exposure. Table 5.11 highlights the key studies reviewed by the committee and the relevant data considered in drawing its conclusion.

The committee concludes, from its assessment of the epidemiologic literature, that there is inadequate/insufficient evidence to determine whether an association exists between chronic exposure to the insecticides under review and multiple myeloma.

TABLE 5.11 Selected Epidemiologic Studies—Multiple Myeloma and Exposure to Insecticides

Reference

Study Population

Exposed Cases

Estimated Relative Risk (95% CI)

Specific Insecticides

Case-Control Study

Brown et al., 1993

Male residents of Iowa

 

 

 

Dichlorvos (animal use)

7

2.0 (0.8–5.0)

 

Lindane (animal use)

16

1.1 (0.6–2.0)

 

Lindane (crop use)

5

1.2 (0.4–3.4)

 

Malathion (animal use)

6

0.8 (0.3–1.9)

 

Malathion (crop use)

8

1.9 (0.8–4.6)

 

Carbaryl (crop use)

6

1.5 (0.6–3.9)

Classes of Insecticides

Case-Control Studies

Nanni et al., 1998

Residents of Forli, Italy

 

 

 

Carbamates (total exposed)

3

1.2 (0.6–2.3)

 

Carbamates (professionals only)

3

1.7 (0.4–6.9)

Burmeister, 1990

Male residents of Iowa

 

 

 

Organophosphorous agents (crops)

NA

1.31

 

Organophosphorous agents (livestock)

NA

1.22

 

Carbamates (crops)

NA

1.83

 

Carbamates (livestock)

NA

1.00

 

Pyrethrins (livestock)

NA

1.00

Insecticides

Case-Control Studies

Brown et al., 1993

Male residents of Iowa

 

 

 

Insecticides

91

1.2 (0.9–1.8)

Zahm et al., 1992

Residents of Nebraska

 

 

 

Insecticides (male)

11

0.6 (0.2–1.4)

 

Insecticides (female)

21

2.8 (1.1–7.3)

ADULT LEUKEMIA

The four main types of leukemia—acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute myeloid leukemia (AML), and chronic myeloid leukemia (CML) (ICD-9 204.0, 204.1, 205.0, 205.1)—are grouped by the developmental pace of the disease and the type of blood cell affected. Therefore, the disease can be either acute or chronic and can affect either myeloid or lymphocytic cells (ACS, 2002j).3

3  

The ICD codes for all types of leukemia include ICD-9 202.4, 203.1, 204.0–204.9, 205.0–205.9, 206.0–06.9, 207.0–207.2, 207.8, 208.0–208.9.



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