. "5. Cancer and Exposure to Insecticides." Gulf War and Health: Volume 2. Insecticides and Solvents. Washington, DC: The National Academies Press, 2003.
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Gulf War and Health: Insecticides and Solvents, Volume 2
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.