Plasma polychlorobiphenyl and organochlorine pesticide level and risk of major lymphoma subtypes.

BACKGROUND: There is conflicting epidemiological evidence concerning an increase in risk of non-Hodgkin's lymphoma (NHL) associated with elevated blood levels of persistent organochlorine (OC) pesticides and polychlorobiphenyls (PCBs). METHODS: We measured the concentration of 17 OC pesticides, including hexachlorobenzene (HCB), four lindane isomers (alpha-, beta-, gamma- and delta-hexachlorocyclohexane (HCH)), two chlordane species (heptachlor and oxy-chlordane), four cyclodiene insecticides (aldrin, dieldrin, endrin and mirex), six dichloro-diphenyl-trichloroethane (DDT) isomers and nine PCB congeners (PCBs 28, 52, 101, 118, 138, 153, 170, 180 and 194) in plasma samples of 377 subjects, including 174 NHL cases and 203 controls from France, Germany and Spain. The risk of NHL and its major subtypes associated with increasing blood levels of OC pesticides and PCBs was calculated using unconditional logistic regression. RESULTS: Risk of NHL, diffuse large B cell lymphoma (DLBCL) and chronic lymphatic leukaemia (CLL) did not increase with plasma levels of HCB, beta-HCH, p,p'-dichloro-diphenyl-dichloroethylene (DDE), or total and individual PCBs or their functional groups, in the overall study population. Substantial heterogeneity in DLBCL risk associated with immunotoxic PCBs (p = 0.03) existed between the Spanish subgroup (odds ratio (OR) for immunotoxic PCB plasma level above the median vs below the median was 0.7, 95% CI 0.3 to 1.6) and the French and German subgroups combined (OR 3.2, 95% CI 0.9 to 11.5). CONCLUSION: We did not find evidence of an association between NHL risk and plasma level of OC pesticides and PCBs.

[A comparison of the information obtained in a health survey by interview with primary care registries]. / Comparación de la información obtenida en una encuesta de salud por entrevista con los registros de atención primaria.

To estimate the levels of underreporting of medical visits and to compare the reporting of chronic restrictive diseases, 203 individuals who had been visited in a Primary Health Center were interviewed in the period of two weeks following the medical visit. Underreporting of a medical visit was identified in 31 (15.3%) of the users. The level of underreporting was not related with age, sex, education or socioeconomic status. Reporting of chronic restrictive illness was compared with the information recorded in the user's medical record. The highest global agreement (91.6%) was observed for hypertensive disease (kappa index = 0.71), while the lowest agreement was found for chronic back pain (global agreement = 77.8% and kappa index = 0.14). Since underreporting of medical visits was moderate, the results suggest that this question can be used for the analysis of social differences in the access to health services. Nevertheless, estimation of the prevalence of chronic limiting conditions in a health interview survey should be done with great caution.