Occupational exposure to ethylene oxide and risk of lymphoma

Sibel Kiran, Pierluigi Cocco, Andreat Mannetje, Giannina Satta, Ileana D'Andrea, Nikolaus Becker, Silvia De Sanjosé, Lenka Foretova, Anthony Staines, Silke Kleefeld, Marc Maynadié, Alexandra Nieters, Paul Brennan, Paolo Boffetta

Research output: Contribution to journalArticlepeer-review

19 Scopus citations

Abstract

Background: Ethylene oxide, a high-volume commodity, is an established human carcinogen, although the relevant epidemiologic evidence is limited. Methods: We explored the association between occupational exposure to ethylene oxide and risk of lymphoma in a case-control study, including 2347 lymphoma cases first diagnosed in 1998-2004 and 2463 controls, from 6 European countries. The diagnosis of lymphoma was based on the 2001 World Health Organization Classification of lymphoma. Occupational exposure to ethylene oxide was retrospectively assessed by industrial hygienists and occupational physicians based on detailed self-reported information. We modeled risk of lymphoma with unconditional logistic regression analysis as a function of various exposure measures, adjusting for age, sex, and participating center. Results: Thirty-one cases and 27 controls (1.2% of the total study population) were defined as ever having been exposed to ethylene oxide (odds ratio = 1.3 [95% confidence interval [CI] = 0.7-2.1]). Lymphoma risk showed a 4.3-fold increase associated with medium-high frequency of exposure to ethylene oxide (95% CI = 1.4-13). Among major subtypes, chronic lymphocytic leukemia was consistently associated with ethylene oxide exposure, related in a dose-response manner to probability, frequency, and duration of exposure, as well as to cumulative exposure and (less definitively) with exposure intensity. Conclusions: Our results add to the evidence that ethylene oxide is a human carcinogen.

Original languageEnglish
Pages (from-to)905-910
Number of pages6
JournalEpidemiology
Volume21
Issue number6
DOIs
StatePublished - Nov 2010

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