Childhood infectious diseases and risk of non-Hodgkin's lymphoma according to the WHO classification: A reanalysis of the Italian multicenter case-control study.

Since 1960, incidence of non-Hodgkin's lymphoma (NHL) has been increasing in most industrialized countries, but causes of this trend remain unclear. A role of the decreased exposure to infectious agents during childhood has been proposed. Our study evaluates the association between common childhood infectious diseases and the risk of NHL and its major subtypes by a reanalysis of the Italian multicenter case-control study. After exclusion of next-of-kin interviews, 1,193 cases, diagnosed between 1990 and 1993, and 1,708 population-based controls were included in the analyses. OR estimates were obtained by logistic regression, adjusting for gender, age, residence area, education, smoking habit and exposure to radiations, pesticides and aromatic hydrocarbons. Among B-cell lymphomas (n = 1,102) an inverse association was observed for rubella (OR = 0.80, 95% CI: 0.65-0.99), pertussis (OR = 0.74, 95% CI: 0.62-0.88) and any infection (OR = 0.75, 95% CI: 0.61-0.93). A negative trend by number of infections was observed, which was more evident among mature B-cell lymphoma (OR = 0.66 for three infections or more, 95% CI: 0.48-0.90). Our results indicate a potential protective role of common childhood infections in the etiology of B-cell NHL.

Coffee consumption and risk of non-Hodgkin's lymphoma: evidence from the Italian multicentre case-control study.

PURPOSE: Several investigations have analysed the association between coffee intake and risk of cancer. Contradictory results were reported by the studies conducted in non-Hodgkin's lymphomas (NHL) few of which report results according to main NHL subgroups. The present study is aimed at evaluating the association between coffee consumption and the risk of NHL by analysing data from a large Italian multicentre case-control study that included 1,418 interviewed cases (1,301 B cell and 117 T cell NHL), diagnosed between 1990 and 1993, and 1,774 population healthy controls. METHODS: The association was evaluated by standard logistic regression analysis. Odds ratio (OR) estimates were adjusted for gender, age, residence area, educational level, previous chemotherapy treatment, smoking habit and exposure to electromagnetic fields, radiation, pesticides and aromatic hydrocarbons. RESULTS: For all B cell lymphomas, an increased risk (OR 1.6, 95% CI 1.2-2.0) was observed in the highest exposure category (consumption >4 cups per day for at least 30 years), but without a clear dose-response trend. Subgroup analyses highlighted an increased risk for drinkers of at least four cups per day for follicular lymphoma (OR 2.0, 95% CI 1.2-3.4). The risk increased with years of exposure and was more elevated among current smokers. CONCLUSIONS: Consumption of more than four cups of coffee per day enhances the risk of lymphoma, especially the follicular subtype. Further investigations based on large cohorts and accurate measures of exposure are needed to confirm the observed associations.

Coffee and tea consumption and risk of leukaemia in an adult population: A reanalysis of the Italian multicentre case-control study.

BACKGROUND: Coffee and tea are the most frequently consumed beverages in the world. Their potential effect on the risk of developing different types of malignancies has been largely investigated, but studies on leukaemia in adults are scarce. METHODS: The present investigation is aimed at evaluating the potential role of regular coffee and tea intake on the risk of adult leukaemia by reanalysing a large population based case-control study carried out in Italy, a country with a high coffee consumption and a low use of green tea. Interviewed subjects, recruited between 1990 and 1993 in 11 Italian areas, included 1771 controls and 651 leukaemia cases. Association between Acute Myeloid Leukaemia (AML), Acute Lymphoid Leukaemia, Chronic Myeloid Leukaemia, Chronic Lymphoid Leukaemia, and use of coffee and tea was evaluated by standard logistic regression. Odds Ratios (OR) were estimated adjusting for the following potential confounders: gender, age, residence area, smoking habit, educational level, previous chemotherapy treatment, alcohol consumption and exposure to electromagnetic fields, radiation, pesticides and aromatic hydrocarbons. RESULTS: No association was observed between regular use of coffee and any type of leukaemia. A small protective effect of tea intake was found among myeloid malignancies, which was more evident among AML (OR=0.68, 95%CI: 0.49-0.94). However, no clear dose-response relation was found. CONCLUSION: The lower risk of leukaemia among regular coffee consumers, reported by a few of previous small studies, was not confirmed. The protective effect of tea on the AML risk is only partly consistent with results from other investigations.

Health Issues of Primary School Students Residing in Proximity of an Oil Terminal with Environmental Exposure to Volatile Organic Compounds.

Residential proximity to industrial sites has been associated with adverse effects on human health. Children are more susceptible to airborne environmental exposure because their immune and respiratory systems are still developing. This study aimed to investigate whether living close to an oil terminal in Genoa where there is higher VOCs exposure is associated with an increased rate of school absenteeism because of disease in primary school children. Five schools were chosen for the recruitment of children and students residing in the industrial site (A) were compared to those living in residential sites (B). Sixty-six of the 407 students involved in the project were also selected for VOC monitoring. Source apportionment was carried out by comparing profiles of VOCs; principal component analysis was performed to study the correlation between profiles, and Kriging interpolation model was used to extend profiles to all participants. The concentration means of total VOCs were significantly higher in the industrial areas compared to controls. Adjusting for potential confounders, children who lived in area A had a significantly higher risk of being absent from school due to sore throat, cough, and cold compared to controls. o-Xylene, which is dispersed during the industrial activity, showed clear evidence of a significant association with respiratory symptoms.

Lifestyle factors and risk of leukemia and non-Hodgkin's lymphoma: a case-control study.

PURPOSE: Risk factors for leukemia and lymphomas in adults are largely unknown. This study was aimed at evaluating the association between lifestyle factors and the risk of hematological malignancies in an adult population. METHODS: Data were drawn from a population-based case-control study carried out in Italy and included 294 cases (199 lymphoid and 95 myeloid) and 279 controls. Analyses were performed using standard multivariable logistic regression. RESULTS: Hair dye use for at least 15 years was associated with a higher risk of lymphoid malignancies among females (OR 2.3, 95 % CI 1.0-4.9, p = 0.036, test for trend). Furthermore, a protective effect of a moderate to heavy tea consumption on the risk of myeloid malignancies was observed (OR 0.4, 95 % CI 0.2-0.9, p = 0.017). No association was found for the use of alcoholic beverages and tobacco smoking. CONCLUSIONS: Our results confirm the potential carcinogenic effect of prolonged hair dye use observed in previous investigations. The excess risk could be explained by exposure to a higher concentration of toxic compounds in hair products used in the past. The protective effect of regular tea consumption observed in an area with a very high prevalence of black tea consumers deserves further investigation.

Chronic diseases, medical history and familial cancer, and risk of leukemia and non-Hodgkin's lymphoma in an adult population: a case-control study.

PURPOSE: This investigation was aimed at evaluating the association between chronic diseases, medical history and familial cancer, and the risk of developing hematological malignancies. METHODS: Data were drawn from a population-based case-control study carried out to assess the risk of non-Hodgkin's lymphoma and leukemia in an adult population exposed to environmental air pollution in Northern Italy. Each case was classified according to the WHO ICD-O-3 classification. Statistical analyses were performed by multivariable unconditional logistic regression in 573 interviewed subjects (199 lymphoid cases, 95 myeloid cases, and 279 healthy controls). RESULTS: Lymphoid malignancies were associated with a history of gastroduodenal ulcer (OR 2.1, 95 % CI 1.2-3.6), rheumatoid arthritis (OR 4.4, 95 % CI 1.3-19.0), anemia (OR 3.3, 95 % CI 1.2-9.3), cholecystectomy (OR 2.9, 95 % CI 1.0-8.0), heavy diagnostic X-ray exposure (OR 2.1, 95 % CI 1.3-3.7), and a familial risk of non-Hodgkin's lymphoma (OR 10.1, 95 % CI 1.3-458). Myeloid malignancies were associated with non-neoplastic thyroid diseases (OR 6.2, 95 % CI 1.7-35.6) and anemia (OR 6.8, 95 % CI 2.0-23.1). Subgroup analysis highlighted an excess risk of MALT in patients with gastroduodenal ulcer (OR 5.3, 95 % CI 1.04-23.7) and of AML in patients with rheumatoid arthritis (OR 6.9, 95 % CI 1.2-38.1), and of MDS in subjects exposed to heavy diagnostic X-ray (OR 3.4, 95 % CI 1.03-11.2) when the analysis was restricted to irradiation of pelvis, abdomen, or thorax. CONCLUSIONS: Most observed associations confirm results from previous studies. The higher risk of lymphoid malignancies among patients with a history of cholecystectomy needs further investigations.

Risk of leukaemia and residential exposure to air pollution in an industrial area in Northern Italy: a case-control study.

Leukaemia risk in adult populations exposed to environmental air pollution is poorly investigated. We have carried out a population-based case-control study in an area that included a fossil fuel power plant, a coke oven and two big chemical industries. Information on residential history and several risk factors for leukaemia was obtained from 164 cases, diagnosed between 2002 and 2005, and 279 controls. A higher risk for subjects residing in polluted areas was observed, but statistical significance was not reached (adjusted OR = 1.11 and 1.56 for subjects living in moderately and in heavily polluted zones, respectively, p = 0.190). Results suggest a possible aetiological role of residential air pollution from industrial sites on the risk of developing leukaemia in adult populations. However, the proportion of eligible subjects excluded from the study and the lack of any measure of air pollution prevent definitive conclusions from being drawn.

Etiologic heterogeneity among non-Hodgkin lymphoma subtypes: the InterLymph Non-Hodgkin Lymphoma Subtypes Project.

BACKGROUND: Non-Hodgkin lymphoma (NHL) comprises biologically and clinically heterogeneous subtypes. Previously, study size has limited the ability to compare and contrast the risk factor profiles among these heterogeneous subtypes. METHODS: We pooled individual-level data from 17 471 NHL cases and 23 096 controls in 20 case-control studies from the International Lymphoma Epidemiology Consortium (InterLymph). We estimated the associations, measured as odds ratios, between each of 11 NHL subtypes and self-reported medical history, family history of hematologic malignancy, lifestyle factors, and occupation. We then assessed the heterogeneity of associations by evaluating the variability (Q value) of the estimated odds ratios for a given exposure among subtypes. Finally, we organized the subtypes into a hierarchical tree to identify groups that had similar risk factor profiles. Statistical significance of tree partitions was estimated by permutation-based P values (P NODE). RESULTS: Risks differed statistically significantly among NHL subtypes for medical history factors (autoimmune diseases, hepatitis C virus seropositivity, eczema, and blood transfusion), family history of leukemia and multiple myeloma, alcohol consumption, cigarette smoking, and certain occupations, whereas generally homogeneous risks among subtypes were observed for family history of NHL, recreational sun exposure, hay fever, allergy, and socioeconomic status. Overall, the greatest difference in risk factors occurred between T-cell and B-cell lymphomas (P NODE < 1.0×10(-4)), with increased risks generally restricted to T-cell lymphomas for eczema, T-cell-activating autoimmune diseases, family history of multiple myeloma, and occupation as a painter. We further observed substantial heterogeneity among B-cell lymphomas (P NODE < 1.0×10(-4)). Increased risks for B-cell-activating autoimmune disease and hepatitis C virus seropositivity and decreased risks for alcohol consumption and occupation as a teacher generally were restricted to marginal zone lymphoma, Burkitt/Burkitt-like lymphoma/leukemia, diffuse large B-cell lymphoma, and/or lymphoplasmacytic lymphoma/Waldenström macroglobulinemia. CONCLUSIONS: Using a novel approach to investigate etiologic heterogeneity among NHL subtypes, we identified risk factors that were common among subtypes as well as risk factors that appeared to be distinct among individual or a few subtypes, suggesting both subtype-specific and shared underlying mechanisms. Further research is needed to test putative mechanisms, investigate other risk factors (eg, other infections, environmental exposures, and diet), and evaluate potential joint effects with genetic susceptibility.

Childhood infectious diseases and risk of leukaemia in an adult population.

Our study is aimed at investigating the association between common childhood infectious diseases (measles, chickenpox, rubella, mumps and pertussis) and the risk of developing leukaemia in an adult population. A reanalysis of a large population-based case-control study was carried out. Original data included 1,771 controls and 649 leukaemia cases from 11 Italian areas. To contain recall bias, the analysis was restricted to subjects directly interviewed and with a good quality interview (1,165 controls and 312 cases). Odds ratios (ORs) and their related 95% confidence intervals (95% CIs) were estimated by unconditional polychotomous logistic regression model adjusting for age, gender and occupational and lifestyle exposures. A protective effect of at least one infection (OR = 0.66, 95% CI: 0.45-0.97), measles (OR = 0.57, 95% CI: 0.39-0.82) and pertussis (OR = 0.66, 95% CI: 0.45-0.98) was observed for chronic lymphoid leukaemia (CLL). The number of infections was strongly inversely associated with the risk of CLL (p = 0.002, test for trend). With regard to the other types of leukaemia, only a protective effect of pertussis was observed for AML (OR = 0.52, 95% CI: 0.32-0.87). Our results pointed out a protective role of childhood infectious diseases on the risk of CLL in adults. Although a specific antioncogenic effect of some infectious disease, especially measles, cannot be ruled out, the observed decrease of risk with increasing number of infections suggests that a more general "hygiene hypothesis" could be the most likely explanation of the detected association. The protective role of pertussis remains to be elucidated.

Infectious diseases and risk of leukemia and non-Hodgkin's lymphoma: a case-control study.

The aim of this investigation was to evaluate the association between common infectious diseases and the risk of hematological malignancies in an adult population. Data were drawn from a population based case-control study that included 165 cases (125 lymphoid and 40 myeloid neoplasms) and 233 controls. Occurrence of childhood diseases (measles, rubella, chickenpox, mumps, pertussis and scarlet fever) was slightly inversely associated with the risk of both malignancies, but statistical significance was not reached. The data of infections occurring after 14 years of age indicated an increasing risk of lymphoid malignancies (OR=2.9, p<0.05).

Risk of leukemia and multiple myeloma associated with exposure to benzene and other organic solvents: evidence from the Italian Multicenter Case-control study.

BACKGROUND: While there is a general consensus about the ability of benzene to induce acute myeloid leukemia (AML), its effects on chronic lymphoid leukemia and multiple myeloma (MM) are still under debate. We conducted a population-based case-control study to evaluate the association between exposure to organic solvents and risk of myeloid and lymphoid leukemia and MM. METHODS: Five hundred eighty-six cases of leukemia (and 1,278 population controls), 263 cases of MM (and 1,100 population controls) were collected. Experts assessed exposure at individual level to a range of chemicals. RESULTS: We found no association between exposure to any solvent and AML. There were elevated point estimates for the associations between medium/high benzene exposure and chronic lymphatic leukemia (OR = 1.8, 95% CI = 0.9-3.9) and MM (OR = 1.9, 95% CI = 0.9-3.9). Risks of chronic lymphatic leukemia were somewhat elevated, albeit with wide confidence intervals, from medium/high exposure to xylene and toluene as well. CONCLUSIONS: We did not confirm the known association between benzene and AML, though this is likely explained by the strict regulation of benzene in Italy nearly three decades prior to study initiation. Our results support the association between benzene, xylene, and toluene and chronic lymphatic leukemia and between benzene and MM with longer latencies than have been observed for AML in other studies.

Alcohol consumption and risk of leukemia: A multicenter case-control study.

A population-based case-control study of 649 leukemia cases and 1771 controls carried out in 11 Italian areas, offered the opportunity to evaluate the relationship between alcohol consumption and leukemia risk. For all leukemias, acute lymphocytic leukemia (ALL), acute myeloid leukemia (AML), and chronic lymphocytic leukemia (CLL), we found a non-significantly inverse association for moderate levels of total alcohol and wine intake, but increased risks at high levels, with, in most cases, significant trend effects (odd ratios (OR) for all leukemias in the lowest quartile of total alcohol consumption [0.1-9.0 g/day of ethanol] versus never-drinker = 0.73; 95% confidence intervals (95% CI) = 0.51-1.03; OR in the highest quartile [> 31.7 g/day] = 1.15; 95% CI = 0.82-1.63; p of the linear trend test = 0.007). For chronic myeloid leukemia (CML), we found a non-significantly positive association for all levels of total alcohol and wine intake, and a significant positive linear trend effect (p = 0.03) for wine intake (OR for 0.1-9.0 g/day of ethanol intake from wine = 1.34; 95% CI = 0.61-2.94; OR in the highest quartile of wine intake [> 27.7 g/day] = 2.13; 95% CI = 1.01-4.50). No consistent dose-response was detected analysing duration of alcohol consumption for any leukemia subtypes. In conclusion, even though our study did not show a clear association between alcohol intake and leukemia risk, some of the patterns of the risk estimates (a possible J-shaped dose-response curve between alcohol intake and ALL, AML, and CLL risks, and the positive association between alcohol and CML), may be suggestive.

Occupational exposure to solvents and the risk of lymphomas.

BACKGROUND: A number of studies have shown possible associations between occupational exposures, particularly solvents, and lymphomas. The present investigation aimed to evaluate the association between exposure to solvents and lymphomas (Hodgkin and non-Hodgkin) in a large population-based, multicenter, case-control study in Italy. METHODS: All newly diagnosed cases of malignant lymphoma in men and women age 20 to 74 years in 1991-1993 were identified in 8 areas in Italy. The control group was formed by a random sample of the general population in the areas under study stratified by sex and 5-year age groups. We interviewed 1428 non-Hodgkin lymphoma cases, 304 Hodgkin disease cases, and 1530 controls. Experts examined the questionnaire data and assessed a level of probability and intensity of exposure to a range of chemicals. RESULTS: Those in the medium/high level of exposure had an increased risk of non-Hodgkin lymphoma with exposure to toluene (odds ratio = 1.8; 95% confidence interval = 1.1-2.8), xylene 1.7 (1.0-2.6), and benzene 1.6 (1.0-2.4). Subjects exposed to all 3 aromatic hydrocarbons (benzene, toluene, and xylene; medium/high intensity compared with none) had an odds ratio of 2.1 (1.1-4.3). We observed an increased risk for Hodgkin disease for those exposed to technical solvents (2.7; 1.2-6.5) and aliphatic solvents (2.7; 1.2-5.7). CONCLUSION: This study suggests that aromatic and chlorinated hydrocarbons are a risk factor for non-Hodgkin lymphomas, and provides preliminary evidence for an association between solvents and Hodgkin disease.

Alcohol consumption and risk of non-Hodgkin lymphoma: a pooled analysis.

BACKGROUND: Previous epidemiological studies of the relation between alcohol consumption and risk of non-Hodgkin lymphoma (NHL) have been inconsistent, probably because of small sample sizes of individual studies that result from stratification by NHL subtype and type of alcoholic beverage. We aimed to assess the role of alcohol consumption in NHL with sufficient sample size to analyse by both type of alcoholic beverage and disease subtype. METHODS: We obtained original data from nine case-control studies from the USA, UK, Sweden, and Italy in the International Lymphoma Epidemiology Consortium (InterLymph), yielding a pooled study population of 15 175 individuals (6492 cases and 8683 controls). We derived odds ratios (OR) and 95% CI from unconditional logistic regression models, controlling for study centre and other confounding factors. Heterogeneity between studies was assessed by comparison of results from joint fixed-effects logistic regression and two-stage random-effects logistic regression, and by calculation of Wald chi(2) statistics. FINDINGS: People who drank alcohol had a lower risk of NHL than did non-drinkers (OR 0.83 [95% CI 0.76-0.89]). Compared with non-drinkers, risk estimates were lower for current drinkers than for former drinkers (0.73 [0.64-0.84] vs 0.95 [0.80-1.14]), but risk did not decrease with increasing alcohol consumption. The protective effect of alcohol did not vary by beverage type, but did change with NHL subtype. The lowest risk estimates were recorded for Burkitt's lymphoma (0.51 [0.33-0.77]). INTERPRETATION: People who drink alcoholic beverages might have a lower risk of NHL than those who do not, and this risk might vary by NHL subtype. Further study designs are needed to determine whether confounding lifestyle factors or immunomodulatory effects of alcohol explain this association.

Cigarette smoking and risk of non-Hodgkin lymphoma: a pooled analysis from the International Lymphoma Epidemiology Consortium (interlymph).

BACKGROUND: The International Lymphoma Epidemiology Consortium (InterLymph) provides an opportunity to analyze the relationship between cigarette smoking and non-Hodgkin lymphoma with sufficient statistical power to consider non-Hodgkin lymphoma subtype. The results from previous studies of this relationship have been inconsistent, likely due to the small sample sizes that arose from stratification by disease subtype. To clarify the role of cigarette smoking in the etiology of non-Hodgkin lymphoma, we conducted a pooled analysis of original patient data from nine case-control studies of non-Hodgkin lymphoma conducted in the United States, Europe, and Australia. METHODS: Original data were obtained from each study and uniformly coded. Risk estimates from fixed-effects and two-stage random-effects models were compared to determine the impact of interstudy heterogeneity. Odds ratios (OR) and 95% confidence intervals (95% CI) were derived from unconditional logistic regression models, controlling for study center, age, sex, and race. RESULTS: In our pooled study population of 6,594 cases and 8,892 controls, smoking was associated with slightly increased risk estimates (OR, 1.07; 95% CI, 1.00-1.15). Stratification by non-Hodgkin lymphoma subtype revealed that the most consistent association between cigarette smoking and non-Hodgkin lymphoma was observed among follicular lymphomas (n = 1452). Compared with nonsmokers, current smokers had a higher OR for follicular lymphoma (1.31; 95% CI, 1.12-1.52) than former smokers (1.06; 95% CI, 0.93-1.22). Current heavy smoking (> or = 36 pack-years) was associated with a 45% increased OR for follicular lymphoma (1.45; 95% CI, 1.15-1.82) compared with nonsmokers. CONCLUSIONS: Cigarette smoking may increase the risk of developing follicular lymphoma but does not seem to affect risk of the other non-Hodgkin lymphoma subtypes we examined. Future research is needed to determine the biological mechanism responsible for our subtype-specific results.

Lung cancer in an urban area in Northern Italy near a coke oven plant.

Coke ovens are well-known sources of potentially carcinogenic air pollutants, but studies on resident populations are still poor. This study investigates the incidence of lung cancer near a coke oven in Cornigliano, a district of the Genoa municipality in Northern Italy. Genoa proper and one district similar to Cornigliano as regards socio-economic deprivation were selected as referents. Incidence data were drawn from the Ligurian Cancer Registry for 1986-1997 calendar period. Concentrations of pollutants related to the industrial activity (namely benzene, benzo[a]pyrene, PM(10), CO, NO(2) and SO(2)) were collected in selected locations before and after the coke oven closing. Spatial trend around the plant was assessed by Stone's test, while the pattern of risk across Cornigliano was evaluated via disease mapping in a Bayesian model. A gradient of air pollutants was observed around the coke oven, which disappeared after its closing. In Cornigliano, 158 lung cancer cases were observed in males and 28 in females. Only a marginal excess risk was observed versus the two selected referents, while a gradient in the areas close to the plant emerged among females. Disease mapping revealed another cluster of risk for both sexes in the Eastern part of the district, where a foundry was operative until the early 1980s. The excess risk for females is consistent with pollution measurements and with other epidemiological evidence. The geographic pattern of incidence suggests a role of industrial air pollution as a risk factor for lung cancer.

[Health conditions of the general population living near a steel plant]. / Stato di salute dei residenti nei pressi di un'acciaieria.

OBJECTIVE: To evaluate the health conditions (period 1986-2003) of the residents in Cornigliano, a district of Genoa (Italy), exposed to air pollution produced by a steel plant with coke-ovens. MATERIALS AND METHODS: Three epidemiological investigations were performed: on all mortality causes; on tumors incidence; on hospitalizations for respiratory diseases. The studies are based on the Regional Mortality Registry, the Ligurian Tumor Registry and the regional hospital discharge records. We calculated both the standardized mortality (SMR) and incidence (SIR) ratios with 95% confidence limits, and we have compared the hospitalization rates in two Cornigliano subareas with different pollution levels; the "rest of Genoa" represents the general reference. RESULTS: In Cornigliano the total mortality is statistically higher among males (SMR 123; n. 1684) and females (SMR 148; n. 2160); in particular all tumours, prostate, brain and emolymphopoietic system were significantly higher among males, while colon-rectum and NOS intestine tumours were higher among females. SMRs were statistically higher in both genders for degenerative illnesses of the nervous central system, brain circulatory disorders and liver cirrhosis; only in males for respiratory tract illnesses and in females for myocardial heart attacks. The incidence has increased to a statistically significant extent among males for all cancer sites (SIR 110; n. 821), and for larynx, brain and emolymphopoietic system tumours. Hospitalizations for respiratory illnesses appear to be higher in the most polluted area among males (age 0-14), and decreased after closing the coke-oven plant (2002). CONCLUSIONS: Results of these studies suggest that air pollution in Cornigliano may have a role on populations health conditions.

Personal use of hair dyes and hematolymphopoietic malignancies.

In the context of a population-based case-control study in Italy, the authors investigated the possible association between the personal use of hair dyes and non-Hodgkin's lymphoma (NHL), leukemia, multiple myeloma, and Hodgkin's disease. They collected all incident cases of hematolymphopoietic malignancies; the control group was formed with a random sample of the general population. Overall, the authors interviewed 2,737 research subjects and 1,779 control subjects. Among women, the authors found no association between ever using hair dyes and the risk of hematolymphopoietic malignancies. However, for permanent hair dyes, the authors observed a slightly increased risk of lymphocytic leukemia (odds ratio [OR] = 1.3; 95% confidence interval [CI] = 0.8-2.2) and of follicular subtypes of NHL (OR= 1.3; 95% CI = 0.8-2.0). Women who used black hair dye colors were at an increased risk of developing leukemia (OR = 1.9; 95% CI = 1.0-3.4), in particular chronic lymphocytic leukemia (OR = 3.0; 95% CI = 1.1-7.5). In spite of the lack of information on the timing and frequency of hair dye use and the imprecision of the ORs, associations were suggested between leukemia and permanent black hair dye use and follicular NHL and the use of permanent hair dyes.

Non-Hodgkin's lymphoma and type of tobacco smoke.

BACKGROUND: In recent decades, the incidence of non-Hodgkin's lymphoma (NHL) has increased in all industrialized countries. Tobacco smoke contains several recognized or putative carcinogenic compounds that differ in concentration depending on which of the two main types, blond or black, is consumed. This investigation sought to evaluate the association between NHL and type of tobacco smoked (blond, black, or mixed), focusing on the Working Formulation (WF) subgroups. METHODS: Reanalysis of Italian data from a recent multicenter population-based case-control study. The 1450 cases of NHL and 1779 healthy controls from 11 Italian areas with different demographic and productive characteristics were included in the study, corresponding to approximately 7 million residents. Odds ratios (ORs) adjusted for age, gender, residence area, educational level, and type of interview were estimated by unconditional logistic regression model. RESULTS: A statistically significant association [OR = 1.4, 95% confidence interval (CI) 1.1-1.7] was found for blond tobacco exposure and NHL risk. A dose-response relationship was limited to men younger than 52 years (chi(2) for trend = 9.95, P < 0.001). Subjects starting smoking at an early age showed a higher risk in men younger than 65 years, whereas no clear trend was evident for the other age and gender subgroups. The analysis by WF categories showed the highest risks for follicular lymphoma in blond (OR = 2.1, 95% CI 1.4-3.2) and mixed (OR = 1.8, 95% CI 1.1-3.0) tobacco smokers and for large cell within the other WF group (OR = 1.6, 95% CI 1.1-2.4) only for blond tobacco. CONCLUSIONS: Smoking blond tobacco could be a risk factor for NHL, especially follicular lymphoma.

Non-Hodgkin's lymphoma, leukemia, and exposures in agriculture: results from the Italian multicenter case-control study.

BACKGROUND: The etiology of non-Hodgkin's lymphoma (NHL) and leukemia is still largely unknown, but exposure to chemicals, in particular pesticides, has been suggested to be a risk factor. METHODS: A large population-based case-control study was conducted in Italy with the aim of investigating the associations between pesticide exposure and NHL, and solvents and leukemia. Data presented in this article refer to 1,575 interviewed cases and 1,232 controls in the nine agricultural study areas. RESULTS: Exposure to nitro-derivatives and phenylimides among fungicides, hydrocarbon derivatives and insecticide oils among insecticides, and the herbicide amides are the chemical classes observed to be associated with the pathologies under investigation. CONCLUSIONS: The results of the case-control study suggest an increased risk for NHL and leukemia, and some chemical classes of pesticides, although few are statistically significant and some are based on few exposed cases. The results also show that men and women experience both similar and different risks for the same environmental agricultural exposures. Am. J. Ind. Med. 44:627-636, 2003.