Occupational ELF-MF exposure and hematolymphopoietic cancers - Swiss National Cohort analysis and updated meta-analysis

2018 · Mixed · Low evidence

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MixedLow evidencePaper 2142

Study snapshot

Publicationmanual · 2018

Study typemeta_analysis

Reported directionMixed

Evidence ratingLow

Abstract

Occupational ELF-MF exposure and hematolymphopoietic cancers - Swiss National Cohort analysis and updated meta-analysis Huss A, Spoerri A, Egger M, Kromhout H, Vermeulen R; Swiss National Cohort. Occupational extremely low frequency magnetic fields (ELF-MF) exposure and hematolymphopoietic cancers - Swiss National Cohort analysis and updated meta-analysis. Environ Res. 2018 Mar 24;164:467-474. doi: 10.1016/j.envres.2018.03.022. Highlights • ELF-MF exposure may affect specific hematolymphopoietic malignancies rather than "all leukaemia". • We evaluated effects of occupational ELF-MF exposure on different types of hematolymphopoietic malignancies. • We observed increased risks of AML if workers were exposed to higher levels and for a longer period of time. • Risks were in line with meta-analysed findings of previous studies. Abstract PURPOSE: Previous studies have examined risks of leukaemia and selected lymphoid malignancies in workers exposed to extremely low frequency magnetic fields (ELF-MF). Most studies evaluated hematolymphopoietic malignancies as a combined category, but some analyses suggested that effects may be contained to some specific leukaemia or lymphoma subtypes, with inconsistent results. METHODS: We examined exposure to ELF-MF and mortality 1990-2008 from different types of hematolymphopoietic cancers in the Swiss National Cohort, using a job exposure matrix for occupations recorded at censuses 1990 and 2000. We analysed 3.1 million workers exposed at different levels to ELF-MF: ever-high, only-medium, only-low exposure using Cox proportional hazard models. We evaluated risk of death from acute myeloid leukaemia (AML), chronic myeloid leukaemia, lymphoid leukaemia, diffuse large B-cell lymphomas, follicular lymphoma, Waldenström's macroglobulinemia, multiple myeloma and Hodgkin lymphoma. RESULTS: Mortality from hematolymphopoietic cancers was not associated with exposure to ELF-MF with the exception of an increase in ever-high exposed men of myeloid leukaemias (HR 1.31, 95% CI 1.02-1.67), and AML (HR 1.26, 95%CI 0.93-1.70). If workers had been high exposed during their vocational training and at both censuses, these HR increased to 2.24 (95%CI 0.91-5.53) and 2.75 (95%CI 1.11-6.83), respectively. CONCLUSIONS: Our analysis provided no convincing evidence for an increased risk of death from a range of hematolymphopoietic cancers in workers exposed to high or medium levels of ELF magnetic fields. However, we observed an increased risk of acute myeloid leukaemia in workers exposed to high levels for a longer duration. Observed risks are in line with meta-analysed previous reports on ELF-MF exposure and AML risk, with a summary relative risk of 1.21 (95%CI 1.08-1.37). ncbi.nlm.nih.gov

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AI evidence extraction

Structured fields below were generated from the paper’s abstract and metadata to make the evidence easier to inspect. Automated extraction may be incomplete or incorrect; verify important details against the original paper.

Study typemeta_analysis

Effect directionmixed

PopulationSwiss National Cohort workers

Sample size3100000

ExposureELF · 1990-2008 (mortality follow-up); longer duration/high exposure defined via vocational training and both censuses

Evidence strengthLowConfidence: 78% · Peer reviewed: yes

Main findings

In the Swiss National Cohort (1990–2008), mortality from hematolymphopoietic cancers was generally not associated with occupational ELF-MF exposure, except increased risks among ever-high exposed men for myeloid leukaemias (HR 1.31, 95% CI 1.02–1.67) and AML (HR 1.26, 95% CI 0.93–1.70). Higher HRs were reported for workers high-exposed during vocational training and at both censuses (myeloid leukaemias HR 2.24, 95% CI 0.91–5.53; AML HR 2.75, 95% CI 1.11–6.83). The updated meta-analysis reported a summary relative risk for ELF-MF exposure and AML of 1.21 (95% CI 1.08–1.37).

Outcomes measured

Mortality from hematolymphopoietic cancers
Acute myeloid leukaemia (AML) mortality
Chronic myeloid leukaemia mortality
Lymphoid leukaemia mortality
Diffuse large B-cell lymphoma mortality
Follicular lymphoma mortality
Waldenström's macroglobulinemia mortality
Multiple myeloma mortality
Hodgkin lymphoma mortality

Limitations

Exposure assessed using a job exposure matrix based on occupations recorded at censuses (potential exposure misclassification).
Outcome assessed as mortality (not incidence).
Some subtype-specific estimates have wide confidence intervals (imprecision), especially in longer-duration/high-exposure subgroup analyses.

View raw extracted JSON

{
  "study_type": "meta_analysis",
  "exposure": {
    "band": "ELF",
    "source": "occupational",
    "frequency_mhz": null,
    "sar_wkg": null,
    "duration": "1990-2008 (mortality follow-up); longer duration/high exposure defined via vocational training and both censuses"
  },
  "population": "Swiss National Cohort workers",
  "sample_size": 3100000,
  "outcomes": [
    "Mortality from hematolymphopoietic cancers",
    "Acute myeloid leukaemia (AML) mortality",
    "Chronic myeloid leukaemia mortality",
    "Lymphoid leukaemia mortality",
    "Diffuse large B-cell lymphoma mortality",
    "Follicular lymphoma mortality",
    "Waldenström's macroglobulinemia mortality",
    "Multiple myeloma mortality",
    "Hodgkin lymphoma mortality"
  ],
  "main_findings": "In the Swiss National Cohort (1990–2008), mortality from hematolymphopoietic cancers was generally not associated with occupational ELF-MF exposure, except increased risks among ever-high exposed men for myeloid leukaemias (HR 1.31, 95% CI 1.02–1.67) and AML (HR 1.26, 95% CI 0.93–1.70). Higher HRs were reported for workers high-exposed during vocational training and at both censuses (myeloid leukaemias HR 2.24, 95% CI 0.91–5.53; AML HR 2.75, 95% CI 1.11–6.83). The updated meta-analysis reported a summary relative risk for ELF-MF exposure and AML of 1.21 (95% CI 1.08–1.37).",
  "effect_direction": "mixed",
  "limitations": [
    "Exposure assessed using a job exposure matrix based on occupations recorded at censuses (potential exposure misclassification).",
    "Outcome assessed as mortality (not incidence).",
    "Some subtype-specific estimates have wide confidence intervals (imprecision), especially in longer-duration/high-exposure subgroup analyses."
  ],
  "evidence_strength": "low",
  "confidence": 0.78,
  "peer_reviewed_likely": "yes",
  "keywords": [
    "extremely low frequency magnetic fields",
    "ELF-MF",
    "occupational exposure",
    "Swiss National Cohort",
    "job exposure matrix",
    "hematolymphopoietic cancers",
    "leukaemia",
    "acute myeloid leukaemia",
    "lymphoma",
    "multiple myeloma",
    "mortality",
    "meta-analysis"
  ],
  "suggested_hubs": [
    {
      "slug": "occupational-exposure",
      "weight": 0.95,
      "reason": "Study evaluates occupational ELF-MF exposure using a job exposure matrix and worker cohort mortality outcomes."
    }
  ]
}

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AI-extracted fields are generated from the abstract and metadata and may be incomplete or incorrect. This material is for informational purposes and is not medical advice.

Identifiers and source

DOI: 10.1016/j.envres.2018.03.022
PubMed: Not supplied

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