Document Detail


Is there a causal relationship between exposure to diesel exhaust and multiple myeloma?
MedLine Citation:
PMID:  15071819     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
This article presents a comprehensive critical review of the epidemiology of multiple myeloma in relation to occupational diesel exhaust exposure. The review includes cohort and proportional mortality studies of workers exposed to diesel exhaust, and population-based case-control studies of multiple myeloma. None of the cohort or proportional mortality studies reported a significant increase of multiple myeloma in relation to diesel exhaust, with the exception of a study of Danish truck drivers. Several limitations in this Danish study (such as inadequate cohort identification, small number of multiple myeloma deaths and inappropriate analytical method) made the result unreliable. Furthermore, the data in this study of Danish truck drivers were part of and, hence, superseded by a large study in Denmark, which did not find any increased risk of multiple myeloma. Similarly, none of the case-control studies reported a significant increase of multiple myeloma in relation to diesel exhaust, with the exception of the smallest case-control study based on multiple myeloma patients in central and southeast Sweden. The result of this small Swedish study was not reliable because of incomplete case ascertainment, inappropriate controls and confounding. Furthermore, the data in this small Swedish study were part of and, hence, superseded by a large national study of workers exposed to diesel exhaust in Sweden, which did not find any increased risk of multiple myeloma. Other than the study of Danish truck drivers and the small case-control study of multiple myeloma patients in central and southeast Sweden, all other epidemiological investigations consistently reported no increase of multiple myeloma in relation to occupational diesel exhaust exposure. Furthermore, none of the studies reported a positive exposure-response relationship between diesel exhaust and multiple myeloma. Several studies that analysed data by jobs or occupations according to level of exposure and by duration of exposure did not find any upward trend. In addition to the review, a formal causation analysis based on an application of the Hill criteria confirms that there is no causal relationship between diesel exhaust and multiple myeloma.
Authors:
Otto Wong
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Toxicological reviews     Volume:  22     ISSN:  1176-2551     ISO Abbreviation:  Toxicol Rev     Publication Date:  2003  
Date Detail:
Created Date:  2004-04-09     Completed Date:  2004-06-28     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  101162874     Medline TA:  Toxicol Rev     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  91-102     Citation Subset:  IM    
Affiliation:
Department of Epidemiology, Tulane University, New Orleans, Louisiana, USA.
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MeSH Terms
Descriptor/Qualifier:
Denmark / epidemiology
Environmental Exposure / adverse effects*
Female
Humans
Male
Multiple Myeloma / epidemiology,  etiology*
Sweden / epidemiology
Vehicle Emissions / adverse effects*
Chemical
Reg. No./Substance:
0/Vehicle Emissions

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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