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Journal of Occupational & Environmental Medicine:
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Occupational Risk Factors for Mycosis Fungoides: A European Multicenter Case-Control Study

Morales-Suárez-Varela, Maria M. MD, PhD; Olsen, Jorn MD, PhD; Johansen, Preben MD; Kaerlev, Linda MD, PhD; Guénel, Pascal MD, PhD; Arveux, Patrick MD; Wingren, Gun PhD; Hardell, Lennart MD, PhD; Ahrens, Wolfgang PhD; Stang, Andreas MD, MPH; Llopis, Agustin PhD; Merletti, Franco MD, PhD; Aurrekoetxea, Juan Jose MD, PhD; Masala, Giovanna MD, PhD

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Abstract

Mycosis fungoides (MF) is a rare disease with an unknown etiology. Its distribution suggests that occupational exposures may play a role. In the present study, we searched for occupational factors associated with MF. A European multicenter case-control study on seven rare cancers, including MF, was conducted from 1995 to 1997. Patients between 35 and 69 years of age diagnosed with MF (n = 134) were identified and their diagnoses were checked by a reference pathologist who classified 83 cases as definitive, 35 cases as possible, and 16 cases as not histologically verified. Of the 118 histologically verified cases, 104 were interviewed, of which 76 were definitive cases. As controls, we selected population controls and colon cancer controls to serve all seven case groups. Altogether, 833 colon cancer controls and 2071 population controls were interviewed. The response rate was 91.5% for cases (76 of the 83 definitive cases), and 66.6% for controls. A high risk of MF for men was observed in the industries of other non-metallic mineral products (Odds Ratio [OR] 5.3, 95% confidence interval [CI] = 1.7–16.2) and of wholesale trade (OR 3.6, 95% CI = 1.3–10.5). A high risk was found for female employees in the sector of pulp paper manufacture (OR 14.4, 95% CI = 2.2–95.1). The male occupations with the highest risks were glass formers, potters, and ceramics workers (OR 17.9, 95% CI = 5.4–59.4) and technical salesmen (OR 8.6, 95% CI = 2.4–30.8). For women, the occupations associated with the highest risks were government executives (OR 4.8, 95% CI = 1.0–22.6) and railway and road vehicles loaders (OR 3.9, 95% CI = 1.0–14.0). The results suggest that some occupational factors are associated with MF. Working as glass formers, pottery, and ceramics workers carried the highest risk, and these findings deserve further attention and replication. Females working in the paper and pulp industries may also be exposed to carcinogens of relevance to MF.

©2004The American College of Occupational and Environmental Medicine

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