Academic journal article Environmental Health Perspectives

A Prospective Study of Organochlorines in Adipose Tissue and Risk of Non-Hodgkin Lymphoma

Academic journal article Environmental Health Perspectives

A Prospective Study of Organochlorines in Adipose Tissue and Risk of Non-Hodgkin Lymphoma

Article excerpt

BACKGROUND: Exposure to organochlorines has been examined as a potential risk factor for non-Hodgkin lymphoma (NHL), with inconsistent results that may be related to limited statistical power or to imprecise exposure measurements.

OBJECTIVE: Our purpose was to examine associations between organochlorine concentrations in prediagnostic adipose tissue samples and the risk of NHL.

METHODS: We conducted a case-cohort study using a prospective Danish cohort of 57,053 persons enrolled between 1993 and 1997. Within the cohort we identified 256 persons diagnosed with NHL in the population-based nationwide Danish Cancer Registry and randomly selected 256 sub-cohort persons. We measured concentrations of 8 pesticides and 10 polychlorinated biphenyl (PCB) congeners in adipose tissue collected upon enrollment. Associations between the 18 organochlorines and NHL were analyzed in Cox regression models, adjusting for body mass index.

RESULTS: Incidence rate ratios and confidence intervals (CIs) for interquartile range increases in concentrations of dichlorodiphenyltrichlorethane (DDT), cis-nonachlor, and oxychlordane were 1.35 (95% CI: 1.10, 1.66), 1.13 (95% CI: 0.94, 1.36), and 1.11 (95% CI: 0.8% 138), respectively, with monotonic dose-response trends for DDT and cis-nonachlor based on categorical models. The relative risk estimates were higher for men than for women. In contrast, no clear association was found between NHL and PCBs.

CONCLUSION: We found a higher risk of NHL in association with higher adipose tissue levels of DDT, cis-nonachlor, and oxychlordane, but no association with PCBs. This is the first study of organochlorines and NHL using prediagnostic adipose tissue samples in the exposure assessment and provides new environmental health evidence that these organochlorines contribute to NHL risk.

KEY WORDS: adipose tissue, case-cohort, non-Hodgkin lymphoma, organochlorines. Environ Health Perspect 120:105-111 (2012). [Online 26 August 2011]

Non-Hodgkin lymphomas (NHLs) are a heterogeneous group of B- and T-cell neoplasms arising primarily in the lymph nodes. Incidence rates have nearly doubled in Western countries since the 1970s, although no further rise has been observed since the mid-1990s (Dreiher and Kordysh 2006). Established risk factors include genetic susceptibility and previous history of malignant disease (Wang et ai. 2007). Immunological conditions are also related to this group of cancers, as evidenced by a more than 100-fold increased risk of NHL among organ transplant recipients receiving immunosuppressive therapy (Fisher and Fisher 2004) and an increased incidence among subjects with primary immunodeficiency and autoimmune diseases (Vineis et at. 2000). However, these factors, in combination with longer life spans and changes in diagnostic patterns, cannot explain all cases, and many researchers speculate that the increase is partly due to exposure to environmental agents, including organochlorines (Hardell and Axelson 1998).

Dichlorodiphenyltrichlorethane (DDT) and other organochlorines are carcinogenic in animals (International Agency for Research on Cancer 1987), and the production and environmental release of these compounds with subsequent bioaccumulation accelerated during the decades after 1945 (World Resources Institute 1990), coinciding with increasing incidence rates for NHL in Western populations. Organochlorines are ubiquitously present as a mixture of mother compounds and metabolites in the environment and are characterized by high lipid solubility, environmental persistence, bioaccumulation (Agency for Toxic Substances and Disease Registry 1993), and long biological half-lives in human tissue (Wolff et al. 2000). Several studies have described immunotoxicity of selected organochlorines (Heilmann et al. 2006; Reed et al. 2004; Tryphonas et al. 2003).

The evidence relating organochlorines to NHL risk has been reviewed (Dreiher and Kordysh 2006) and the association remains unclear, with some studies reporting associations and others finding none. …

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