B cell neoplasms and occupational asbestos exposure

To evaluate the etiologic role of asbestos exposure in B cell neoplasms, we compared the estimated level of occupational exposure to asbestos of cases with chronic lymphocytic leukemia (CLL; N = 429) and multiple myeloma (MM; N = 698) with that of controls (N = 1,683). Cases were identified through four population-based cancer registries in the U.S. and controls were randomly selected from the same geographic areas. Exposure to asbestos was assessed by classifying each job held by a subject into one of four categories, based on the estimated intensity of exposure to asbestos. Evidence was found for a modest increasing risk of CLL with increasing asbestos exposure. Relative to persons with no known occupational exposure to asbestos, the risk for CLL was 1.1 (95% confidence interval (CI) = 0.8-1.6) for low, 1.2 (CI = 0.8-1.8) for medium, and 1.4 (CI = 0.8-2.3) for high peak asbestos exposure (p value for trend = 0.13). The association was strongest in white study subjects and in those individuals exposed 10 to 19 years prior to the interview. No association was observed between MM and occupational exposure to asbestos in the entire study population or within specific subgroups. Given the pattern of immunologic abnormalities that occur with increased frequency in asbestos-exposed persons, our observation of an association between occupational asbestos exposure and CLL deserves attention in subsequent studies.