The role of occupational and environmental exposures in the aetiology of acquired severe aplastic anaemia: a case control investigation

Br J Haematol. 2003 Dec;123(5):906-14. doi: 10.1046/j.1365-2141.2003.04718.x.

Abstract

Aplastic anaemia is a rare but serious disorder with a high morbidity and mortality rate. The causes of aplastic anaemia are, for the most part, unknown. We report on the hypothesis that aplastic anaemia may be caused by occupational and/or environmental exposures to certain chemicals. The UK Aplastic Anaemia Study was an interview-based case-control study covering the whole of Great Britain. Those patients diagnosed between 1 July 1993 and 20 October 1997, aged < or =75 years and born and diagnosed in the UK were eligible for the study. Two hundred eligible cases of aplastic anaemia were compared with 387 age- and sex-matched controls. A number of occupational exposures showed increases in risk. In a multivariate model of these exposures the odds ratios (ORs) for solvents/degreasing agents, pesticides and radiation were >2 and statistically significant. Reported chemical treatment of houses within 5 years of diagnosis had a significantly raised risk for adults [OR = 2.51, 95% confidence interval (CI) 1.02-12.01], particularly for woodworm treatment (OR = 5.1, 95% CI 1.5-17.4). This study identified significant risks associated with self-reported exposure to solvents, radiation and pesticides in the workplace. Self-reported chemical treatment of houses was also associated with an increased risk of developing aplastic anaemia, in keeping with previous literature.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Agriculture
  • Anemia, Aplastic / chemically induced
  • Anemia, Aplastic / etiology*
  • Case-Control Studies
  • Child
  • Child, Preschool
  • Commerce
  • Environmental Exposure*
  • Female
  • Hobbies
  • Household Products / adverse effects
  • Humans
  • Industry*
  • Infant
  • Logistic Models
  • Male
  • Medical Staff
  • Middle Aged
  • Multivariate Analysis
  • Occupational Diseases / chemically induced
  • Occupational Diseases / etiology*
  • Occupational Exposure
  • Pesticides / adverse effects
  • Radiation
  • Risk
  • Social Class
  • Solvents / adverse effects

Substances

  • Pesticides
  • Solvents