Occupational history and exposure and the risk of adult leukemia in Shanghai

PURPOSE: Evaluation of the association of selected occupational exposures with leukemia risk. METHODS: Population-based case-control study of 486 leukemia subjects and 502 healthy controls residing in Shanghai from 1987 to 1989. Adjusted odds ratios (OR) were calculated for the association between occupational factors and leukemia risk. RESULTS: Significant increase in leukemia risk was observed in chemical manufacturing industry workers (OR = 3.1, 95% CI = 1.0-9.8). Increased risks for leukemia were observed from self-reported exposures to benzene (OR = 1.7, 95% CI = 1.1-2.6), radioactive materials (OR = 3.7, 95% CI = 1.310.2), synthetic fiber dust (OR = 2.0, 95% CI = 1.2-3.5), and toluene (OR = 1.6, 95% CI = 1.0-2.5). Dose-response relations of leukemia risk was observed with the duration of exposure to benzene (OR = 3.3, 95% CI = 1.6-6.9 for greater than or equal to15 years exposure; p for trend <0.01), radioactive materials (OR = 5.2, 95% CI = 1.1-24.7 for greater than or equal to15 years exposure; p for trend = 0.02), paints (OR 2.3, 95% CI = 1.2-4.7 for greater than or equal to15 years exposure; p for trend = 0.09), and toluene (OR = 2.9, 95 % CI 1.3-6.7 for greater than or equal to15 years exposure; p for trend = 0.02). CONCLUSIONS: Adult leukemia risk may be associated with working in the chemical industry, and exposure to benzene, synthetic fiber dust, radioactive materials, and toluene in the study population. Ann Epidemiol 2003;13:485-494. (C) 2003 Elsevier Inc. All rights reserved.