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© 1992 Oxford University Press

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Occupational Risk Factors for Acute Leukaemia: A Case-Control Study

S RICHARDSON*, R ZITTOUN**, S BASTUJI-GARIN*, V LASSERRE{dagger}, C GUIHENNEUC{dagger}, M CADIOU**, F VIGUIE{ddagger} and I LAFFONT-FAUST§

* INSERM U 170, 16 Avenue Paul Vaillant Couturier, 94807 Villejuif, France
** Service d'Hématologie H{odot}tel-Dieu, I Place du Parvis Notre Dame, 75004 Paris, France
{dagger}Laboratoire de statistiques médicales CNRS URA 13-23,45 rue des Saints Péres, 75006 Paris, France
{ddagger}Laboratoire d'histologie, embryologie et cytogénétique H{odot}tel-Dieu, 75004 Paris, France
§ Ministére du Travail, 1 place de Fontenay, 75007 Paris, France

A case-control study has been performed for occupational risk factors of acute leukaemia, based on 185 cases more than 30 years old and 513 matched controls. There was a significant excess of potyvalent farming and electronic engineers among professons of cases, and, in addition of metal workers when considering the professions pursued for more than 5 years. The corresponding exposures were analysed through a detailed questionnaire, and assessed by an industrial hygienist after blinding the case-control status. The odds ratios (OR) were computed after adjustment on matching variables and prior cheerio-or radiotherapy treatment, and after stratification for the level and total duration of exposure. There was no excess of professional exposure to ionizing radiation among cases. A significant relationship was observed between acute leukeemnia and high or medium exposure to benzene, as well as over 10 years high or medium exposure to exhaust gas. In addition a significant relationship was observed with exposure to pesticides—insecticides and/or weed killers—and to electric and magnetic fields (EMF). The relationship with pesticides was significant when considering high or medium exposure to weed killers and more than 10 years ex posure to both subtypes of pesticides. The relationship with pesticides and EMF remained significant when confound ing factors were taken into consideration and after adjustment on co-exposure to benzene.

The cytological studies showed that acute leukaemias following exposure to benzene (high or medium) and to EMF were only of myelogenous subtypes, whereas those following exposure to pesticides were divided between Iym phoblastic and myeloblastic subtypes. Cytogenetic studies failed to show increased frequency of chromosomal abnor rnalities, as described in acute leukaemias secondary to anti-cancer treatments. Our study adds credence to the hypothesis that pesticides and EMF are leukaemogenic agents, together with benzene.

Revised 1 June 1992


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