A Hospital-based Case-control Study Of Acute Myeloid Leukemia In Adults: Lifestyle And Environmental Risk Factors As Well As Occupational And Residential Electric And Magnetic Field Exposure For Acute Myeloid Leukemia In Adults-A Meta-analysis

Objective:To determine the risk factors of environment and lifestyle involved in acute myeloid leukemia (AML) of adult.Methods:A matched 1:2 case-control study was conducted in 29 hospitals in Shanghai. There were 206 de novo AML cases, and 412 age and gender matched controls from same hospitals with other diseases. Subjects were all surveyed using the same standard questionnaire face to face, including histories of family, medications, Chinese traditional herbs, Occupational risk factors, lifestyle risk factors etc within 5 years prior to the onset of the disease. We carried out a Meta analysis based on primary data (1980-2010) from 11 studies of electric and magnetic fields exposure and acute myeloid leukemia in adults to assess whether the combined results, adjusted for potential confounding, indicated an association.Results:1. Taking traditional Chinese medicine decrease the risk of AML (OR:0.39,95%CI:0.16～0.98), maybe this is a protective factor. However, there was no statistically different for other risk factors, such as metal (OR:1.73,95%CI: 0.77～3.91), others (including glues, paint and coating material, etc) (OR:1.72, 95%CI:0.93～3.2), planting crops (OR:1.09,95%CI:0.70～1.70), raising animals (OR:1.33,95%CI:0.79～2.24), smoking (OR:0.97,95%CI:0.67～1.42), as well as hairdye, renovation within one year, taking alcohol and living near power line within 100ms, etc. Multiple Logistic regression analysis showed the same result. In order to investigate the etiologic commonality and heterogeneity of AML, we still need further epidemiologic research.2. In conclusion, we found an increased odds ratio of 1.30(95%CI=1.19-1.42) for acute myeloid leukemia in adults for residential and occupational exposure. These findings were significantly positive when subgroup of exposure level and distance were in consideration. However, the reviewed studies contained insufficient qualitative and quantitative information on exposure in order to distinguish the possible influence of electromagnetic fields from other occupational, environmental, lifestyle, or genetic factors. The odds ratios for exposure categories of 0.1-0.2μT,≥0.2μT, compared with <0.1μT, were 1.17 (95% CI 0.98-1.39) and(OR=1.51,95%CI= 1.15-1.98) respectively. Analyses employing alternate cut points, stratification by level of exposure or distance, and relation of different exposure ways did reveal consistent evidence of increased acute myeloid leukemia in adults risk associated with extremely low frequency-electromagnetic field exposure.