Document e7xmGZw1jzrO41x444V5QVbVg

I ! : i I I ! . \ $' -=- . I Leukaemia, lymphoma, and multiple rnyeTomain seamen on tankers Ralph I Nilsson, Rolf Nordlinda, ~ ~ - G U HMonUe, B e n e J i r v h o h Absusct pePoleum ptoduca such as gasoline,diesel od, 06jecti-To invesrigste the risk of lym- and fuel oils whereas a wde range of chemicals ph8tic md hrcmatopoicdc m r l l p m n c i r and p ~ ~ o l c u pmroducts are transported on in deck crew on UPLetl exposed to c y 0 chemical tankers.' ' Benzene concenuaoons up v8poun. to some 100 ppm have been measured during M # l o d . - - T h e s t u d y d e s i l p ru 88 8 tank cleaning, lording! and unloading of gaso- nested core-referent study In tuo cohorts line and some ocher light refinery products." of male Swedish seamen Z w * y ~ v orf am Benzene is a well k n o w leukaernogen' and has 8t th8 M d O d census 1960 (n 13 449) and also been suspected KO cause orher malignan- 1970 (n I t 290), mpecdvely. Cua were d e such u lymphoma, including multiple derecud by m o d IlnLI.d t h the S r d - myc10m8.'c" The m u l o of a luge benzene Lh C P ~ C WR e s t e r 1961-79 .nd 197147, cohort study, recentty published, showed a s i p rerpudvely. For each csse, thm to fhm nificant QCCU of leukaemia and I>mphoma age nuuhed refereno &om the popul- and a significant a m d in che dose-response for don w m wlutcd. Erposura w u M S U U ~ both of these rypo of cancer separately." from bu in the Srwdth RyLey of Sea- The objective of this srudy was ro mvcsogate men md from 8 register of Swedishships. whether work on deck on tankers, especially R u u l ~ S e u n e nin rh8 1970 cohort, who chemical and p r e @ ~ta~nk~ers, u usoaatcd had been crposed to cargo vrpoun for u with an increased risk of lymphrac and leut one month on chemical or product hremrropoictic m.iiqrurcies. In a nested case- *, h d Increrrrd rlrk of lym- referent mdy h e exposure was aamated &om ph8dc and h8enutopoi8dc dgnaada type of job and rypc of ship. -(.MUI~.~-HWESICI oddr =do (OR)2.6, 95Ya coaAd8ncr i n u m l (95% Q) 1.1 00 S.9)) d t h a s L ~ c a netxposure-mpoau rCl.do0 (condidoarl logbtle mgrouioa e b , ~ 4 . 0 4 )T.b8 OR8 borrud hlnhod. mSrVDr WKSN A..D S v I J E C n i8 8 U d cuc-referart mug cf s:zdish S C M ~ wi& mdy b r m In rhc populaaon for borh Iympboau (3.2). muldplo my- and hoUtiry cmausu 1960 and 1970 Swedish e l o m (4.0), and Lruluemi8 (M)b,ut th. a- wwe u h d abour cheu occupation at inarru w u only s l ~ c M ftw nom- the dmc of rhe census. The two rrudied popu- H U ' s tymphoms (OR 3.3,9S% Cl 1.1 ladons arc awn. 2- yean of age, regwered t O 10.6). nbm W8f8 00 8 H C 8 D d y inarrrud Nlu for rhe 1960 cohort or fbr u nunen(deckd engine room crew) (code, 6 0 1 6 11 in the Nordic Clusificaaon of Occu- seamen exposed only on crud. oil ram&n, p8Cion) at the NraonJ Censuses u1 Swcden buc theu groups had f.r .xpord cssa 1960 and 1970 mspedvely. In all 13 449 and 8 d lor clwl.dn -8UN (0 bemum 8nd orher Ught peCm~.umproduct% 1 1 290 mea lUfUed rhctc airma. C.nrcr casu were available horn linkage - -GNhr#rr-seuwa ap0m.d to vapoun h m F.olh .ad 0- light p.cml.um producta 00 ch.nJcJ or pmd- U C t m h dMh ? 8 8 8 8 d h d d a r r O f lymph.dc and humscopo&dc ma&^^- C h . OIU p0Sdbh C 8 W b t0 d v l 4 ~ O d i W U, lIl-. Md t.pL O~dOlm. bcCamn rhc and the Swbrh N8- ti04Caacer Regiscer. A potentul case in rho i8 dcfiacd U 8 seamen in the CcmU Of 1960 or 1970. aho b d a lymphatic or h.rm8tOpOdC (ICD8 200-207). Due m moicdon on linhn8 census dam. we uaed two dredy m i l r b k linb. T h e Swedish C w a Euvironment Rtgmer 1960 (CER60) (o&nptrrrr .aiwa.55 0-0) Urbkkmrnrhc 1960c~n~~andch~Cm cer for thc period 1961-79. The K.prdr hnuw.,- acuproos CER70 is a link bcrmn the 1970 census and rhe Cancer wter for rhe pcnod 1971-87. Thc mrmdy b u a rhus p m a l l y overlap. For ucb cane, rhm to tsn poreadd refawm were randomly selmed h o r n the u m c S-year birth year suarum among men dadkd u seaaten hthe same Naoonal Cen- NQ. AU potmbl refcrmo w m checked yrinrr thc N d o 4 C a w of Death Regma as thc referent hrd to be alive at rhe year of ~ o a i of8thc case. A u u or 8 referent a h had to haw a record inthe Swedish Rrolay of Seamen. In rhu reg- . ., * 3 If . \ 0t . \ little sueirocrl PO(YCI to detect excesses of speCrAc cell typrr of leuhemu. A diilcreari.l reponins of e x w d or non-qoscd wamcn ro the Cancer Rcgurer Lnprobsble. All CUCJ of cancer m Sweden hm to be reponed to the Saoonal Cancer wer.An investigation showed char about 17% of cases of leukaemia or multiple myeloma were not reponed to the Regsrer ' This is somewhat hgher than for most other mdignancier. One of the ovo index c a m ' was treated m a Swedish hospital bur was not reporred to the Cancer Register.and was, rhus, not mcluded m thu study. Exclusion of the o t h a mdex case resulted only in muprnrl c h a n m of the O b for tbc 1970cohort (dllymphatic and haematopoiedc malignancies OR 2.S, 9% CI 1. I to 5.8; IesICmu OR 1.3, 95V0 CI 0.3 to 9.2). The daa inrhe population and howmg cenS W I inSweden 1960 and 1970 arc considered to be diable. The mirclusificaaon of occupation in the sector of transport and cornrnunica; tion work wu about 14% in the I960 census, which is somewhat lugher than for most ocher occupWiOCU. As drir is a bested cuc-referenr m d y m which bo& caws and referenu were selected among tbc same study populanon of seamen 11 ia M y hnthe mh&&cmon of both hagnosir and occupation is noe-ddkenad. The cl.uifiudon of exposure w u bued on occupational d e b in L regum as wrll u on the cualpriyioo of boau Funhumore, the classdhoon wm Minded svllh regard to uae-refercat s m c u The rquknnenc Czt h e referent should be aliw at the rime of duposrr of the caw tends to so0mnvh.t owmamate the 7amongreferenu, leading to comerva- memucIofrhc nrh. Engine mom ~WSOMCI wnh possible expo- nm to o b , diad exhaust. and some cleanmg chemic& were included among the refereno. Ifchey W an incrrucd inadence of lymph+ hmmmpokck nulipmma, chu wuld also tmd tolowarbe risk rmmucr for the exposed -up. Exdwioo of mgw room personnel &om &e rmnrkl mulred Isomewhu lorn O b mdwider coa5deace r n t a l r Thw, I t u not likely Ihu t&rc exposum rrwnucd the rirh for lymph& or hrcmrtopowoc canccn. We h ody infornuaon on occuproon for UlCI .ad fckmlo for rbe cum mods they hm workd n ~ u n e aon S w t d d shp. olbrr relevaatexposure could htvr led to muduridcrdoa of exposure. whKb probably u bon-dillamdrl, chw leading ro ruk esumtes dour to unity. The numben of exposed CIYI of lymphaac rad hranrtapo'M'cc m c r n ~ m y r U U ( n = 6 m &e 1960cohon rad n= I4 m rh 1970 cohort). whicb mJI rhc power ro dnm m mueased riJ low, upea8Uy inrbr 1960c o h m . Despite thL, ae fouad a S ~ M *m u r u e d n t e r d a in che 1970 cohort, W WMsupponed a -t doswesporuc r e l a w a - . ,. , 5 .. .d f 1 , . \ IT I8 20 21 13 24 29 n 18 n 30 . .. .