This cohort study aimed to elucidate cancer occurrence in relation to occupational exposure to speci(r)c chemical, biological and physical agents among biomedical research personnel in Sweden. Elevated SIRs were noted for malignant melanoma among female laboratory employees for whom use was reported of solvents (SIR 2.73; CI 1.10+-5.63) a light increase of the risk estimate for breast cancer was also observed.
This cohort study aimed to elucidate cancer occurrence in relation to occupational exposure to speci(r)c chemical, biological and physical agents among biomedical research personnel in Sweden. Elevated SIRs were noted for malignant melanoma among female laboratory employees for whom use was reported of solvents (SIR 2.73; CI 1.10+-5.63) a light increase of the risk estimate for breast cancer was also observed.
This cohort study aimed to elucidate cancer occurrence in relation to occupational exposure to speci(r)c chemical, biological and physical agents among biomedical research personnel in Sweden. Elevated SIRs were noted for malignant melanoma among female laboratory employees for whom use was reported of solvents (SIR 2.73; CI 1.10+-5.63) a light increase of the risk estimate for breast cancer was also observed.
A.J. Sasco Harri Vainio Per Gustavsson Cancer incidence and work place exposure among Swedish biomedical research personnel Received: 11 January 2001 / Accepted: 29 June 2001 / Published online: 14 September 2001 Springer-Verlag 2001 Abstract Objective: This cohort study aimed to elucidate cancer occurrence in relation to occupational exposure to specic chemical, biological and physical agents among biomedical research laboratory personnel in Sweden. Methods: Standardized incidence ratios (SIRs) for the period 19701994 were calculated for specic exposures in the laboratory group (n=3,277) and for personnel working in non-laboratory departments (n=2,011), as an internal reference group. Expected numbers were based on national cancer rates. Results: The total number of cancer cases was lower than expected in both laboratory and non-laboratory personnel. Elevated SIRs were noted for malignant melanoma among female laboratory employees for whom use was reported of solvents (SIR 2.73; CI 1.10 5.63) and of selected carcinogenic (International Agency for Research on Cancer (IARC) group 2B) agents (SIR 3.15; CI 1.166.85). A light increase of the risk estimate for breast cancer was also observed. Conclusions: In general, there were few cases of cancer in this compar- atively young cohort, but the ndings give some indi- cation of increased risks for malignant melanoma in female laboratory personnel after exposure to organic solvents or substances classied by IARC as being possibly carcinogenic. Keywords Cancer Melanoma Breast cancer Cohortstudy Laboratory personnel Organic solvents Introduction A number of chemical, biological and physical agents in biomedical research laboratory environments constitute possible risk factors for cancer. A previous study of cancer incidence and mortality in Swedish biomedical laboratories showed a slightly increased standardized incidence ratio (SIR) for brain tumors among male laboratory personnel and breast cancer among female scientists (Wennborg et al. 1999). Also in a number of earlier studies, an excess of brain tumors (Belli et al. 1992; Cordier et al. 1995; Daly et al. 1994), as well as an excess of breast cancer (Dosemeci et al. 1992; Belli et al. 1992) have been reported in association with laboratory work, although a British study did not show any ele- vated SIRs for these outcomes (Brown et al. 1996). An increased SIR was observed for malignant melanoma among female scientists in the above-mentioned Swedish study (Wennborg et al. 1999) as well as among labora- tory technicians in a study based on register information Int Arch Occup Environ Health (2001) 74: 558564 DOI 10.1007/s004200100267 H. Wennborg (&) Department of Biosciences, Unit for Environmental Medicine, Novum Research Park, Karolinska Institute, 141 57 Huddinge, Sweden E-mail: helena.wennborg@biosci.ki.se Fax: +46-8-6081501 H. Wennborg H. Vainio The National Institute of Environmental Medicine, Division of Health Risk Assessment, Karolinska Institute, Stockholm, Sweden J. Yuen Department of Ecology and Crop Production Sciences, Swedish University of Agricultural Sciences, Uppsala, Sweden G. Nise P. Gustavsson Department of Occupational Health, Karolinska Hospital, Stockholm, Sweden G. Nise P. Gustavsson Division of Occupational Health, Department of Public Health Sciences, Karolinska Institute, Stockholm, Sweden A.J. Sasco Unit of Epidemiology for Cancer Prevention, International Agency for Research on Cancer, Lyon, France A.J. Sasco Institut National de la Sante et de la Recherche Me dicale, Lyon, France H. Vainio Unit for Chemoprevention, International Agency for Research on Cancer, Lyon, France from the Nordic countries (Andersen et al. 1999). Elevated SIRs for all lymphohematopoietic tumors have been described in a study of laboratory technicians ever employed in laboratories of clinical chemistry, patholo- gy or clinical genetics (Gustavsson et al. 1999), and in a study of laboratory workers in Italy (Belli et al. 1992). Some studies have also noted increased SIRs for pan- creatic tumors in connection with laboratory work (Belli et al. 1992; Cordier et al. 1995). A recently published review about cancer risk in laboratory workers (Rachet et al. 2000) concluded that the studies suggest a low overall risk of cancer, albeit a higher risk may be suggested for cancers of the pancreas and brain, and non-Hodgkin's lymphoma. Organic solvents have been studied in association with cancer risk because of their common occurrence in the laboratory environment and their potential carcin- ogenic properties. Exposure to solvents in general has been connected to increased risk of non-Hodgkin's lymphoma (Vienna and Polan 1979; Olsson and Brandt 1988; Hardell et al. 1994). Formaldehyde has been shown to cause nasal malignancies in the rat (Kamata et al. 1996; Morgan 1997) and is currently classied as probably carcinogenic (2A) to humans according to the International Agency for Research on Cancer (IARC) classication (IARC 1995). This retrospective follow-up study was an extension of the investigation about mortality and cancer inci- dence among biomedical research laboratory personnel in Sweden that was reported previously (Wennborg et al. 1999). The present study was performed to elucidate cancer occurrence in laboratory personnel by using questionnaire-collected, more-detailed, exposure infor- mation i.e. use of specic biological, chemical and physical agents in laboratories. Furthermore, the follow- up time was 2 years longer than in the previous study. Materials and methods Cohort information and exposure assessment The study base of the present investigation has been described in detail (Wennborg et al. 1999). Briey, the cohort included 5,035 employees from laboratory departments and 2,923 from non-lab- oratory departments at the Karolinska Institute and at the uni- versities of Lund, Gothenburg and Linko ping, encompassing 70 laboratory and 34 non-laboratory departments, the latter included as an internal reference group. For each individual the following information was collected: name, Swedish personal identication number also indicating gender, start and end dates for all em- ployment periods, leaves of absence of 6 months or longer, work positions, work places and changes of work places or work tasks. This information was obtained from manual records from univer- sities and, when available, from computerized records from the universities and the Swedish National Government Employee Salaries and Pension Board (SPV). The present study is based on an exposure assessment by a questionnaire directed to research group leaders. The director of each institution was contacted and asked to compile a list of all research group leaders in the department. The laboratory and non- laboratory units, if they so wished, were visited for information about the project by the study investigators. The questionnaires were subsequently sent to all research group leaders in every par- ticipating laboratory and non-laboratory department. In cases where the group leader assessed that the methods used by personnel in the current group diered markedly between the subgroups within the unit, the research group was divided into two or several new research groups according to the suggestions of the group members, in order to obtain more homogenous exposures within each research group. Retired research group leaders, or in some cases other researchers, were also contacted to represent the re- search groups which were no longer existing at the time of data collection. The total number of laboratory and non-laboratory research groups participating in this study was 714, encompassing 5,288 individuals (3,277 laboratory personnel with 1,476 men and 1,801 women, 2,011 non-laboratory personnel with 1,290 men and 721 women), giving a participation proportion of 66.4% for the whole cohort. This proportion was larger for personnel from non-labo- ratory departments, 68.8%, than from laboratory departments, 65.1%. The follow-up started in 1970 or with each employee's entry into the cohort, if later, and lasted until 31 December 1994, death, or until the last known date of employment for those lost to follow- up (n=7), Table 1. Employees who had moved from a laboratory department to a non-laboratory department were considered as laboratory employees in the follow-up. Most individuals participating in the study were directly working in research; other occupations included are described in the previous study about cancer mortality and incidence in labo- ratory personnel (Wennborg et al. 1999). The minimum employ- ment period was 1 year and the longest 20 years. The laboratory personnel were slightly younger than the non-laboratory personnel at entrance into the cohort (Fig. 1). Exposure and questionnaire information The questionnaire included items about chemical, biological and physical agents such as chemicals, viruses, bacteria, plants and organisms manipulated with recombinant-DNA techniques. The chemical agents asked for were 74 of the most commonly used Table 1 Number of subjects and vital status at the end of follow-up (1994), among laboratory and non-laboratory personnel at Swedish University departments from 1970 to 1989 Vital status Laboratory departments Non-laboratory departments Total Women % Men % Women % Men % Number % Alive 1,715 95.2 1,355 91.8 691 95.8 1,229 95.3 4,990 94.4 Dead 53 3.0 77 5.2 18 2.5 37 2.9 185 3.5 Emigrated 31 1.7 40 2.7 12 1.7 23 1.7 106 2.0 Unknown 2 0.1 4 0.3 0 0.0 1 0.1 7 0.1 Total 1,801 100.0 1,476 100.0 721 100.0 1,290 100.0 5,288 100.0 559 chemicals in the laboratory environment. These included organic solvents and agents classied as carcinogens according to IARC. A possibility to add more chemicals was also oered in the ques- tionnaire. Chemical and biological agents and techniques used in biomedical laboratories were identied from method manuals used in the 1970s and 1980s (Sambrook et al. 1989) and partly from the questionnaire designed at IARC (Sasco 1994). Discussions with safety personnel and the ad hoc registers of departments, if such records existed, were used, and scientists with competence in chemistry, immunology, molecular biology and toxicology gave comments on the choice of agents and techniques in the ques- tionnaire. The carcinogenic substances used in the laboratories were categorized according to the IARC classication of carcino- genic compounds: group 1 exposures carcinogenic to humans, group 2A probably carcinogenic to humans and group 2B possibly carcinogenic to humans (IARC 1998). An occupational hygienist made a nal classication of solvents to be included. The exposure during the period 19701989 was considered and collected in subperiods of 5 years for each research group. If the group an- nounced that some of the individuals within it had not been working with certain specic agents, a new research group was formed including these persons. A pilot study was conducted at one of the laboratory depart- ments showing that the use of this study questionnaire was feasible. The exposure was dened for an individual from the reported ex- posure data in that individual's research group after linkage with the relevant work periods concurrent with the time of exposure. The exposure categories included in the analyses were: work with organic solvents, bacteria, radioactive isotopes, DNA, RNA, formaldehyde, carcinogens according to IARC classication (1, 2A, 2B, or any of these), cell techniques and recombinant-DNA techniques. Classication and identication of cancer cases Cancer cases were identied by record linkage to the cancer register administrated by the Swedish National Board of Health and Welfare. The Swedish personal identication number (``person number''), which is unique to each individual living in Sweden, was used for identication of cases diagnosed between 1 January 1970 and 31 December 1994, coded according to the ICD7 classication system. Statistical analysis The SIR (Breslow and Day 1987) was calculated for each cancer site in every exposure group for the laboratory departments and for employees from non-laboratory departments. Only the cancer types reported earlier in association with exposures similar to laboratory environments, and most common cancers e.g. breast and prostate cancers were included. The Swedish national cancer incidence rates for the years 1970 to 1994 were used to calculate expected numbers. All malignancies for each person were included in the calculations, except in the analysis of total number of cancers, where only the rst malignancy was taken into consideration. Person-year calcu- lations were stratied for gender, age (5-year age groups) and calendar time, calculated from 1 year after the introduction of a specic potentially hazardous agent up to the date of cancer di- agnosis (for all cancers, date of the rst cancer diagnosis), death, emigration or until 31 December 1994, whichever came rst. For the non-laboratory personnel, person-year calculations started 1 year from the start of the employment or from 1970 if started earlier than 1969, and with the same follow-up as for the laboratory personnel. Condence intervals (95% CI) were calculated, based on the Poisson distribution (Gardner and Altman 1989). The DATAB module of the EPICURE program package was used (HiroSoft, Seattle, Wash., USA). This study was approved by the local Ethics Committee at the Karolinska Institute, Sweden and by the Swedish Data Inspection Board. Results In general, the SIRs were low for all cancers together as well as for most of the common cancer types for both men and women in the laboratory and non-laboratory groups. The total number of cancer cases in the present subcohort was 178 (122 among laboratory and 56 among non-laboratory personnel). The most commonly used carcinogens (including several organic solvents) according to the IARC classi- cation are shown in Table 2. The occurrence of the most common cancer types and the cancer types that were earlier reported as being possible outcomes in as- sociation with exposures similar to those in the labora- tory environment are shown, by use, in Table 3: radioactive isotopes, solvents and formaldehyde among laboratory personnel. For women who worked with solvents, an elevated SIR of 2.73 (CI 1.105.63) was obtained for malignant melanoma, based on seven cases, but an increase in melanoma was also seen for the other two agents. Use of radioactive isotopes produced an elevated SIR of 1.26 (95% CI 0.154.54) for all lym- phohematopoietic tumors among female laboratory employees, but the number of cases was low (n=2). Moreover, work with DNA techniques gave an in- creased SIR of 1.75, CI 0.574.07 for breast cancer (six cases), as did work with RNA, but the number of indi- viduals using these techniques was approximately the same. No other increased SIRs were seen in connection with these agents (data not shown). The total number of employees working with DNA was small (n=349). Fig. 1 Age distribution of a laboratory and b non-laboratory personnel at the time of entry into the cohort 560 Table 3 Occurrence of cancer by specic exposures: radioactive isotopes, solvents and formaldehyde among personnel working in Swedish biomedical laboratories during 19701989 (O observed number of cases) Agent Cancer Women Men O SIR CI O SIR CI Non-laboratory n=721 Women/1,290 men All cancers 27 0.84 0.561.23 29 0.77 0.511.10 Lung 3 2.09 0.436.11 1 0.25 0.011.37 Breast/prostate 7 0.66 0.261.35 6 1.11 0.412.42 Malignant melanoma 2 1.25 0.154.51 5 2.07 0.674.82 Non melanoma skin 0 0 Urinary organs 1 1.74 0.049.70 1 0.37 0.012.04 Lymphohematopoietic 1 0.54 0.013.03 2 0.49 0.061.77 Radioactive isotopes n=844 Women/709 men All cancers 20 0.72 0.441.11 13 0.67 0.351.14 Lung 0 3 1.56 0.324.56 Breast/prostate 9 0.95 0.431.79 2 0.76 0.092.76 Malignant melanoma 4 2.28 0.625.48 0 Non melanoma skin 1 2.53 0.0614.1 2 2.92 0.3510.5 Urinary organs 0 1 0.76 0.024.25 Lymphohematopoietic 2 1.26 0.154.54 0 Solvents n=1,173 Women/1,150 men All cancers 38 0.85 0.601.17 30 0.71 0.481.02 Lung 0 4 0.91 0.252.33 Breast/prostate 17 1.13 0.661.81 7 0.98 0.392.02 Malignant melanoma 7 2.73 1.105.63 1 0.44 0.012.45 Non melanoma skin 1 1.44 0.048.03 3 1.85 0.385.41 Urinary organs 1 1.34 0.037.41 4 1.34 0.363.42 Lymphohematopoietic 2 0.76 0.092.75 1 0.23 0.011.30 Formaldehyde n=756 Women/741 men All cancers 21 0.82 0.511.25 18 0.78 0.461.23 Lung 0 3 1.27 0.263.71 Breast/prostate 8 0.89 0.381.75 5 1.37 0.453.20 Malignant melanoma 4 2.52 0.696.44 0 Non melanoma skin 1 2.76 0.0715.4 2 2.33 0.288.40 Urinary organs 0 1 0.62 0.023.46 Lymphohematopoietic 1 0.69 0.023.83 1 0.41 0.012.30 Table 2 The most commonly used carcinogenic substances and solvents in biological research in Sweden in the 1970s and 1980s according to classications of 1998 (n number of research groups) Classication 19701974 19751979 19801984 19851989 (n) (n) (n) (n) IARC 1 Benzene (62) Benzene (55) Benzene (61) Benzene (37) Asbestos (19) Asbestos (22) Asbestos (18) Asbestos (14) Benzidine (11) Benzidine (11) Benzidine (15) Benzidine (8) IARC 2A Formaldehyde (113) Formaldehyde (144) Formaldehyde (189) Formaldehyde (207) Acrylamide (40) Acrylamide (58) Acrylamide (93) Acrylamide (116) Trichloroethylene (27) Trichloroethylene (29) Trichloroethylene (32) Trichloroethylene (26) Benzo(a)pyrene (8) Benzo(a)pyrene (16) Benzo(a)pyrene (18) Benzo(a)pyrene (14) MMS (4) Tetrachloroethylene (11) Tetrachloroethylene (10) Azacitidin (8) IARC 2B Chloroform (101) Chloroform (124) Chloroform (150) Chloroform (168) Trypan blue (43) Trypan blue (62) Trypan blue (78) Trypan blue (90) Carbon tetrachloride (39) Carbon tetrachloride (48) Carbon tetrachloride (40) Dichloromethane (37) Dioxane (36) Dioxane (32) Phenobarbital (34) Carbon tetrachloride (32) Propylene oxide (21) 1,2-Dichloroethane (24) Dichloromethane (32) Phenobarbital (31) Phenobarbital (20) Phenobarbital (23) Dioxane (29) Propylene oxide (26) Hydrazine (14) Propylene oxide (22) 1,2-Dichloroethane (25) 1,2-Dichloroethane (24) 1,2-Dichloroethane (12) Dichloromethane (22) Propylene oxide (25) Hydrazine (23) Dichloromethane (10) DDT (15) Hydrazine (17) Dioxane (21) DDT (9) EMS (11) DDT (16) Mitomycin C (17) o-Toluidine (9) Hydrazine (11) EMS (16) DDT (16) EMS (8) o-Toluidine (11) Mitomycin C (13) EMS (11) 561 For men, elevated SIRs could be seen for non-mela- noma skin cancer in connection with work with radio- active isotopes (SIR 2.92, CI 0.3510.50; two cases) and for formaldehyde (SIR 2.33, CI 0.288.40; two cases). Work with formaldehyde also showed an increased SIR for prostate cancer (SIR 1.37, CI 0.453.20; ve cases). A slight increase in the SIR also existed for tumors in urinary organs and for non-melanoma skin cancer in association with use of organic solvents, SIR 1.34, CI 0.363.42; four cases, and SIR 1.85, CI 0.385.41; three cases, respectively. In Table 3, the SIRs for the same tumor types are also given for the non-laboratory university personnel, showing reduced SIRs for most of the cancer types. However, an increased SIR, 2.07 (CI 0.674.82; four cases) for malignant melanoma was also seen among men working in non-laboratory departments. Work with carcinogenic substances used in labora- tories and the same cancer sites as above, are displayed in Table 4. Use of carcinogens of group 2B was associ- ated with an increased SIR for malignant melanoma for female personnel to 3.15 (CI 1.166.85). The numbers of cases of the other cancer types for female laboratory workers by dierent exposure agents and techniques were low. Concerning the male personnel, a slightly elevated SIR was seen for lung cancer with use of carcinogenic substances group 1 (SIR 1.93, CI 0.405.65; three cases) and for prostate cancer in association with exposure to all IARC-classied substance groups; the SIR for group 1 was 1.28, for group 2A 1.21 and for group 2B 1.33. Prostate cancer and use of recombinant-DNA tech- niques gave a SIR of 1.79 (CI 0.494.59; four cases). Data are not shown for other cancer types with use of this agent. Discussion In comparison with the general population, the inci- dence of most cancers was low in every exposure cate- gory in the present cohort. Yet, for malignant melanoma among female personnel working with organic solvents an elevated SIR was obtained. However, the number of cases was low, limiting the possibility of drawing con- clusions about associations between laboratory expo- sures and malignant melanoma. Furthermore, for breast cancer among women working with DNA and RNA, elevated SIRs were seen, but the numbers of cases were also small. For the male laboratory personnel, slightly elevated SIRs for prostate cancer in connection with work with carcinogens and recombinant-DNA techniques were obtained. The participation proportion was somewhat lower in the laboratory group than in the non-laboratory group, which had also received the questionnaire. The reason for sending the questionnaire to the non-laboratory groups was to identify those employees who had previously worked in laboratory departments. It should also be noted that the research groups for four cases of brain tumors previously identied in the study base (Wennborg et al. 1999) never answered the questionnaire. Table 4 Occurrence of cancer up to 1994, by each exposure group according to the IARC classications of carcinogenic substances, among personnel working in Swedish biomedical laboratories during 19701989 (O observed number of cases) Agent Cancer Women Men O SIR CI O SIR CI IARC 1 n=436 Women/393 men All cancers 8 0.48 0.210.95 14 0.98 0.531.64 Lung 0 3 1.93 0.405.65 Breast/prostate 4 0.70 0.191.79 3 1.28 0.263.73 Malignant melanoma 2 2.02 0.257.31 1 1.22 0.036.77 Non melanoma skin 0 0 Urinary organs 0 1 0.95 0.025.31 Lymphohematopoietic 0 1 0.66 0.023.67 IARC 2A n=872 Women/794 men All cancers 23 0.79 0.501.18 17 0.66 0.381.05 Lung 0 3 1.13 0.233.31 Breast/prostate 10 0.99 0.481.82 5 1.21 0.392.82 Malignant melanoma 4 2.21 0.605.65 0 Non melanoma skin 1 2.48 0.0613.8 2 2.08 0.257.53 Urinary organs 0 2 1.11 0.134.01 Lymphohematopoietic 0 1 0.37 0.012.07 IARC 2B n=927 Women/833 men All cancers 23 0.72 0.461.08 18 0.65 0.381.02 Lung 0 2 0.70 0.082.52 Breast/prostate 9 0.85 0.391.60 6 1.33 0.492.88 Malignant melanoma 6 3.15 1.166.85 0 Non melanoma skin 1 1.95 0.5010.3 2 1.91 0.236.89 Urinary organs 0 2 1.02 0.123.70 Lymphohematopoietic 1 0.59 0.013.26 1 0.35 0.011.93 562 Moreover, the low risk estimates in general indicate that there is a selection of healthy individuals in the present study. This fact also shows that the general population is not the optimal reference group to the university laboratory employees. The information about cancer cases can be consid- ered as reliable; almost no cases should be missing, due to the high validity of the Swedish Cancer Registry (Mattsson 1984). The exclusion of certain departments, e.g. organic chemistry and physics, with hazardous occupational exposures other than those in the present study, has decreased the confounding eects from these agents. There were no data about smoking in this study, but the low occurrence of lung cancer in the previous study on this cohort indicates that smoking can probably not be considered as a potential confounder in these occupa- tional groups (Wennborg et al. 1999). Moreover, the frequency of smokers at the time of conception, ac- cording to information collected by questionnaires and from the medical birth register, was low in a study of time-to-pregnancy among Swedish female laboratory employees (Wennborg et al. 2001). Exposures were assessed for research groups ac- cording to the recommendations by IARC, since the present investigation was part of an international mul- ticenter study adhering to these criteria (Sasco 1992). Collection of information was not considered feasible on the individual level. Data collection performed in this way precludes the gathering of information about some potential confounders in the study, but this approach made it possible to obtain exposure information about the employees who had died during the follow-up. Some of the group members may not have worked personally with all types of agents reported in the questionnaire, but the members of the research groups were working in the same facilities and theoretically they could, there- fore, have been exposed to the vapors and aerosols from chemicals used in the laboratories. No historic measurements of exposures were avail- able and no measurements were performed during the study. Measurements of current exposure conditions are both expensive and complex, and do not reect past exposure conditions. Problems in exposure assessment in occupational studies with mixed chemical exposures are widely discussed and some authors suggest the use of biomarkers to improve the exposure assessment (Rachet et al. 2000). The recombinant-DNA molecular biology techniques were introduced broadly during the middle of the 1980s, i.e. their use started relatively late during the present follow-up. Because carcinogenic agents act at both early and late stages, this might lead to underesti- mation of cancer risk in cases where the induction time is longer than the period that is being presently studied. An elevated SIR was seen for malignant melanoma in female employees in connection with work with solvents and carcinogens, although the numbers of cases were low. Elevated SIRs for malignant melanoma were also found in previous occupational studies of laboratory workers (Hoar and Pell 1981; Hunter et al. 1993; Va gero et al. 1990) as well as among lithographers (Nielsen et al. 1996). Malignant melanomas are common among the more auent social groups, possibly associated with exposure to solar UV-light during holidays (Va gero et al. 1990). A Canadian study concluded that there is no evidence of occupational risk for melanoma, but on the other hand, all the studies conducted so far have been too small for this conclusion to be denitive (Fritschi and Siemiatycki 1996). Several previous studies have found an excess of lymphohematopoietic tumors among laboratory work- ers (Belli et al. 1992; Brown et al. 1996). In a study on mortality and cancer incidence among laboratory tech- nicians in Sweden, an increased risk for this cancer type was also observed (Gustavsson et al. 1999). That study and the present one have a partly overlapping study population of exposed individuals of 705 women and men. However, in the material reported here, no ele- vated SIR was seen for lymphohematopoietic malig- nancies. The explanation is possibly related to dierences in the study bases. No clinical departments were included in the present study, and the lymphohe- matopoietic tumors in the study by Gustavsson et al. were found among women working in such laboratories, e.g. of clinical chemistry, pathology or clinical genetics. The previously reported study on this cohort showed slightly elevated SIRs for breast cancer (Wennborg et al. 1999). In the present study, only weak associations in connection with work with DNA or RNA was observed (data not shown). Work with these techniques includes use of organic solvents, such as phenol, chloroform and isoamyl alcohol for extraction, as well as use of ethidiumbromide for staining of nucleic acids. The occurrences of cancer types for which elevated SIRs have been observed in the present study as well as in several previous studies (Belli et al. 1992; Cordier et al. 1995; Wennborg et al. 1999) dier between women and men. There are two possible explanations: the exposures are not similar for both sexes despite identical job titles, or the mechanisms of carcinogenicity dier between sexes (Blair et al. 1999; Docemeci et al. 1999). Despite of the relatively small number of participat- ing employees, which leads to a lack of power in the study, there are other aspects to be considered. The present cohort is relatively young and has been followed for a limited period. Many employees have thus worked for only a few years, which possibly mask a carcinogenic eect of the exposures. However, work place safety regulations in Sweden are very well dened and rea- sonably well followed, which may reduce the exposure to hazardous agents, e.g. with use of gloves, face masks, fume hoods, exhaust work benches and restrictions in handling of carcinogenic compounds. In general and in connection with the specic agents in the laboratory environment, the numbers of cancer cases were small, producing wide condence intervals but indicating that occurrence of most types of cancers among Swedish laboratory employees is low. However, 563 increased SIRs were observed for malignant melanoma in female laboratory employees using solvents. Acknowledgements We are grateful to Professor Anders Ahlbom for responsibility in the design of the study; to Professors Go sta Axelsson and Bo Lambert for fruitful discussions and for critical comments on the manuscript. 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