Occupational and environmental risk factors of the myelodysplastic syndromes in the North of France

Aetiological factors of the myelodysplastic syndromes (MDS) are largely unk nown, with the exception of alkylating agents, ionizing radiation and benze ne. Some other risk factors have been suggested by the few epidemiological studies reported (solvents, ammonia, exhaust gases, metals, pesticides, alc ohol). We performed a case-control study to assess the relationship between occupational or environmental factors and MDS. Two hundred and four patien ts with newly diagnosed MDS, and 204 sex- and age-matched controls were inc luded. Medical history, demographic data, lifetime exposure and hobbies wer e obtained. Qualitative and quantitative exposure to chemical and physical hazards were evaluated with the patients and reviewed by a group of experts in occupational exposure. The median age was 70 years and 62% of the patie nts were men. In univariate analyses, we found relationships between MDS an d smoking habits, gardening, occupations such as health professionals, tech nical and sale representatives, machine operators, agricultural workers, te xtile workers, qualitative occupational exposures (exposed/non-exposed) to oil, solvents, ammonia, pesticides, fertilizers, cereal dusts, contact with poultry Dr livestock and infective risk, and lifetime cumulative exposure to solvents, oil, textile dust and infective risk. The main risk factors of MDS determined by multivariate analyses (conditional logistic regression) were, being an agricultural worker [odds ratio (OR) = 3.66; 95% confidence interval (CI) 1.9-7.0], textile operator (OR= 3.66; 95% CI 1.19-7.9), healt h professional (OR = 10.0; 95% CI 2.1-48.7), commercial and technical sale representative (OR = 4.45; 95% CI 1.4-14.6), machine operator (OR = 2.69; 9 5% CI 1.2-6.0), living next to an industrial plant (OR = 2.45; 95% CI 1.5-4 .1), smoking (OR = 1.74; 95% CT 1.1-2.7) and lifetime cumulative exposure t o oil (OR = 1.1; 95% CI 1.0-1.2). Further studies should be performed to as sess specific exposures more precisely and it would be of interest to devel op a map of haematological malignancies according to industrial background.