Farmers face increased risk for multiple myeloma

By Joanna Lyford, Senior medwireNews Reporter

People working as farmers and those with long-term exposure to pesticides have an increased risk for multiple myeloma, results of a large European study suggest.

Data from EPILYMPH, a multicenter case-control study on lymphoma etiology conducted in six European countries, add further weight to the hypothesis that multiple myeloma is associated with pesticide exposure, say the authors.

A total of 277 patients with multiple myeloma were matched by center, age, and gender with 1108 healthy controls. The average age of participants was 62.3 years and 57% were men.

The researchers collected detailed demographic, clinical, and occupational information for each participant. Local industrial hygienists then calculated the likelihood and intensity of exposure to specific substances, including pesticides, organic solvents, living animals, radiation, and dust, explain Carla Perrotta (Hospital Italiano de Buenos Aires, Argentina) and colleagues writing in the Journal of Occupational Medicine & Toxicology.

In logistic regression analysis, a low level of education was significantly associated with multiple myeloma risk, with an odds ratio (OR) of 1.68.

Of the occupational factors, the risk for multiple myeloma was significantly increased in people who worked as farmers (OR=1.77), cleaners (OR=1.69), and telephone and radio operators (OR=6.17), and nonsignificantly increased in those who worked as printers (OR=2.06) and gardeners (OR=3.26).

Interestingly, the risks in farm workers and printers increased over time, suggesting a dose-response relationship. Also, long-term exposure to pesticides was associated with increased multiple myeloma risk (OR=1.62) whereas exposure to organic solvents, living animals, and benzene was not.

Taken together, the EPILYMPH data confirm previous suggestions of an increased risk of multiple myeloma among farmers and a link with prolonged pesticide exposure, Perrotta et al write.

They conclude: "Although this is one of the single largest epidemiological studies of multiple myeloma published to date, it might still suffer from inadequate power to detect the origins of the observed increased risk in farmers, and to find significant relationships with other occupations, such as painters and printers…

"Further collaborative efforts will need to be pursued to better understand the observed associations."

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