Multiple myeloma and work in agriculture: Results of a case-control study in Forli, Italy

Objectives: To evaluate the relation between the exposure to specific pesticides in agricultural work and the risk of multiple myeloma (MM). Methods: A case-control study was conducted in the province of Forli, Italy. Forty-six cases of IMM (20 females, 26 males; mean age 64 years, range 40 to 74) identified through the Romagna Cancer Registry in the years 1987-90, and 230 age- and gender-matched controls from the general population were interviewed in-person using a structured questionnaire focused on exposure to pesticides and other occupational and nonoccupational variables. Results: Among nonoccupational factors, the education level and the altitude of the place of residence were related inversely to MM risk. First-degree familiarity for hematolymphopoietic neoplasias and previous herpes tester diagnosis were associated positively with the disease. A nonsignificant increase in MM risk was observed among workers in agriculture as a whole (odds ratio [OR] = 1.31, 95 percent confidence interval [CI] = 0.62-2.74). An increased risk was associated specifically with the cultivation of apples and pears (OR = 1.75, CI = 1.05-2.91). As regards pesticide exposure, only the chlorinated insecticides were related to an increase in the risk of MM. Conclusions: This study suggests that agricultural work and exposure to pesticides have a role in the etiology of MM.