Multiple myeloma and occupation: Results from the Epilymph study Free

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Multiple myeloma (MM) is a neoplasm of plasma cells. A systematic review done by our group showed associations with farming and cleaning services. We present results of the MM and occupation analyses from the Epilymph study, a case control study on Lymphomas conducted in six European countries.

Methods: Cases were all consecutive patients with a diagnosis of MM in the six participant countries (Germany, Italy, Spain, France, Czech Republic, and Ireland). Standardized interviews were conducted. The occupational interview comprised a life time job history. A hygienist coded job titles using international occupational codes (ISCO code) and define likelihood of exposure to specific substances. We use unconditional regression model to assess the OR of individual occupations according to job duration ( Less than 9 years, 10 years or more) and exposures adjusting by age, sex, country and level of education.

Results: 277 MM cases and 2463 matched controls were included. Controls had a mean age of 56.17 (SD 15.98) and cases 62 (SD12.05). Using ISCO coded job titles, we found an elevated odds ratio (OR) of 1.96, with a 95% Confidence Interval (CI) 1.06 to 3.62, for general farmers; and OR = 1.93 (95% CI: 1.08-3.46) for crop farmers, among subjects with more than 10 years of work in both instances. OR was also elevated for printers OR = 2.36; CI (1.32-4.22), and cleaners OR = 1.68; CI (0.70-3.98). We did not find an elevated risk for farmers working only with animals. Analysis of specific exposures showed no significantly elevated risk for exposure to pesticides, or for a range of industrial chemicals. A low level of education remains an independent risk factor in all the models.

Conclusions: Our finding of a positive association with working as a farmer and cleaners confirms previous studies. The association with the occupation as printers has not been previously reported. Level of education appears to be an independent risk factor to be considered in MM epidemiology. Further analysis of these data will include assessment for intensity of exposure in specific occupational exposures.