Review Article

Multiple Myeloma and Occupational Risk Factors: A Narrative Review

Abstract

Multiple Myeloma (MM) is a neoplastic hematologic disorder caused by the excessive proliferation of plasma cells and leads to bone lesions, anemia, and kidney failure. No definite etiology has been proposed for MM, but several environmental and genetic risk factors have been implicated so far. Exposure to pesticides, benzene, and organic solvents like methyl chloride have been considered a potential risk factor. Asbestos, ionizing radiation, and wood dust exposure have also been associated with MM. As MM is a relatively rare condition, the number of studies is insufficient, and in many studies, only a few study participants recall exposure to any agents. Therefore, establishing a definite risk factor is cumbersome and further studies with large study samples are needed. By recognizing these occupational risk factors, clinicians can encourage employees to reduce their exposure as more as possible and implement precautionary measures. In this review, we highlighted the current research on the potential association between occupational exposures and MM. Because of these studies, new regulations with the goal of occupational exposure reduction are anticipated in the future.

1. Heineman EF, Olsen J H, L Pottern M, et al (1992). Occupational risk factors for multiple myeloma among Danish men. Cancer Causes Control, 3(6):555-68.
2. Becker N (2011). Epidemiology of Multiple Myeloma. In: Multiple Myeloma. Ed(s), Moehler T, Goldschmidt H. Berlin, Heidelberg: Springer Berlin Heidelberg, pp. 25-35.
3. Laubach J, Richardson P, Anderson K (2011). Multiple myeloma. Annu Rev Med, 62:249-64.
4. Chesi M, Nardini E, Lim RS, et al (1998). The t(4;14) translocation in myeloma dysregulates both FGFR3 and a novel gene, MMSET, resulting in IgH/MMSET hybrid transcripts. Blood, 92 (9):3025-34.
5. Pottern LM, Heineman EF, Olsen JH, et al (1992). Multiple myeloma among Danish women: employment history and workplace exposures. Cancer Causes Control, 3(5):427-32.
6. McLaughlin JK, Malker HS, Linet MS, et al (1988). Multiple myeloma and occupation in Sweden. Arch Environ Health, 43 (1):7-10.
7. De Roos AJ, Spinelli J, Brown EB, et al (2018). Pooled study of occupational exposure to aromatic hydrocarbon solvents and risk of multiple myeloma. Occup Environ Med, 75(11):798-806.
8. Séverine Tual, Amandine Busson, Mathilde Boulanger, et al (2019). Occupational exposure to pesticides and multiple myeloma in the AGRICAN cohort. Cancer Causes Control, 30(11):1243-1250.
9. Baris D, Silverman DT, Brown LM, et al (2004). Occupation, pesticide exposure and risk of multiple myeloma. Scand J Work Environ Health, 30 (3):215-22.
10. Perrotta C, Staines A, Codd M, et al (2012). Multiple Myeloma and lifetime occupation: results from the EPILYMPH study. J Occup Med Toxicol, 7(1):25.
11. G. Frost TBaA-HH (2011). Mortality and cancer incidence among British agricultural pesticide users. Occup Med (Lond), 61(5):303-10.
12. Gold LS, Milliken K, Steart P, et al (2010). Occupation and multiple myeloma: an occupation and industry analysis. Am J Ind Med, 53 (8):768-79.
13. Gold LS, Stewart PA, Milliken K, et al (2011). The relationship between multiple myeloma and occupational exposure to six chlorinated solvents. Occup Environ Med, 68 (6):391-9.
14. Liu T, Xu QE, Zhang CH, Zhang P (2013). Occupational exposure to methylene chloride and risk of cancer: a meta-analysis. Cancer Causes Control, 24 (12):2037-49.
15. Glass DC, Gray CN, Jolley DJ, et al (2003). Leukemia risk associated with low-level benzene exposure. Epidemiology, 14 (5):569-77.
16. Kirkeleit J, Riise T, Bratveit M, Moen BE (2008). Increased risk of acute myelogenous leukemia and multiple myeloma in a historical cohort of upstream petroleum workers exposed to crude oil. Cancer Causes Control, 19 (1):13-23.
17. Wong, GK Raabe (1997). Multiple Myeloma and Benzene Exposure in a Multinational. Cohort of More Than 250,000 Petroleum Workers. Regul Toxicol Pharmacol, 26(2):188-99.
18. Lee WJ, Baris D, Jarvholm B, Silverman DT, Bergdahl IA, Blair A (2003). Multiple myeloma and diesel and other occupational exposures in swedish construction workers. Int J Cancer, 107 (1):134-8.
19. Jonathan N. Hofmann, Lakshmi Ramanathan CFL, et al (2021). Lifetime Pesticide Use and Monoclonal Gammopathy of Undetermined Significance in a Prospective Cohort of Male Farmers. Environ Health Perspect, 129(1):17003.
20. Gangemi S, Gofita E, Costa C, et al (2016). Occupational and environmental exposure to pesticides and cytokine pathways in chronic diseases. Int J Mol Med, 38 (4):1012-1020.
21. Poh C, McPherson JD, Tuscano J, Li Q, et al (2022). Environmental pesticide exposure and non-Hodgkin lymphoma survival: a population-based study. BMC Med, 20 (1):165.
22. Svec MA, Ward MH, Dosemeci M, et al (2005). Risk of lymphatic or haematopoietic cancer mortality with occupational exposure to animals or the public. Occup Environ Med, 62 (10):726-35.
23. Demers PA, Vaughan TL, Koepsell TD, et al (1993). A Case-Control Study of Multiple. Myeloma and Occupation. Am J Ind Med, 23(4):629-39.
24. Lemarchand C, Tual S, Leveque-Morlais N, et al (2017). Cancer incidence in the AGRICAN cohort study (2005-2011). Cancer Epidemiol, 49:175-185.
25. Lope V, Perez-Gomez B, Aragones N, et al (2008). Occupation, exposure to chemicals, sensitizing agents, and risk of multiple myeloma in Sweden. Cancer Epidemiol Biomarkers Prev, 17 (11):3123-7.
26. Lerro CC, Koutros S, Andreotti G, et al (2019). Cancer incidence in the Agricultural Health Study after 20 years of follow-up. Cancer Causes Control, 30(4):311-22.
27. L F Burmeister GDE, S F Van Lier, P Isacson (1983). Selected cancer mortality and farm practices in Iowa. Am J Epidemiol, 118(1):72-7.
28. Perrotta C, Staines A, Cocco P (2008). Multiple myeloma and farming. A systematic review of 30 years of research. Where next? J Occup Med Toxicol, 3:27.
29. Pahwa P, Karunanayake CP, Dosman JA, et al (2012). Multiple myeloma and exposure to pesticides: a Canadian case-control study. J Agromedicine, 17 (1):40-50.
30. Nanni, Buiatti E, Bucchi L, et al (1998). multiple myeloma and work in agriculture: results of a case-control study in Forli, Italy. Cancer Causes Control, 9(3):277-83.
31. Kristensen P, A Andersen, LM Irgens, et al (1996). Incidence and risk factors of cancer among men and women in Norwegian agriculture. Scand J Work Environ Health, 22(1):14-26.
32. Mahin Ghafari, Zahra Cheraghi, Amin Doosti-Irani (2017). Occupational risk factors among Iranian farmworkers: a review of the available evidence. Epidemiol Health, 39:e2017027.
33. A Nandakumar, B K Armstrong, N H de Klerk (1986). Multiple myeloma in Western Australia: a case-control study in relation to occupation, father's occupation, socioeconomic status and country of birth. Int J Cancer, 37(2):223-6.
34. R C Brownson, J S Reif (1988). A Cancer Registry-Based Study of Occupational Risk for Lymphoma, Multiple Myeloma and Leukaemia. Int J Epidemiol, 17(1):27-32.
35. N E Pearce, A H Smith, J K Howard, et al (1986). Case-control study of multiple myeloma and farming. Br J Cancer, 54(3):493-500.
36. Orsi L, Troussard X, Monnereau A, et al (2007). Occupation and lymphoid malignancies: results from a French case-control study. J Occup Environ Med, 49 (12):1339-50.
37. Perrotta C, Kleefeld S, Staines A, et al (2013). Multiple myeloma and occupation: a pooled analysis by the International Multiple Myeloma Consortium. Cancer Epidemiol, 37 (3):300-5.
38. Eriksson M, Karlsson M (1992). Occupational and other environmental factors and multiple myeloma: a population based case-control study. Br J Ind Med, 49(2):95-103.
39. Joseph J Shearer, Laura E Beane Freeman, Danping Liu et al (2018). Longitudinal investigation of haematological alterations among permethrin-exposed pesticide applicators in the Biomarkers of Exposure and Effect in Agriculture study. Occup Environ Med, 76(7):467-470.
40. Anneclaire J. De Roos, Aaron Blair, Jennifer A. Rusiecki, et al (2005). Cancer Incidence among Glyphosate-Exposed Pesticide Applicators in the Agricultural Health Study. Environ Health Perspect, 113(1):49-54.
41. Kachuri L, Demers PA, Blair A, et al (2013). Multiple pesticide exposures and the risk of multiple myeloma in Canadian men. Int J Cancer, 133 (8):1846-58.
42. Leah Weber, Kevin Song, Terry Boyle, et al (2018). Organochlorine Levels in Plasma and Risk of Multiple Myeloma. J Occup Environ Med, 60(10):911-916.
43. Lydia M Louis, Catherine C Lerro, Melissa C Friesen, et al (2017). A prospective study of cancer risk among Agricultural Health Study farm spouses associated with personal use of organochlorine insecticides. Environ Health, 16(1):95.
44. Demers PA, Boffetta P, Kogevinas M, et al. (1995). Pooled reanalysis of cancer mortality among five cohorts of workers in wood-related industries. Scand J Work Environ Health, 21 (3):179-90.
45. Larry W. Figgs MDaAB (1994). Risk of Multiple Myeloma by Occupation and Industry Among Men and Women: A 24-State Death Certificate Study. J Occup Med, 36(11):1210-21.
46. Fritschi L, Ambrosini GL, Kliewer EV, et al (2004). Dietary fish intake and risk of leukaemia, multiple myeloma, and non-Hodgkin lymphoma. Cancer Epidemiol Biomarkers Prev, 13 (4):532-537.
47. Tomoko Sonoda, Masamitsu Mori, Mitsuru Mori, et al (2005). A Case-control Study of Multiple Myeloma in Japan: Association with Occupational Factors. Asian Pac J Cancer Prev, 6(1):33-6.
48. Jiang Y, Chen J, Tong J, Chen T (2014). Trichloroethylene-induced gene expression and DNA methylation changes in B6C3F1 mouse liver. PLoS One, 9 (12):e116179.
49. Lincz LF, Scorgie FE, Robertson R, Enno A (2007). Genetic variations in benzene metabolism and susceptibility to multiple myeloma. Leuk Res, 31 (6):759-63.
50. Ralph I Nilsson, R Nordlinder, L G Hörte, et al (1998). Leukaemia, lymphoma, and multiple myeloma in seamen on tankers. Occup Environ Med, 55(8):517-21.
51. Kubale T, Hiratzka S, Henn S, et al (2008). A cohort mortality study of chemical laboratory workers at Department of Energy Nuclear Plants. Am J Ind Med, 51 (9):656-67.
52. Forsell K, Björ O, Järvholm B, et al (2020). Hematologic malignancy in tanker crewmembers: A case-referent study among male Swedish seafarers. Am J Ind Med, 63 (8):685-692.
53. Glass DC, Gray CN, Jolley DJ, Gibbons C, Sim MR (2006). The health watch case-control study of leukemia and benzene: the story so far. Ann N Y Acad Sci, 1076:80-9.
54. Glass DC, Gray CN, Jolley DJ, Gibbons C, Sim MR (2005). Health Watch exposure estimates: do they underestimate benzene exposure? Chem Biol Interact, 153-154:23-32.
55. Schnatter AR, Armstrong TW, Nicolich MJ, et al (1996). Lymphohaematopoietic malignancies and quantitative estimates of exposure to benzene in Canadian petroleum distribution workers. Occup Environ Med, 53 (11):773-81.
56. Frank AL, Joshi TK (2014). The Global Spread of Asbestos. Ann Glob Health, 80 (4):257-262.
57. Mangone L, Storchi C, Pinto C, et al (2022). Incidence of malignant mesothelioma and asbestos exposure in the Emilia-Romagna region, Italy. Med Lav, 113 (5):e2022047.
58. Morris PD, Koepsell TD, Daling JR, et al (1986). Toxic substance exposure and multiple myeloma: a case-control study. J Natl Cancer Inst, 76 (6):987-94.
59. Boffetta P, Stellman SD, Garfinkel L (1989). A case-control study of multiple myeloma nested in the American Cancer Society prospective study. Int J Cancer, 43 (4):554-9.
60. Linet MS, Harlow SD, McLaughlin JK (1987). A case-control study of multiple myeloma in whites: chronic antigenic stimulation, occupation, and drug use. Cancer Res, 47 (11):2978-81.
61. Pukkala E, Martinsen JI, Weiderpass E, et al (2014). Cancer incidence among firefighters: 45 years of follow-up in five Nordic countries. Occup Environ Med, 71 (6):398-404.
62. Seidler A, Becker N, Nieters A, et al (2010). Asbestos exposure and malignant lymphoma: a multicenter case-control study in Germany and Italy. Int Arch Occup Environ Health, 83 (5):563-70.
63. Ghosh S, McLaughlin JR, Spinelli JJ, et al (2011). Multiple myeloma and occupational exposures: a population-based case-control study. J Occup Environ Med, 53 (6):641-6.
64. La Vecchia C, Negri E, D'Avanzo B, Franceschi S (1989). Occupation and lymphoid neoplasms. Br J Cancer, 60 (3):385-8.
65. Milham S, Jr. (1988). Increased mortality in amateur radio operators due to lymphatic and hematopoietic malignancies. Am J Epidemiol, 127 (1):50-4.
66. J C Schroeder, D A Savitz (1997). Lymphoma and Multiple Myeloma Mortality in Relation to Magnetic Field Exposure Among Electric Utility Workers. Am J Ind Med, 32(4):392-402.
67. James H Yiin, Jeri L Anderson, Robert D Daniels, et al (2009). A Nested Case-Control Study of Multiple Myeloma Risk and Uranium Exposure among Workers at the Oak Ridge Gaseous Diffusion Plant. Radiat Res, 171(6):637-45.
68. Rericha V, Kulich M, Rericha R, et al (2006). Incidence of leukemia, lymphoma, and multiple myeloma in Czech uranium miners: a case-cohort study. Environ Health Perspect, 114 (6):818-22.
69. Schull WJ (1983). Late radiation responses in man: current evaluation from results from Hiroshima and Nagasaki. Adv Space Res, 3 (8):231-9.
70. Hsu WL, Preston DL, Soda M, et al (2013). The incidence of leukemia, lymphoma and multiple myeloma among atomic bomb survivors: 1950-2001. Radiat Res, 179 (3):361-82.
71. Spinelli JJ, Gallagher RP, Band PR, Threlfall WJ (1984). Multiple myeloma, leukemia, and cancer of the ovary in cosmetologists and hairdressers. Am J Ind Med, 6(2):97-102.
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IssueVol 53 No 3 (2024) QRcode
SectionReview Article(s)
DOI https://doi.org/10.18502/ijph.v53i3.15137
Keywords
Multiple myeloma Plasma cells Risk factors Occupational exposure Pesticides

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Hejrati A, Parvin S, Omidali M, Hejrati L, Shateri Amiri B. Multiple Myeloma and Occupational Risk Factors: A Narrative Review. Iran J Public Health. 2024;53(3):568-576.