Soft Tissue Sarcoma and Non-Hodgkin's Lymphoma in Workers Exposed to Phenoxy Herbicides, Chlorophenols, and Dioxins: Two Nested Case-Control Studies.

Kogevinas, Manolis; Kauppinen, Timo; Winkelmann, Regina; Becher, Heiko; Bertazzi, Pier Alberto; Bueno-de-Mesquita, H. Bas; Coggon, David; Green, Lois; Johnson, Eric; Littorin, Margareta; Lynge, Elsebeth; Marlow, David A.; Mathews, John D.; Neuberger, Manfred; Benn, Trevor; Pannett, Brian; Pearce, Neil; Saracci, Rodolfo

We examined the effect of exposure to chemicals present in the production and spraying of phenoxy herbicides or chloro-phenols in two nested case-control studies of soft tissue sarcoma and non-Hodgkin's lymphoma. Eleven sarcoma and 32 lymphoma cases occurring within an international cohort were matched for age, sex, and country of residence with 55 and 158 controls, respectively. Exposures to 21 chemicals or mixtures were estimated by three industrial hygienists who were blind to the subject's case-control status. Excess risk of soft tissue sarcoma was associated with exposure to any phenoxy herbicide [odds ratio (OR) = 10.3; 95% confidence interval (Cl) = 1.2-91] and to each of the three major classes of phenoxy herbicides (2,4-dichlorophenoxyacetic acid, 2,4,5-trichloro-phenoxyacetic acid, and 4-chloro-2-methylphenoxyacetic acid), to any polychlorinated dibenzodioxin or furan (OR = 5.6; 95% CI = 1.1-28), and to 2,3,7,8-tetrachlorodibenzo-p-dioxm (OR = 5.2; 95% CI = 0.85-32). Sarcoma risk was not associated with exposure to raw materials or other process chemicals. In the non-Hodgkin's lymphoma study, associations were generally weaker than those found in the study on sarcoma. These findings indicate that workers exposed to phenoxy herbicides and their contaminants are at a higher risk of soft tissue sarcoma.

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