| Study Populationa | Exposed Casesb | Exposure of Interest/Estimated Relative Risk (95% CI)b | Reference |
|---|---|---|---|
| VIETNAM VETERANS | |||
| US Vietnam Veterans | |||
| US VA Cohort of Army Chemical Corps—Expanded as of 1997 to include all Army men with chemical MOS (2,872 deployed vs 2,737 nondeployed) serving during Vietnam era (July 1, 1965–March 28, 1973) | All COIs | ||
| Mortality | |||
| Through 2005 | Cypel and Kang, 2010 | ||
| Deployed veterans (2,872) vs nondeployed | 2 | — | |
| (2,737) | |||
| Through 1991 | 2 | 4.0 (0.5–14.5) | Dalager and Kang, 1997 |
| US VA Proportionate Mortality Study—sample of deceased male Vietnam-era Army and Marine veterans who served 7/4/1965–3/1/1973 | All COIs | ||
| 1965–1988 | Watanabe and Kang, 1996 | ||
| Army, deployed (n = 27,596) vs nondeployed (n = 31,757) | 114 | 1.1 (nr) | |
| Marine Corps, deployed (n = 6,237) vs nondeployed (n = 5,040) | 28 | 1.0 (nr) | |
| 1965–1984 | Watanabe et al., 1991 | ||
| Army, deployed (n = 24,145) vs nondeployed (n = 27,917) | 109 | 1.2 (ns) | |
| Served in I Corps (n = 6,668) | 12 | 2.6 (1.1–6.2) | Bullman et al., 1990 |
| Marine Corps, deployed (n = 5,501) vs nondeployed (n = 4,505) | 28 | 0.8 (ns) | Watanabe et al., 1991 |
| 1965–1982 | Breslin et al., 1988 | ||
| Army, deployed (n = 19,708) vs nondeployed (n = 22,904) | 90 | 1.1 (0.8–1.5) | |
| Marine Corps, deployed (n = 4,527) vs nondeployed (n = 3,781) | 26 | 1.3 (0.5–3.6) | |
| State Studies of US Vietnam Veterans | |||
| District of Columbia patients (18–42 yrs of age) in 3 hospitals, diagnosed with testicular cancer (1976–June 30, 1981) | 31 | 2.3 (1.0–5.5) | Tarone et al., 1991 |
| Massachusetts Vietnam-era veterans | |||
| Veterans aged 35–65 years in 1993—cases diagnosed 1988–1993 vs gastrointestinal cancers | 30 | 1.2 (0.4–3.3) | Clapp, 1997 |
| 923 White male Vietnam veterans with Wisconsin death certificate (1968–1978) vs proportions for Vietnam-era veterans | 9 | 1.0 (0.5–1.9) | Anderson et al., 1986 |
| International Vietnam-Veterans Studies | |||
| Australian Vietnam Veterans—58,077 men and 153 women served on land or in Vietnamese waters during 5/23/1962–7/1/1973 vs Australian population | All COIs | ||
| Incidence | |||
| All branches, 1982–2000 | 54 | 0.9 (0.6–1.1) | ADVA, 2005a |
| Navy | 17 | 1.2 (0.7–1.8) | |
| Army | 34 | 0.8 (0.5–1.0) | |
| Air Force | 3 | 0.8 (0.2–2.3) | |
| Validation Study | Expected number of exposed cases | AIHW, 1999 | |
| 59 | 110 (89–139) | ||
| Men | 151 | 110 (89–131) | |
| Mortality | |||
| All branches, return–2001 | 14 | 0.9 (0.4–1.4) | ADVA, 2005b |
| Navy | 3 | 0.8 (0.2–2.4) | |
| Army | 10 | 0.9 (0.4–1.7) | |
| Air Force | 0 | 0.0 (0.0–3.3) | |
| 1980–1994 | 4 | ns | CDVA, 1997a |
| Australian Conscripted Army National Service (18,940 deployed vs 24,642 nondeployed) | All COIs | ||
| Incidence | |||
| 1982–2000 | 17 | 0.7 (0.4–1.2) | ADVA, 2005c |
| Mortality | |||
| 1966–2001 | 4 | 0.8 (0.2–2.0) | ADVA, 2005c |
| 1982–1994 | 1 | 1.3 (nr) | CDVA, 1997b |
| OCCUPATIONAL—INDUSTRIAL | |||
| IARC Phenoxy Herbicide Cohort—Workers exposed to any phenoxy herbicide or chlorophenol (production or spraying) vs respective national mortality rates | |||
| Mortality 1939–1992 | 68 | 1.1 (0.9–1.4) | Kogevinas et al., 1997 |
| 13,831 exposed to highly chlorinated PCDDs | 43 | 1.1 (0.8–1.5) | |
| 7,553 not exposed to highly chlorinated PCDDs | 25 | 1.1 (0.3–1.6) | |
| Mortality 1955–1988 of 12,492 production workers and 5,898 sprayers exposed—13,482 in exposed subcohort | 7 | 2.3 (0.9–4.6) | Saracci et al., 1991 |
| British MCPA Plant—Production 1947–1982 (n = 1,545) (included in IARC cohort) and spraying 1947–1972 (n = 2,561) (not included in IARC cohort) | MCPA | ||
| Mortality through 1983 | 4 | 2.2 (0.6–5.7) | Coggon et al., 1986 |
| New Zealand Phenoxy Herbicide Production Workers and Sprayers (1,599 men and women working any time in 1969–1988 at Dow plant in New Plymouth) (in IARC cohort) | Dioxins; 2,4-D; 2,4,5-T; MCPA; MCPB; 2,4,5-TCP; Picloram | ||
| Mortality 1969–2004 | McBride et al., 2009a | ||
| Ever-exposed workers | 0 | 0.0 (0.0–15.6) | |
| Never-exposed workers | |||
| All Dow TCP-Exposed Workers (TCP production 1942–1979 or 2,4,5-T production 1948–1982 in Midland, Michigan) (in IARC and NIOSH cohorts) | 2,4,5-T; 2,4,5-TCP | ||
| 1942–2003; testes and other male genital (n = 1,615) | 1 | 1.6 (0.0–8.9) | Collins et al., 2009a |
| Dow 2,4-D Production Workers (1945–1982 in Midland, Michigan) (subset of all TCP-exposed workers) | 2,4-D, lower chlorinated dioxins | ||
| Through 1994 (n = 1,517) | 1 | 2.2 (0.0–12.5) | Burns et al., 2001 |
| Through 1982 (n = 878) | 1 | 4.6 (0.0–25.7) | Bond et al., 1988 |
| Dow PCP Production Workers (1937–1989 in Midland, Michigan) (not in IARC and NIOSH cohorts) | Low chlorinated dioxins, 2,4-D | ||
| Mortality 1940–2004 (n = 577, excluding 196 also having exposure to TCP); testes and other male genital | Collins et al., 2009b | ||
| 0 | 0.0 (0.0–12.5) | ||
| Mortality 1940–1989 (n = 770) | 0 | nr | Ramlow et al., 1996 |
| OCCUPATIONAL—PAPER AND PULP | TCDD | ||
| WORKERS | |||
| IARC cohort of pulp and paper workers—60,468 workers from 11 countries, TCDD among 27 agents assessed by JEM | McLean et al., 2006 | ||
| Exposure to nonvolatile organochlorine compounds | |||
| Never | 2 | 1.1 (0.1–4.1) | |
| Ever | 5 | 3.6 (1.2–8.4) | |
| OCCUPATIONAL—HERBICIDE-USING | |||
| WORKERS (not related to IARC sprayer cohorts) | |||
| CANADA | |||
| Sawmill Workers in British Columbia—23,829 workers for ≥ 1 year at 11 mills using chlorophenates 1940–1985 | Chlorophenates, not TCDD | ||
| Incidence 1969–1989 | 18 | 1.0 (0.6–1.4) | Hertzman et al., 1997 |
| Mortality 1950–1989 (male genital cancers) | 116 | 1.0 (0.8–1.1) | |
| DENMARK | |||
| Danish Farmers—incidence from linking farmers on 1970 census with national cancer registry (1970–1980) | Herbicides | Ronco et al., 1992 | |
| Men | |||
| Self-employed | 74 | 0.9 (nr) | |
| Employee | 23 | 0.6 (p < 0.05) | |
| ICELANDIC men (1,860), women (859) exposed to agricultural pesticides, primarily 2,4-D—incidence | 2,4-D | Zhong and Rafnsson, 1996 | |
| 2 | 1.2 (0.1–4.3) | ||
| NEW ZEALAND National Cancer Registry (1980–1984)—case-control study of 339 incident testicular cancer cases vs remainder of 19,904 men with any incident cancer | Herbicides | Reif et al., 1989 | |
| Forestry workers (n = 134) | 6 | 1.0 (0.4–2.6) | |
| SWEDEN | |||
| Incident testicular cancer cases 1961–1973 with agriculture as economic activity in 1960 census | 99% CI | Wiklund, 1983 | |
| 101 | 1.0 (0.7–1.2) | ||
| UNITED STATES | |||
| US farmers—usual occupation of farmer and industry of agriculture on death certificates 1984–1988 from 23 states | Herbicides PCMRs | Blair et al., 1993 | |
| Men | |||
| Whites (n = 119,648) | 32 | 0.8 (0.6–1.2) | |
| Nonwhites (n = 11,446) | 6 | 1.3 (0.5–2.9) | |
| US Agricultural Health Study—prospective study of licensed pesticide sprayers in Iowa and North Carolina: commercial (n = 4,916), private/farmers (n = 52,395, 97.4% men), and spouses of private sprayers (n = 32,347, 0.007% men), enrolled 1993–1997; followups with CATIs 1999–2003 and 2005–2010 | Phenoxy herbicides | ||
| Incidence | |||
| Enrollment through 2006—SIRs for participants | Koutros et al., 2010a | ||
| Private applicators | 32 | 1.0 (0.7–1.4) | |
| Commercial applicators | 6 | 1.2 (0.5–2.6) | |
| Spouses | 0 | nr | |
| Enrollment through 2002 | Alavanja et al., 2005 | ||
| Private applicators | 23 | 1.1 (0.7–1.6) | |
| Spouses of private applicators (> 99% women) | nr | 0.0 (0.0–50.2) | |
| Commercial applicators | 4 | 1.2 (0.3–3.2) | |
| Mortality | |||
| Enrollment through 2000, vs state rates | Blair et al., 2005a | ||
| Private applicators (men and women) Spouses of private applicators (> 99% women) | 0 | nr | |
| 0 | nr | ||
| Florida Licensed Pesticide Applicators (common phenoxy use assumed but not documented; had been listed by Blair et al., 1983) | Herbicides | ||
| Mortality 1975–1993 | 23 | 2.5 (1.6–3.7) | Fleming et al., 1999b |
| ENVIRONMENTAL | |||
| Seveso, Italy Residential Cohort—Industrial accident July 10, 1976 (723 residents Zone A; 4,821 Zone B; 31,643 Zone R; 181,574 local reference group) (ICD-9 171) | TCDD | ||
| Incidence | |||
| 20-yr followup to 1996—men and women | |||
| Zone A | 0 | Pesatori et al., 2009 | |
| Zone B | 2 | 0.8 (0.2–3.3) | |
| Zone R | 22 | 1.4 (0.9–2.3) | |
| 10-yr followup to 1991—men | Bertazzi et al., 1993 | ||
| Zone B | 1 | 1.0 (0.1–7.5) | |
| Zone R | 9 | 1.4 (0.7–3.0) | |
| Mortality | |||
| 20-yr followup to 1996 | Bertazzi et al., 2001 | ||
| Zones A, B—men | 17 | 1.0 (0.6–1.7) | |
| 15-yr followup to 1991—men | Bertazzi et al., 1998 | ||
| Zone B | 10 | 1.0 (0.5–1.8) | |
| Zone R | 73 | 1.0 (0.8–1.3) | |
| CASE-CONTROL STUDIES | |||
| International Case-Control Studies | |||
| Swedish Cancer Registry (1989–1992)—testicular cancer patients (20–75 yrs old) (n = 148) | Herbicides | Hardell et al., 1998 | |
| Exposed to herbicides | 4 | 0.3 (0.1–1.0) | |
NOTE: 2,4-D, 2,4-dichlorophenoxyacetic acid; 2,4,5-T, 2,4,5-trichlorophenoxyacetic acid; 2,4,5-TCP, 2,4,5-trichlorophenol; CATI, computer-assisted telephone interviewing; CI, confidence interval; COI, chemical of interest; IARC, International Agency for Research on Cancer; ICD, International Classification of Diseases; JEM, job–exposure matrix; MCPA, 2-methyl-4-chlorophenoxyacetic acid; MCPB, 4-(4-chloro-2-methylphenoxy)butanoic acid; MOS, military occupation specialty; NIOSH, National Institute for Occupational Safety and Health; nr, not reported; PCDD, polychlorinated dibenzo-p-dioxin (highly chlorinated, if four or more chlorines); PCMR, proportionate cancer mortality ratios; PCP, pentachlorophenol; SIR, standardized incidence ratio; TCDD, 2,3,7,8-tetrachlorodibenzo-p-dioxin; TCP, trichlorophenol; VA, US Department of Veterans Affairs.
Subjects are male and outcome is mortality unless otherwise noted.
Given when available; results other than estimated risk explained individually.
From: 8, Cancer
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