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Br J Ind Med. Feb 1992; 49(2): 95–103.
PMCID: PMC1012073

Occupational and other environmental factors and multiple myeloma: a population based case-control study.


Epidemiological studies on the aetiology of multiple myeloma are reviewed as a background to this population based case-control study performed in an area with a high incidence of multiple myeloma. The purpose was to identify and evaluate several suspected environmental factors in relation to this disease. A total of 275 confirmed cases diagnosed in four counties in northern Sweden during four years were compared with the same number of control subjects drawn from population registries. The controls were matched for age, sex, county, and vital status. Occupations and work associated exposures to chemicals and other potential carcinogens were assessed by an extensive questionnaire that also included questions on smoking habits, residential building materials, vicinity to electrical power lines, and leisure time contact with animals, electrical equipment, and chemicals. Information obtained from the questionnaires was completed by telephone interviews when necessary. Univariate analysis and multivariate logistic regression were performed. The study confirmed an association found earlier between farming and multiple myeloma. Some domestic animals (cattle, horses, and goats) and two types of pesticides (phenoxyacetic acids and DDT) were indicated as risk factors within farming. Exposure to electromagnetic fields, asbestos, and organic solvents were negatively associated with myeloma in this study.

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  • Maldonado JE, Kyle RA. Familial myeloma. Report of eight families and a study of serum proteins in their relatives. Am J Med. 1974 Dec;57(6):875–884. [PubMed]
  • Shoenfeld Y, Berliner S, Shaklai M, Gallant LA, Pinkhas J. Familial multiple myeloma. A review of thirty-seven families. Postgrad Med J. 1982 Jan;58(675):12–16. [PMC free article] [PubMed]
  • Bourguet CC, Grufferman S, Delzell E, DeLong ER, Cohen HJ. Multiple myeloma and family history of cancer. A case-control study. Cancer. 1985 Oct 15;56(8):2133–2139. [PubMed]
  • Eriksson M, Bergström I. Familial malignant blood disease in the country of Jämtland, Sweden. Eur J Haematol. 1987 Mar;38(3):241–245. [PubMed]
  • Preston DL, Kato H, Kopecky K, Fujita S. Studies of the mortality of A-bomb survivors. 8. Cancer mortality, 1950-1982. Radiat Res. 1987 Jul;111(1):151–178. [PubMed]
  • Gilbert ES, Marks S. An analysis of the mortality of workers in a nuclear facility. Radiat Res. 1979 Jul;79(1):122–148. [PubMed]
  • Gilbert ES, Marks S. An updated analysis of mortality of workers in a nuclear facility. Radiat Res. 1980 Sep;83(3):740–741. [PubMed]
  • Gilbert ES, Petersen GR, Buchanan JA. Mortality of workers at the Hanford site: 1945-1981. Health Phys. 1989 Jan;56(1):11–25. [PubMed]
  • Cuzick J. Radiation-induced myelomatosis. N Engl J Med. 1981 Jan 22;304(4):204–210. [PubMed]
  • Agu VU, Christensen BL, Buffler PA. Geographic patterns of multiple myeloma: racial and industrial correlates, State of Texas, 1969-71. J Natl Cancer Inst. 1980 Oct;65(4):735–738. [PubMed]
  • Burmeister LF. Cancer mortality in Iowa farmers, 1971-78. J Natl Cancer Inst. 1981 Mar;66(3):461–464. [PubMed]
  • Burmeister LF, Everett GD, Van Lier SF, Isacson P. Selected cancer mortality and farm practices in Iowa. Am J Epidemiol. 1983 Jul;118(1):72–77. [PubMed]
  • Gallagher RP, Spinelli JJ, Elwood JM, Skippen DH. Allergies and agricultural exposure as risk factors for multiple myeloma. Br J Cancer. 1983 Dec;48(6):853–857. [PMC free article] [PubMed]
  • Cantor KP, Blair A. Farming and mortality from multiple myeloma: a case-control study with the use of death certificates. J Natl Cancer Inst. 1984 Feb;72(2):251–255. [PubMed]
  • Pearce NE, Smith AH, Howard JK, Sheppard RA, Giles HJ, Teague CA. Case-control study of multiple myeloma and farming. Br J Cancer. 1986 Sep;54(3):493–500. [PMC free article] [PubMed]
  • Nandakumar A, Armstrong BK, de Klerk NH. Multiple myeloma in Western Australia: a case-control study in relation to occupation, father's occupation, socioeconomic status and country of birth. Int J Cancer. 1986 Feb 15;37(2):223–226. [PubMed]
  • Cuzick J, De Stavola B. Multiple myeloma--a case-control study. Br J Cancer. 1988 May;57(5):516–520. [PMC free article] [PubMed]
  • La Vecchia C, Negri E, D'Avanzo B, Franceschi S. Occupation and lymphoid neoplasms. Br J Cancer. 1989 Sep;60(3):385–388. [PMC free article] [PubMed]
  • Boffetta P, Stellman SD, Garfinkel L. A case-control study of multiple myeloma nested in the American Cancer Society prospective study. Int J Cancer. 1989 Apr 15;43(4):554–559. [PubMed]
  • Alavanja MC, Blair A, Merkle S, Teske J, Eaton B. Mortality among agricultural extension agents. Am J Ind Med. 1988;14(2):167–176. [PubMed]
  • Steineck G, Wiklund K. Multiple myeloma in Swedish agricultural workers. Int J Epidemiol. 1986 Sep;15(3):321–325. [PubMed]
  • McLaughlin JK, Malker HS, Linet MS, Ericsson J, Stone BJ, Weiner J, Blot WJ, Fraumeni JF., Jr Multiple myeloma and occupation in Sweden. Arch Environ Health. 1988 Jan-Feb;43(1):7–10. [PubMed]
  • Linet MS, Harlow SD, McLaughlin JK. A case-control study of multiple myeloma in whites: chronic antigenic stimulation, occupation, and drug use. Cancer Res. 1987 Jun 1;47(11):2978–2981. [PubMed]
  • Brownson RC, Reif JS. A cancer registry-based study of occupational risk for lymphoma, multiple myeloma and leukaemia. Int J Epidemiol. 1988 Mar;17(1):27–32. [PubMed]
  • Flodin U, Fredriksson M, Persson B. Multiple myeloma and engine exhausts, fresh wood, and creosote: a case-referent study. Am J Ind Med. 1987;12(5):519–529. [PubMed]
  • Amandus HE, Wheeler R, Jankovic J, Tucker J. The morbidity and mortality of vermiculite miners and millers exposed to tremolite-actinolite: Part I. Exposure estimates. Am J Ind Med. 1987;11(1):1–14. [PubMed]
  • Morris PD, Koepsell TD, Daling JR, Taylor JW, Lyon JL, Swanson GM, Child M, Weiss NS. Toxic substance exposure and multiple myeloma: a case-control study. J Natl Cancer Inst. 1986 Jun;76(6):987–994. [PubMed]
  • Schwartz DA, Vaughan TL, Heyer NJ, Koepsell TD, Lyon JL, Swanson GM, Weiss NS. B cell neoplasms and occupational asbestos exposure. Am J Ind Med. 1988;14(6):661–671. [PubMed]
  • Rinsky RA, Smith AB, Hornung R, Filloon TG, Young RJ, Okun AH, Landrigan PJ. Benzene and leukemia. An epidemiologic risk assessment. N Engl J Med. 1987 Apr 23;316(17):1044–1050. [PubMed]
  • Lundberg I. Mortality and cancer incidence among Swedish paint industry workers with long-term exposure to organic solvents. Scand J Work Environ Health. 1986 Apr;12(2):108–113. [PubMed]
  • Thomas TL, Decoufle P, Moure-Eraso R. Mortality among workers employed in petroleum refining and petrochemical plants. J Occup Med. 1980 Feb;22(2):97–103. [PubMed]
  • Ott MG, Holder BB, Gordon HL. Respiratory cancer and occupational exposure to arsenicals. Arch Environ Health. 1974 Nov;29(5):250–255. [PubMed]
  • Axelson O, Dahlgren E, Jansson CD, Rehnlund SO. Arsenic exposure and mortality: a case-referent study from a Swedish copper smelter. Br J Ind Med. 1978 Feb;35(1):8–15. [PMC free article] [PubMed]
  • Greene MH, Hoover RN, Eck RL, Fraumeni JF., Jr Cancer mortality among printing plant workers. Environ Res. 1979 Oct;20(1):66–73. [PubMed]
  • Guidotti S, Wright WE, Peters JM. Multiple myeloma in cosmetologists. Am J Ind Med. 1982;3(2):169–171. [PubMed]
  • Spinelli JJ, Gallagher RP, Band PR, Threlfall WJ. Multiple myeloma, leukemia, and cancer of the ovary in cosmetologists and hairdressers. Am J Ind Med. 1984;6(2):97–102. [PubMed]
  • Gallagher RP, Threlfall WJ. Cancer mortality in metal workers. Can Med Assoc J. 1983 Dec 1;129(11):1191–1194. [PMC free article] [PubMed]
  • Dörken H, Vollmer I. Die Epidemiologie des multiplen Myeloms. Untersuchung von 149 Fällen. Arch Geschwulstforsch. 1968;31(1):18–38. [PubMed]
  • Walrath J, Decouflé P, Thomas TL. Mortality among workers in a shoe manufacturing company. Am J Ind Med. 1987;12(5):615–623. [PubMed]
  • Brinton LA, Stone BJ, Blot WJ, Fraumeni JF., Jr Nasal cancer in U.S. furniture industry countries. Lancet. 1976 Sep 18;2(7986):628–628. [PubMed]
  • Tollerud DJ, Brinton LA, Stone BJ, Tobacman JK, Blattner WA. Mortality from multiple myeloma among North Carolina furniture workers. J Natl Cancer Inst. 1985 Apr;74(4):799–801. [PubMed]
  • Miettinen OS. Estimation of relative risk from individually matched series. Biometrics. 1970 Mar;26(1):75–86. [PubMed]
  • Kaplan HS. From experimental animal models to human lymphoid tissue neoplasia: search for a viral etiology. Recent Results Cancer Res. 1978;64:325–336. [PubMed]
  • CHAPMAN I, JIMENEZ FA. ALEUTIAN-MINK DISEASE IN MAN. N Engl J Med. 1963 Nov 28;269:1171–1174. [PubMed]
  • Henry LW. Multiple myeloma in a mink handler following exposure to Aleutian disease. Cancer. 1979 Jul;44(1):273–275. [PubMed]
  • Ressang AA, Mastenbroek N, Quak J, van Griensven LJ, Calafat J, Hilgers J, Hageman PC, Souissi T, Swen S. Studies on bovine leukemia. I. Establishment of type C virus producing cell lines. Zentralbl Veterinarmed B. 1974 Aug;21(8):602–617. [PubMed]
  • Kettmann R, Portetelle D, Mammerickx M, Cleuter Y, Dekegel D, Galoux M, Ghysdael J, Burny A, Chantrenne H. Bovine leukemia virus: an exogenous RNA oncogenic virus. Proc Natl Acad Sci U S A. 1976 Apr;73(4):1014–1018. [PMC free article] [PubMed]
  • Priester WA, Mason TJ. Human cancer mortality in relation to poultry population, by county, in 10 southeastern States. J Natl Cancer Inst. 1974 Jul;53(1):45–49. [PubMed]
  • Hardell L, Eriksson M, Lenner P, Lundgren E. Malignant lymphoma and exposure to chemicals, especially organic solvents, chlorophenols and phenoxy acids: a case-control study. Br J Cancer. 1981 Feb;43(2):169–176. [PMC free article] [PubMed]
  • Hoar SK, Blair A, Holmes FF, Boysen CD, Robel RJ, Hoover R, Fraumeni JF., Jr Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma. JAMA. 1986 Sep 5;256(9):1141–1147. [PubMed]
  • Kociba RJ, Keyes DG, Beyer JE, Carreon RM, Wade CE, Dittenber DA, Kalnins RP, Frauson LE, Park CN, Barnard SD, et al. Results of a two-year chronic toxicity and oncogenicity study of 2,3,7,8-tetrachlorodibenzo-p-dioxin in rats. Toxicol Appl Pharmacol. 1978 Nov;46(2):279–303. [PubMed]
  • Pitot HC, Goldsworthy T, Campbell HA, Poland A. Quantitative evaluation of the promotion by 2,3,7,8-tetrachlorodibenzo-p-dioxin of hepatocarcinogenesis from diethylnitrosamine. Cancer Res. 1980 Oct;40(10):3616–3620. [PubMed]
  • Eriksson M, Hardell L, Adami HO. Exposure to dioxins as a risk factor for soft tissue sarcoma: a population-based case-control study. J Natl Cancer Inst. 1990 Mar 21;82(6):486–490. [PubMed]
  • Kashyap SK, Nigam SK, Karnik AB, Gupta RC, Chatterjee SK. Carcinogenicity of DDT (dichlorodiphenyl trichloroethane) in pure inbred Swiss mice. Int J Cancer. 1977 May 15;19(5):725–729. [PubMed]
  • Cabral JR, Hall RK, Rossi L, Bronczyk SA, Shubik P. Effects of long-term intake of DDT on rats. Tumori. 1982 Feb 28;68(1):11–17. [PubMed]
  • Persson B, Dahlander AM, Fredriksson M, Brage HN, Ohlson CG, Axelson O. Malignant lymphomas and occupational exposures. Br J Ind Med. 1989 Aug;46(8):516–520. [PMC free article] [PubMed]
  • Flodin U, Fredriksson M, Persson B, Axelson O. Chronic lymphatic leukaemia and engine exhausts, fresh wood, and DDT: a case-referent study. Br J Ind Med. 1988 Jan;45(1):33–38. [PMC free article] [PubMed]

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