, CPO San Giovanni Battista Hospital of Turin, University of Turin,Turin, Italy 13Preventive Medicine Service, Local Health Unit, Florence, Italy