Incidence of leukemia in occupations with potential electromagnetic field exposure in United States Navy personnel

Cancer Incidence and Etiology in the Active Duty Population of U.S. Military

INTRODUCTION

As members of the military, all active duty service members (ADS) must meet physical fitness requirements and are provided with equal-access healthcare through the DoD. In addition, 92% of ADS are ≤40 years of age. Together, these characteristics suggest that ADS represent a healthy population that may have a low risk of cancer. Each year, however, >800 ADS are diagnosed with cancer and the resulting in time off for treatment, reassignment, or medical retirement may significantly impact force readiness.

MATERIAL AND METHODS

Relevant literature was identified by searching the PubMed database using search terms ACTIVE DUTY and CANCER. Only articles written in English were included.

RESULTS

Melanoma is the most common cancer in ADS, while testicular cancer is the most common cancer in males and breast cancer is the most common in females. Cancer incidence patterns in ADS differ from those in the general U.S. population and from military veterans. Tumor etiology in ADS may be influenced by military-enriched exposures such as prolonged use of oral contraceptives, suboptimal use of sunscreen, exposure to volatile organic compounds, or germline predisposition/family history.

CONCLUSIONS

The etiology of cancer within ADS remains largely unknown. A number of new research programs may provide the means to improve understanding of the etiology of cancer in ADS. Together, these efforts will improve prevention, early detection, and clinical management, thus improving the outcomes of ADS and preserving force readiness.

Hematobiochemical and histopathological alterations of kidney and testis due to exposure of 4G cell phone radiation in mice

The radiofrequency electromagnetic radiation emitted by smart phones on biological systems has wide media coverage and public concern in recent years. The aim of this study was to explore the effects of fourth-generation cell phone radiation exposure on hematological (Total leukocyte count, Total erythrocyte count, and hemoglobin %), biochemical (Serum creatinine) parameters, and histopathological changes in the kidney and testis of Swiss albino mice. A total of 30 male Swiss albino mice weighing 45–65 g was randomly divided into three groups (n = 10). The first group A was the control group, the second group B, was exposed to 40 minutes of mobile phone radiation daily, the third group C was exposed to 60 minutes of radiation daily from two 2400 Megahertz fourth-generation connected mobile phones for 60 days, respectively. The electromagnetic radiation frequency radiometer measured the frequency of electromagnetic radiation emitted from cell phones. The specific absorption rate was calculated as 0.087 W/kg. The control group was kept under similar conditions, but the electromagnetic field was not given for the same period. All the mice were sacrificed at the end of the experiment. The blood samples were collected for hematobiochemical study, and then kidney and testis tissues were collected for histopathological study. Results of the study showed that the body weight and total erythrocyte count values were significantly (p < 0.05) decreased while total leukocyte count, hemoglobin %, and serum creatinine values were significantly (p < 0.05) increased in both the radiation exposure groups relative to the control group. Histopathological observation showed the kidney of 60 minutes exposed mice interstitial inflammation that causes marked mononuclear cellular infiltration compared to the 40 minutes and control mice. Compared to control mice, histopathological examinations of testicular tissue from the exposed mice, showed irregular in shapes and non-uniform sizes and fewer spermatogenic cells layer that leads to the larger lumen in the seminiferous tubules. It is concluded that fourth-generation cell phone radiation exposure may affect blood hemostasis and inflammation of mice's kidney and testis tissue. Based on these studies, it is important to increase public consciousness of potential adverse effects of mobile phone radiofrequency electromagnetic radiation exposure.

Lymphohaematopoietic malignancies in Scottish military veterans: Retrospective cohort study of 57,000 veterans and 173,000 non-veterans

BACKGROUND

Lymphohaematopoietic malignancies are common in the general population. There have been concerns that military service may be associated with increased risk as a result of occupational exposures. To date, few studies have demonstrated an increased risk, although a disability pension is payable to veterans who were present at nuclear tests and who develop leukaemia (other than chronic lymphocytic leukaemia). The aim of the study was to utilise data from the Scottish Veterans Health Study to examine the risk of lymphohaematopoietic malignancy following military service in a large national cohort of veterans.

METHODS

Retrospective cohort study of 57,000 veterans and 173,000 non-veterans born between 1945 and 1985 matched for age, sex and area of residence, adjusted for areal deprivation and followed up for up to 30 years, using Cox proportional hazard models to compare the risk of lymphohaematopoietic malignancy overall, by diagnosis and by sex and birth cohort.

RESULTS

We found no statistically significant difference in risk between veterans and non-veterans either for all leukaemias (Cox proportional hazard ratio 1.03, 95% confidence intervals 0.84-1.27, p=0.773), Hodgkin lymphoma (hazard ratio 1.19, 95% confidence intervals 0.87-1.61, p=0.272) or for non-Hodgkin lymphoma (hazard ratio 0.86, 95% confidence intervals 0.71-1.04, p=0.110).

CONCLUSION

Our findings provide reassurance that service in the UK Armed Forces is not associated with increased risk of lymphohaematopoietic malignancy.

Doenças hematológicas e situações de risco ambiental: a importância do registro para a vigilância epidemiológica

A problemática de grupos populacionais expostos a situações de risco que afetam o sistema sangüíneo e a gravidade dos danos causados à saúde faz com que este tema ganhe relevância para a saúde pública. A compreensão do comportamento epidemiológico de doenças hematológicas relacionadas ao ambiente/ocupação é fundamental para a instituição de medidas protetoras da saúde. A informação em epidemiologia depende de dados fidedignos sobre os diversos agravos. Este estudo verificou em prontuários de pacientes de um centro de referência o registro de condições de risco ambiental, em um período de dez anos. As patologias selecionadas foram as mais freqüentemente assistidas e que apresentam na literatura maiores evidências de associação com exposições a riscos químicos e/ou físicos de origem ambiental. As mesmas apresentaram-se com alta letalidade (52% da casuística). Para todas houve um grande sub-registro das situações de nocividade e de outros condicionantes de vulnerabilidade, revelando uma despreocupação dos profissionais de saúde com os aspectos da causalidade, no sentido de orientar a prevenção de novos casos. No momento em que o Ministério da Saúde reconhece a relevância desta problemática mediante recentes normatizações, é fundamental aprimorar o registro de situações de risco e agravos possivelmente relacionados a estes, especialmente nos serviços que podem identificar casos sentinelas, auxiliando, assim, a efetivação da vigilância epidemiológica e da saúde para grupos de expostos.

Trends and occupational associations in incidence of hospitalized pulmonary sarcoidosis and other lung diseases in Navy personnel: a 27-year historical prospective study, 1975-2001

STUDY OBJECTIVES

This study examines long-term trends in incidence rates of hospitalized pulmonary sarcoidosis in a large cohort of Navy personnel, and evaluates the possible relationship of sarcoidosis with occupation.

DESIGN

Incidence rates of first hospitalizations were determined for black and white male Navy enlisted personnel on active duty from 1975 to 2001.

SETTING

Navy service includes a potential for exposure to a variety of substances, including nonskid coatings used on ship decks that may be aerosolized during removal. Particulate matter containing aluminum, titanium, and silicates has been identified in nonskid samples. Specific occupational groups may have had greater exposure potential than others.

PATIENTS OR PARTICIPANTS

Hospitalized cases included sarcoidosis (n = 674), asthma (n = 3,536), emphysema and chronic bronchitis (n = 1,103), respiratory conditions due to fumes and vapors (n = 61), and pneumoconiosis (n = 51) observed in 9,953,607 person-years of active-duty service.

INTERVENTIONS

None. However, improvements were made in personal protective gear and other countermeasures to prevent or limit respiratory exposures during service.

MEASUREMENTS AND RESULTS

Annual overall hospitalized sarcoidosis incidence rates per 100,000 were 24.9 for black men and 3.5 for white men (black/white ratio of 7.1, p < 0.0001). Annual incidence rates in blacks declined markedly, particularly since 1989, but the black/white ratio remained high through 1999. Occupational associations were present in blacks and whites. Black ship's servicemen (23 cases) and aviation structural mechanics specializing in structures (12 cases) had more than twice the expected incidence rate compared to all blacks, and white mess management specialists (15 cases) had twice the overall white incidence rate.

CONCLUSIONS

There was a steep decline in incidence of hospitalized sarcoidosis in blacks in the Navy. Occupational associations suggest the possibility that a dust or moisture-related lung disease may have been erroneously classified as sarcoidosis, or, alternatively, that sarcoidosis had a previously unrecognized occupational component.

Epidemiology of health effects of radiofrequency exposure

We have undertaken a comprehensive review of epidemiologic studies about the effects of radiofrequency fields (RFs) on human health in order to summarize the current state of knowledge, explain the methodologic issues that are involved, and aid in the planning of future studies. There have been a large number of occupational studies over several decades, particularly on cancer, cardiovascular disease, adverse reproductive outcome, and cataract, in relation to RF exposure. More recently, there have been studies of residential exposure, mainly from radio and television transmitters, and especially focusing on leukemia. There have also been studies of mobile telephone users, particularly on brain tumors and less often on other cancers and on symptoms. Results of these studies to date give no consistent or convincing evidence of a causal relation between RF exposure and any adverse health effect. On the other hand, the studies have too many deficiencies to rule out an association. A key concern across all studies is the quality of assessment of RF exposure. Despite the ubiquity of new technologies using RFs, little is known about population exposure from RF sources and even less about the relative importance of different sources. Other cautions are that mobile phone studies to date have been able to address only relatively short lag periods, that almost no data are available on the consequences of childhood exposure, and that published data largely concentrate on a small number of outcomes, especially brain tumor and leukemia.

Radio frequency electromagnetic fields: Cancer, mutagenesis, and genotoxicity

We present critiques of epidemiologic studies and experimental investigations, published mostly in peer-reviewed journals, on cancer and related effects from exposure to nonionizing electromagnetic fields in the nominal frequency range of 3 kHz to 300 GHz of interest to Subcommittee 4 (SC4) of the International Committee on Electromagnetic Safety (ICES). The major topics discussed are presented under the headings Epidemiologic and Other Findings on Human Exposure, Mammals Exposed In Vivo, Mammalian Live Tissues and Cell Preparations Exposed In Vitro, and Mutagenesis and Genotoxicity in Microorganisms and Fruit Flies. Under each major topic, we present minireviews of papers on various specific endpoints investigated. The section on Epidemiologic and Other Findings on Human Exposure is divided into two subsections, the first on possible carcinogenic effects of exposure from emitters not in physical contact with the populations studied, for example, transmitting antennas and other devices. Discussed in the second subsection are studies of postulated carcinogenic effects from use of mobile phones, with prominence given to brain tumors from use of cellular and cordless telephones in direct physical contact with an ear of each subject. In both subsections, some investigations yielded positive findings, others had negative findings, including papers directed toward experimentally verifying positive findings, and both were reported in a few instances. Further research on various important aspects may resolve such differences. Overall, however, the preponderance of published epidemiologic and experimental findings do not support the supposition that in vivo or in vitro exposures to such fields are carcinogenic.

Occupational exposure to electromagnetic fields and acute leukaemia: analysis of a case-control study

AIMS

To investigate whether the risk of acute leukaemia among adults is associated with occupational exposure to electromagnetic fields.

METHODS

Probable occupational exposure to electromagnetic fields at higher than typical residential levels was investigated among 764 patients diagnosed with acute leukaemia during 1991-96 and 1510 sex and age matched controls. A job exposure matrix was applied to the self reported employment histories to determine whether or not a subject was exposed to electromagnetic fields. Risks were assessed using conditional logistic regression for a matched analysis.

RESULTS

Study subjects considered probably ever exposed to electromagnetic fields at work were not at increased risk of acute leukaemia compared to those considered never exposed. Generally, no associations were observed on stratification by sex, leukaemia subtype, number of years since exposure stopped, or occupation; there was no evidence of a dose-response effect using increasing number of years exposed. However, relative to women considered never exposed, a significant excess of acute lymphoblastic leukaemia was observed among women probably exposed to electromagnetic fields at work that remained increased irrespective of time prior to diagnosis or job ever held.

CONCLUSION

This large population based case-control study found little evidence to support an association between occupational exposure to electromagnetic fields and acute leukaemia. While an excess of acute lymphoblastic leukaemia among women was observed, it is unlikely that occupational exposure to electromagnetic fields was responsible, given that increased risks remained during periods when exposure above background levels was improbable.

Teratogenic effect of broad-band electromagnetic field on neonatal mice (Mus musculus)

Pregnant mice (Mus musculus), strain Swiss Webster, were exposed to a continuous electromagnetic field (12.8V/m) beginning in the third week of pregnancy. Histological and hematological analysis showed gender specific responses in 21 day-old mice after in-utero and post-natal continuous exposure. Automated lymphocyte percentage and total white blood cell counts were significantly elevated in exposed 21 day-old female mice compared to control mice. Lymphoma-like cells were seen in higher numbers in exposed 21 day-old male mice. Megaloblastic changes, such as hypersegmented neutrophils, were observed in exposed mice. The blood from control neonatal mice was more viscous than that of exposed mice, enough to interfere with making a blood smear. The adult female mice showed no significant differences in the above hematologic parameters between exposed and control groups. Histological study showed the following pathological changes in the adrenal cortex: degeneration/necrosis in the zona glomerulosa; hypertrophy in zona reticularis; degeneration/necrosis, intracytoplasmic inclusions and inflammation in the zona fasciculata/reticularis, more prominent in exposed female neonates; and lipidosis in the zona fasciculata. In the adrenal medulla: atrophy was more common in exposed female neonates; and intracytoplasmic inclusions and vacuolation were more common in exposed male neonates. Cystic proliferations were found in the cortical area of the thymus. In the medulla of the thymus, there was vacuolation, inflammation, or eosinophilic intracytoplasmic inclusions in exposed adults. Behavioral differences occurred in both neonates and adult females. Control neonates were able to manipulate through a maze more quickly than exposed neonates; and control adult females displayed more thorough grooming behavior than exposed mothers, and maintained more distance between the nest and dropping location than did the exposed group.

Chronic exposure to a GSM-like signal (mobile phone) does not stimulate the development of DMBA-induced mammary tumors in rats: results of three consecutive studies

Certain epidemiological and experimental studies raised concerns about the safety of radiofrequency (RF) electromagnetic fields because of a possible increased risk of leukemia and lymphoma. In this study, an RF field used in mobile telecommunication was tested using 7,12-dimethylbenz[a]anthracene (DMBA)-induced mammary tumors in female Sprague-Dawley rats as a model for human breast cancer. Three experiments were carried out under strictly standardized conditions and were started on the same day of three consecutive years. The field consisted of a GSM-like signal (900 MHz pulsed at 217 Hz, pulse width 577 micros) of relatively low power flux density (100 microW/cm(2) +/- 3 dB) and was applied continuously throughout each experiment to freely moving animals. The specific absorption rates averaged over the whole body were 17.5-70 mW/kg. The highest values in young animals were at or around the exposure limit permissible for the general public (i.e. 80 mW/kg). The animals were palpated weekly for the presence of mammary tumors and were killed humanely when tumors reached a diameter of 1-2 cm to allow a reliable histopathological classification and a distinction between malignant and benign subtypes. The overall results of the three studies are that there was no statistically significant effect of RF-field exposure on tumor latency and that the cumulative tumor incidence at the end of the experiment was unaffected as well. The risk ratios were 1.08 (95% CI: 0.91-1.29) and 0.96 (95% CI: 0.85-1.07) for benign and malignant tumors, respectively. These observations are in agreement with other published findings. In the first experiment, however, the median latency for the development of the first malignant tumor in each animal was statistically significantly extended for RF-field-exposed animals compared to controls (278 days compared to 145 days, P = 0.009). No such differences were detected in the two subsequent experiments. These results show that low-level RF radiation does not appear to possess carcinogenic or cancer-promoting effects on DMBA-induced mammary tumors. To explain the mechanisms underlying the different results obtained in the three experiments, a hypothesis is presented which is based upon the neuroendocrine control mechanisms involved in the promotion of DMBA-induced mammary tumors. Despite the apparent absence of stimulatory effects of low-level RF-field exposure on the development and growth of solid tumors, it will be necessary to verify these results for leukemias and lymphomas, which may have completely different biological control mechanisms.

[Cancer mortality among Brazilian Navy personnel]

OBJECTIVE

To identify differences in cancer proportionate mortality among male servicemen of the Brazilian Navy when compared to a referent population and to detect potential occupational risk factors.

METHODS

Cancer proportionate mortality was estimated using death certificates and occupational histories of Brazilian navy servicemen aged 19 or more in the period of 1991 to 1995. The population of Rio de Janeiro (Brazil) was chosen as referent group because this city concentrates 70% of all Navy servicemen.

RESULTS

Servicemen are more likely to die from brain neoplasm (age-adjusted cancer proportionate mortality ratio - ACPMR=339.27), prostate cancer (ACPMR=135.04), and non-Hodgkin lymphoma (ACPMR=152.28) than the referent population. Health-related occupations show an excess of brain neoplasm (ACPMR=2.7, 95% confidence interval, CI: 1.1-6.5) and liver cancer (ACPMR=2.9; 95% CI: 1.1-7.8); colon-rectal cancer was higher among officials of the Army Corp and other administrative occupations (ACPMR=2.4, 95% CI: 1.3-4.5); larynx cancer (ACPMR=2.3, 95% CI; 1.1-5.0) is more common among men working in maintenance and repair occupations.

CONCLUSIONS

In this study, servicemen of the Brazilian Navy Force have a distinct cancer mortality profile from the general reference population. Risk factors for cancer need to be further evaluated, by using more specific diagnosis and occupational-related exposure data.

Biological effects of prolonged exposure to ELF electromagnetic fields in rats: III. 50 Hz electromagnetic fields

Groups of adult male Sprague Dawley rats (64 rats each) were exposed for 8 months to electromagnetic fields (EMF) of two different field strength combinations: 5microT - 1kV/m and 100microT - 5kV/m. A third group was sham exposed. Field exposure was 8 hrs/day for 5 days/week. Blood samples were collected for hematology determinations before the onset of exposure and at 12 week intervals. At sacrifice, liver, heart, mesenteric lymph nodes, bone marrow, and testes were collected for morphology and histology assessments, while the pineal gland and brain were collected for biochemical determinations. At both field strength combinations, no pathological changes were observed in animal growth rate, in morphology and histology of the collected tissue specimens (liver, heart, mesenteric lymph nodes, testes, bone marrow), and in serum chemistry. An increase in norepinephrine levels occurred in the pineal gland of rats exposed to the higher field strength. The major changes in the brain involved the opioid system in frontal cortex, parietal cortex, and hippocampus. From the present findings it may be hypothesized that EMF may cause alteration of some brain functions.

[Is there an increased risk of leukemia, brain tumors or breast cancer after exposure to high-frequency radiation? Review of methods and results of epidemiologic studies]

BACKGROUND

There are only a few epidemiologic studies investigating risk factors in persons occupationally exposed to high-frequency radiation (e.g. radio-, TV-waves, mobile phones or microwaves). The results of the studies are mostly inconsistent.

METHODS

All epidemiologic studies which investigated the association between occupational exposure to high-frequency radiation and the risk of leukemia, brain tumors or breast cancer were included in this review. All studies published between 1980 and 1997, such as record-linkage, case-control, and cohort studies, were retrieved from MEDLINE. Incidence and mortality studies are included. Methodologic problems of these investigations are discussed.

RESULTS

Most of the recent epidemiologic studies do not present quantitative exposure data or data on the specific frequencies of electro magnetic fields. In general, the relative risks for leukemia, brain tumors or breast cancer are small, not significant and inconsistent. Confounder variables were not included in most of the analyses and no dose-response relationship was reported.

CONCLUSION

To increase the power and the validity of the studies a re-analysis based on original data of all previous studies in this field is recommended. Additionally, to investigate the influence of high-frequency radiation on the development of cancer, international epidemiologic studies are necessary. Only they would have sufficient sample size to detect small elevated risks.

Occupational electric and magnetic field exposure and leukemia. A meta-analysis

We conducted a meta-analysis to acquire an understanding of the association between leukemia and occupational exposure to electric and magnetic fields. To explore sources of heterogeneity, study characteristics were scored and examined using regression analysis. While most studies present a small elevation in risk, the apparent lack of a clear pattern of exposure to EMF and risk of leukemia substantially detracts from the hypothesis that measured magnetic fields in the work environment are responsible for the observed excess risk of leukemia. Findings were not sensitive to assumptions, influence of individual studies, weighting schemes, and modeling. Some evidence of publication bias is noted.

[Cancer mortality among electricity utility workers in a the state of Sao Paulo, Brazil]

A number of epidemiologic studies have observed an association between exposure to 50-60 Hz electromagnetic fields and the development of specific types of cancer. In Brazil, a preliminary report from a study of electricity facility workers in Rio de Janeiro (RJ) has mentioned relatively similar results. An exploratory analysis of death certificates obtained from a sample of electricity workers in S. Paulo was made. Data was analysed by using the Proportional Mortality Ratio (PMR) and the Proportional Cancer Mortality Ratio (PCMR). A slightly elevated all-sites cancer mortality was observed among these workers (PMR 1.11; 95% CI 0.91-1.35). Site specific analysis has shown a statistically significant higher mortality of laryngeal cancer (PCMR 2.04; 95% CI 1.05-4.20). An excess of deaths was also seen for cancers of the buccal cavity/pharynx, prostate, bladder, brain and Hodgkin's disease, although the results lacked statistical significance. When analysed by categories of estimated exposure to magnetic fields, an excess of deaths from bladder cancer (PCMR 4.17; 95% CI 1.35-9.72), neoplasms of the brain (PCMR 7.7; 95% CI 1.02-9.65) and Hodgkin's disease (PCMR 5.55; 95% CI 1.14-16.21) was observed in the group with probably higher exposure to EMF. A comparison of cancer mortality between these workers and petrochemical employees has shown a higher PCMR for larynx tumours (PCMR 3.51; 95% CI 3.02-15.51) and bladder cancer (PCMR 7.53; 95% CI 3.02-15.51). For brain tumours, however, a PCMR of 0.74 (95% CI 0.27-1.61) was noted. Although restrictions related to sample size in the study and the lack of information about known confounders must be considered, the results of this study do not fully disagree with others previously mentioned in the literature.

The postwar hospitalization experience of U.S. veterans of the Persian Gulf War

BACKGROUND

Since the Persian Gulf War ended in 1991, many veterans of that conflict have reported diverse, unexplained symptoms. To evaluate the health of Gulf War veterans, we studied their postwar hospitalization experience and compared it with that of other military personnel serving at the same time who did not go to the Persian Gulf.

METHODS

Using a retrospective cohort approach and data from Department of Defense hospitals, we studied hospitalizations of 547,076 veterans of the Gulf War who were serving in the Army, Navy, Marine Corps, and Air Force and 618,335 other veterans from the same era who did not serve in the Persian Gulf. Using multivariate logistic-regression models, we analyzed risk factors for hospitalization both overall and in 14 broad diagnostic categories during three periods from August 1991 through September 1993 (a total of 45 specific comparisons).

RESULTS

After the war, the overall odds ratio for hospitalization of the Gulf War veterans was not higher than that of the other veterans, even after adjustment for selection effects related to deployment. In 16 of the 42 comparisons involving specific diagnoses, the risk of hospitalization among Gulf War veterans differed significantly from that among other veterans. Among these 16 comparisons, Gulf War veterans were at higher risk in 5: neoplasms (largely benign) during 1991, diseases of the genitourinary system during 1991, diseases of the blood and blood-forming organs (mostly forms of anemia) during 1992, and mental disorders during both 1992 and 1993. The differences were not consistent over time and could be accounted for by deferred care, postwar pregnancies, and postwar stress.

CONCLUSIONS

During the two years after the Persian Gulf War, there was no excess of unexplained hospitalization among Americans who remained on active duty after serving in that conflict.

Carpal tunnel syndrome and occupation in U.S. Navy enlisted personnel

The objectives of this study were to (a) describe demographic factors associated with high rates of carpal tunnel syndrome (CTS), cubital tunnel syndrome, and other neuritis of the arm and hand, and (2) identify the high-risk occupations associated with these disorders in the Navy. Computerized records of first hospitalizations of all active-duty Navy-enlisted personnel were searched for all cases of CTS, cubital tunnel syndrome, and other neuritis of the arm and hand (ICD-9 CM codes 354.0-354.9) during 1980-1988. There were 1039 first hospitalizations (including 493 cases of CTS) for all neuritis of the arm and hand in 4095708 person-years in men and 186 first hospitalizations (including 90 cases of CTS) in 365668 person-years in women. Incidence rates of hospitalized cases with CTS rose with age for both sexes. Rates in white women were approximately three times those in white men (p < .0001), but rates in black women were not significantly different from those in black men. Rates of cubital tunnel syndrome also increased with age in both sexes and were higher in white women than white men (p < .05). Occupations with significantly high standardized incidence ratios (p < .05) for CTS in men included aviation-support equipment technician, engineman, hull-maintenance technician, boatswain's mate, and machinist's mate. In women, occupations with significantly high standardized incidence ratios included boatswain's mate, engineman, hospital corpsman, ocean-systems technician, and personnelman. Several occupations for each sex had significantly high standardized incidence ratios for cubital tunnel syndrome, with high rates in hospital corpsmen of both sexes (p < .05). Gender and race differences according to occupation did not account for the occupations at highest risk. Further research is needed to determine the extent to which CTS and related disorders could be prevented by modifying the motions currently performed in occupations with the highest standardized incidence ratios.

Cancer in electrical workers: an analysis of cancer registrations in England, 1981-87

Associations between work in the electrical and electronic industry and cancer incidence were assessed using data for 371 890 cancers registered in England between 1981 and 1987, of which 7981 were in electrical workers. Proportional registration ratios (PRRs) were calculated, both with and without the commonest cancers, with adjustment for age, social class, cancer registry of origin and sex. Of four cancers previously linked with work in the electrical and electronic industry (leukaemia, brain, breast and melanoma), only two were significantly raised: leukaemia (PRR=124, 95% CI=109-142, based on 217 cases) and malignant brain cancer (PRR=118, 95% CI=103-136, based on 204 cases). A significantly increased risk was also observed for pleural cancer (PRR=201, 95% CI=167-241, based on 115 cases). The histology of almost 90% of pleural cancers was coded as mesothelioma, confirming the previously observed association between pleural cancer and exposure to asbestos in electrical workers. The extent to which workplace exposures to extremely low frequency electromagnetic fields explains the excesses seen here for leukaemia and brain cancer requires further study.

Occupational and environmental exposures and myelodysplasia: a case-control study

A case-control study of newly diagnosed myelodysplastic syndrome patients investigated lifetime exposures through occupation, environment or hobby by questionnaire, structured and semi-structured interview. The exposure histories of 400 individually matched pairs were compared. Increased or possibly increased odds ratios were observed for radiation (2.05, 95% confidence interval 1.16-3.76), halogenated organics (1.57, 0.97-2.57), metals (1.40, 0.99-2.00), several specific radiation exposures and individual chemicals and for childlessness (1.46, 1.01-2.11). Since myelodysplasia generally carries a poor prognosis, whether or not individuals convert to leukaemia or to other cancer, these findings add to previous reports of exposures implicated in the aetiology of leukaemia and add to the case for minimizing exposures to radiation and halogenated organics.

Exposure to magnetic fields among electrical workers in relation to leukemia risk in Los Angeles County

To address the hypotheses that electrical workers are exposed to higher magnetic fields and are at higher risk of leukemia than nonelectrical workers, we performed a registry-based case-control study among men aged 20-64 years with known occupation who were diagnosed with cancer in Los Angeles County between 1972 and 1990. Controls were men with cancers other than those of the central nervous system or leukemia. Magnetic field measurements on workers in each electrical occupation and in a random sample of occupations presumed to be nonelectrical were used to estimate magnetic field exposures for each occupation. Among men in electrical occupations, 121 leukemias were diagnosed. With the exception of electrical engineers, magnetic field exposures were higher among workers in electrical occupations than in nonelectrical occupations. A weakly positive trend in leukemia risk across average occupational magnetic field exposure was observed (odds ratio [OR] per 10 milligauss increase in average magnetic field = 1.2, 95% confidence interval [CI] 1.0-1.5). A slightly stronger association was observed for chronic myloid leukemia, although only 28 cases occurred among electrical workers (OR 10 milligauss increase = 1.6, 95% CI = 1.2-2.0). The results were not materially altered by adjustment for exposure to several agents known or suspected to cause leukemia. Although not conclusive, these results are consistent with findings from studies based on job title alone that electrical workers may be at slightly increased risk of leukemia.