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Occupational Medicine Advance Access published online on August 11, 2006
Occupational Medicine, doi:10.1093/occmed/kql083
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© The Author 2006. Published by Oxford University Press on behalf of the Society of Occupational Medicine. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Article

A meta-analysis of occupational trichloroethylene exposure and multiple myeloma or leukaemia

Dominik D. Alexander 1 *, Pamela J. Mink 1, Jeffrey H. Mandel 1, and Michael A. Kelsh 1

1 Exponent-Health Sciences, 185 Hansen Court, Suite 100, Wood Dale, IL 60191, USA

* To whom correspondence should be addressed.
Dominik D. Alexander, E-mail: dalexander{at}exponent.com


  Abstract

Background Trichloroethylene (TCE) has been widely used as an industrial solvent and degreasing agent.

Aims We conducted a meta-analysis of epidemiologic studies of occupational TCE exposure and multiple myeloma (MM) or leukaemia.

Methods We identified a total of eight cohort or case-control studies that enumerated a TCE-exposed study population and presented relative risk (RR) estimates for MM (n = 7) and/or leukaemia (n = 7). The individual studies included aerospace or aircraft workers (n = 3 studies), workers from a transformer manufacturing plant (n = 1 study) and workers from numerous occupations who, based on biomonitoring or extensive industrial hygiene exposure measurements, were likely exposed to TCE (n = 4). We used random effects models to calculate summary relative risk estimates (SRRE). In addition, we examined heterogeneity across studies and the relative influence of each individual study on the overall meta-analysis.

Results No association was observed for MM (SRRE = 1.05, 95% CI: 0.80-1.38; P value for heterogeneity = 0.94) or leukaemia (SRRE = 1.11, 95% CI: 0.93-1.32; P value for heterogeneity = 0.50), based on TCE-exposed subgroup meta-analyses. Study-specific RR estimates for MM ranged between 0.57 and 1.62. RRs for leukaemia ranged between 1.05 and 1.15 in five studies, while one study reported a 2-fold increased RR and another study reported an inverse association of 0.60. All confidence intervals (CIs) for study-specific estimates included 1.0.

Conclusions The results of this meta-analysis do not support an etiologic association between occupational TCE exposure and risk of MM or leukaemia.

Keywords: Leukaemia; meta-analysis; multiple myeloma; TCE; trichloroethylene.
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