| Study Populationa | Exposed Casesb | Exposure of Interest/Estimated Relative Risk (95% CI)b | Reference |
|---|---|---|---|
| VIETNAM VETERANS | |||
| US Vietnam Veterans | |||
| US Air Force Health Study—Ranch Hand veterans vs SEA veterans (unless otherwise noted) | All COIs | ||
| Incidence | |||
| Through 1999—White subjects vs national rates | Akhtar et al., 2004 | ||
| Ranch Hand veterans (n = 1,189) | 14 | 1.1 (0.6–1.7) | |
| With tours between 1966–1970 | 14 | 1.3 (0.7–2.1) | |
| SEA comparison veterans (n = 1,776) | 8 | 0.4 (0.2–0.8) | |
| With tours between 1966–1970 | 4 | 0.3 (0.1–0.7) | |
| Mortality | |||
| Through 1999—White subjects vs national rates | |||
| Ranch Hand veterans | 1 | 0.9 (nr) | |
| SEA comparison veterans | 1 | 0.6 (nr) | |
| US CDC Vietnam Experience Study—Cross-sectional study, with medical examinations, of Army veterans: 9,324 deployed vs 8,989 nondeployed | All COIs | ||
| Mortality | |||
| 1965–2000 | 1 | nr | Boehmer et al., 2004 |
| 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 | ||
| 1965–1982 | Breslin et al., 1988 | ||
| Army, deployed (n = 19,708) vs nondeployed (n = 22,904) | 9 | 0.6 (0.3–1.2) | |
| Marine Corps, deployed (n = 4,527) vs nondeployed (n = 3,781) | 4 | 2.4 (0.1–66.4) | |
| State Studies of US Vietnam Veterans | |||
| Massachusetts Vietnam-era veterans | |||
| Veterans served 1958–1973—cases diagnosed 1988–1993 (served in Vietnam) (updates Clapp et al., 1991) | 80 | 0.6 (0.2–1.3) | Clapp et al. 1997 |
| 923 White male Vietnam veterans with Wisconsin death certificate (1968–1978) vs proportions for Vietnam-era veterans (includes lymphosarcoma, reticulosarcoma) | 1 | nr | Anderson et al., 1986 |
| International Vietnam-Veteran 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 | All COIs | ||
| Incidence | |||
| All branches, 1982–2000 | 164 | 1.0 (0.9–1.2) | ADVA, 2005a |
| Navy | 34 | 1.0 (0.7–1.4) | |
| Army | 104 | 1.0 (0.8–1.2) | |
| Air Force | 26 | 1.3 (0.8–1.8) | |
| Mortality | |||
| All branches, return–2001 | 22 | 0.7 (0.4–1.0) | ADVA, 2005b |
| Navy | 4 | 0.6 (0.2–1.6) | |
| Army | 13 | 0.7 (0.3–1.1) | |
| Air Force | 5 | 1.1 (0.4–2.5) | |
| 1980–1994 | 11 | 1.1 (0.6–1.9) | CDVA, 1997a |
| Australian Conscripted Army National Service | All COIs | ||
| (18,940 deployed vs 24,642 nondeployed) | |||
| Incidence—1982–2000 | 19 | 0.7 (0.4–1.1) | ADVA, 2005c |
| Mortality | |||
| 1966–2001 | 1 | 0.3 (0.0–1.7) | |
| 1982–1994 | 1 | 0.6 (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 | 34 | 1.0 (0.7–1.5) | Kogevinas et al., 1997 |
| 13,831 exposed to highly chlorinated PCDDs 7,553 not exposed to highly chlorinated PCDDs | 24 10 | 1.4 (0.9–2.1) 0.7 (0.3–1.2) | |
| Mortality 1955–1988 of 12,492 production workers and 5,898 sprayers exposed—13,482 in exposed subcohort | 13 | 0.8 (0.4–1.4) | 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 | 8 | 0.9 (0.4–1.7) | Coggon et al., 1986 |
| Danish Production Workers (3,390 men and 1,069 women involved in production of phenoxy herbicides unlikely to contain TCDD at 2 plants in 1947–1987) (in IARC cohort) | Dioxins, but TCDD unlikely; 2,4-D, 2,4-DP, MCPA, MCPP | ||
| Incidence 1943–1982 (men only) | 11 | 0.8 (nr) | Lynge, 1985 |
| Mortality 1955–2006 | 15 | 1.1 (0.8–1.4) | Boers et al., 2012 |
| TCDD plasma level (hazard ratios, by tertile) | |||
| Background (≤ 0.4) | 4 | nr | |
| Low (0.4–4.1) | 10 | 2.4 (0.8–8.3) | |
| Medium (4.1–20.1) | 7 | 4.0 (1.1–14.3) | |
| High (≥ 20.1) | 2 | 3.1 (0.6–17.0) | |
| Dutch production workers in Plant A (549 men exposed during production 1955–1985; 594 unexposed) (in IARC cohort) | Dioxins, 2,4,5-T, 2,4,5-TCP | ||
| Mortality 1955–2006 (hazard ratios for lagged TCDD plasma levels) | 11 | 1.0 (0.7–1.5) | Boers et al., 2012 |
| Mortality 1955–2006 | 9 vs 2 | 2.3 (0.5–10.3) | Boers et al., 2010 |
| Mortality 1955–1991 | 4 | 3.7 (1.0–9.5) | Hooiveld et al., 1998 |
| Accidentally exposed subcohort | 1 | 2.8 (0.1–15.5) | |
| Mortality 1955–1985 | 1 | 1.5 (0.0–8.8) | Bueno de Mesquita et al., 1993 |
| Dutch production workers in Plant B (414 men exposed during production 1965–1986; 723 unexposed) (in IARC cohort) | 2,4-D; MCPA; MCPP; highly chlorinated dioxins unlikely | ||
| Mortality 1965–2006 | 2 vs 2 | 1.1 (0.2–7.2) | Boers et al., 2010 |
| Mortality 1965–1986 | 0 | 0.0 (0.0–20.5) | Bueno de Mesquita et al., 1993 |
| German Production Workers at BASF Ludwigshafen Plant (680 men working > 1 month in 1957–1987) (in IARC cohort as of 1997) and women—no results | Dioxins; 2,4-D; 2,4,5-T; MCPA; MCPP; 2,4-DP | ||
| BASF Cleanup Workers from 1953 accident (n = 247); 114 with chloracne, 13 more with erythema; serum TCDD levels (not part of IARC) | Focus on TCDD | ||
| Incidence | |||
| 1960–1992 | Ott and Zober, 1996 | ||
| TCDD < 0.1 μg/kg of body weight | 1 | 0.7 (0.0–4.0) | |
| TCDD 0.1–0.99 μg/kg of body weight | 3 | 3.0 (0.6–8.9) | |
| TCDD > 1 μg/kg of body weight | 1 | 0.8 (0.0–4.4) | |
| Mortality | |||
| 1960–1992 | |||
| TCDD < 0.1 μg/kg of body weight | 0 | 0.0 (0.0–5.7) | |
| TCDD 0.1–0.99 μg/kg of body weight | 2 | 4.1 (0.5–14.7) | |
| TCDD > 1 /k of bod wei ht | 0 | 0 0 (0 0–5 4) | |
| Through 1987 | 90% CI | Zober et al., 1990 | |
| 0 | nr (0.0–15.0) | ||
| German Production Workers at Boehringer–Ingelheim Plant in Hamburg (1,144 men working > 1 month in 1952–1984; generation of TCDD reduced after chloracne outbreak in 1954) and women—no results (some additions to observed cancers over Manz et al., 1991) (in IARC cohort as of 1997) | Dioxins; 2,4,5-T; 2,5-DCP; 2,4,5-TCP | ||
| Mortality 1952–2007 | 13 | 1.8 (1.0–3.1) | Manuwald et al., 2012 |
| Men | 11 | 1.8 (0.9–3.3) | |
| Women | 2 | 1.8 (0.2–6.6) | |
| 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 (0.0–2.9) | |
| Production Workers (713 men and 100 women worked > 1 month in 1969–1984) | |||
| Mortality 1969–2000 | 0 | nr | 't Mannetje et al., 2005 |
| Sprayers (697 men and 2 women registered any time 1973–1984) | |||
| Mortality 1973–2000 | 0 | nr | 't Mannetje et al., 2005 |
| NIOSH Mortality Cohort (12 US plants, 5,172 male production and maintenance workers 1942–1984) (included in IARC cohort as of 1997) | Dioxins, phenoxy herbicides | ||
| Through 1993 | 16 | 2.0 (1.1–3.2) | Steenland et al., 1999 |
| Chloracne subcohort (n = 608) | 6 | 3.0 (1.4–8.5) | |
| Through 1987 (bladder, other) | 9 | 1.6 (0.7–3.0) | Fingerhut et al., 1991 |
| ≥ 1-year exposure, ≥ 20-year latency Mortality—754 Monsanto workers, among most highly exposed workers from Fingerhut et al. (1991) | 4 | 1.9 (0.5–4.8) | |
| 16 | 6.8 (3.9–11.1) | Collins et al., 1993 | |
| 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 (n = 1,615) | 6 | 1.2 (0.5–2.7) | Collins et al., 2009a |
| 1940–1994 (n = 2,187 men) | nr | 0.7 (0.1–2.0) | Bodner et al., 2003 |
| All Dow PCP-Exposed Workers—all workers from the two plants that only made PCP (in Tacoma, Washington, and Wichita, Kansas) and workers who made PCP and TCP at two additional plants (in Midland, Michigan, and Sauget, Illinois) | 2,4,5-T; 2,4,5-TCP | Ruder and Yiin, 2011 | |
| 1940–2005 (n = 2,122) (bladder and other urinary organs, ICD-9 188, 189.3, 189.9) | 8 | 1.1 (0.5–2.1) | |
| PCP and TCP (n = 720) | 1 | 0.4 (0.0–2.3) | |
| PCP (no TCP) (n = 1,402) | 7 | 1.4 (0.6–2.9) | |
| Dow 2,4-D Production Workers (1945–1982 in Midland, Michigan) (subset of all TCP-exposed workers) | 2,4-D, lower chlorinated dioxins | ||
| Cancer incidence through 2007 in Dow workers (n = 1,256) vs comparisons from state cancer registries (n = 23,354) (Cohort 3) | 19 | 1.2 (0.7–1.9) | Burns et al., 2011 |
| Through 1994 (n = 1,517) | 1 | 0.5 (0.1–2.8) | Burns et al., 2001 |
| Through 1982 (n = 878) | 0 | nr (0.0–7.2) | 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) | 2 | 0.7 (0.1–2.7) | Collins et al., 2009b |
| 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 | 50 | 1.0 (0.7–1.3) | |
| Ever | 43 | 1.1 (0.8–1.5) | |
| New Hampshire pulp and paper workers, 883 white men working ≥ 1 yr, mortality through July 1985 | 4 | 1.2 (0.3–3.2) | Henneberger et al., 1989 |
| Pulp and Paper cohorts independent of IARC cohort | |||
| Northwestern US paper and pulp workers—5 mills in Washington, Oregon, and California, 3,523 worked ≥ 1 yr 1945–1955, mortalit throu h March 1977 | 90% CI | Robinson et al., 1986 | |
| 8 | 1.2 (0.6–2.6) | ||
| 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 | 33 | 0.9 (0.7–1.2) | Hertzman et al., 1997 |
| Mortality 1950–1989 | 94 | 1.0 (0.8–1.2) | |
| Herbicide sprayers routinely exposed to herbicides for 6 months or more (1950–1982) | Phenoxy herbicides | Green, 1991 | |
| Diseases of genitourinary system | 1 | 1.0 (0.0–5.6) | |
| DENMARK | |||
| Danish gardeners (n = 3,124) exposed to pesticides | 59 | 0.8 (0.6–1.1) | Kenborg et al., 2012 |
| Danish farmers—incidence from linking farmers on 1970 census with national cancer registry (1970–1980) | Herbicides | Ronco et al. 1992 | |
| Men | |||
| Self-employed | 300 | 0.6 (p < 0.05) | |
| Employee | 70 | 0.7 (p < 0.05) | |
| Women | |||
| Self-employed | 1 | 0.2 (nr) | |
| Employee | 2 | 0.6 (nr) | |
| Family worker | 25 | 0.6 (p < 0.05) | |
| Danish gardeners—incidence from 3,156 male and 859 female gardeners (urinary system, | Hansen et al., 2007 | ||
| ICD-7 180–181) | |||
| 25-year followup (1975–2001) | Herbicides | ||
| Born before 1915 (high exposure) | 25 | 1.1 (0.7–1.6) | |
| Born 1915–1934 (medium exposure) | 23 | 0.5 (0.4–0.8) | |
| Born after 1934 (low exposure) | 1 | 0.2 (0.0–1.1) | |
| 10-year followup (1975–1984) of male gardeners | 18 | 0.9 (0.5–1.4) | Hansen et al., 1992 |
| FINNISH Phenoxy Herbicide Sprayers (1,909 men working 1955–1971 ≥ 2 wks) not IARC | Phenoxy herbicides | ||
| Incidence | Asp et al., 1994 | ||
| No latency | 12 | 1.6 (0.8–2.8) | |
| 10-yr latency | 11 | 1.7 (0.8–3.0) | |
| Mortality | |||
| No latency | 1 | 0.5 (0.0–2.6) | |
| 10-yr latency | 1 | 0.5 (0.0–3.0) | |
| ITALIAN Licensed Pesticide Users—male farmers in southern Piedmont licensed 1970–1974 | |||
| Mortality 1970–1986 (n = 23,401) | 31 | 0.5 (0.4–0.8) | Torchio et al., 1994 |
| Italian rice growers with documented phenoxy use (n = 1,487) | Phenoxy herbicides | Gambini et al., 1997 | |
| 12 | 1.0 (0.5–1.8) | ||
| NEW ZEALAND National Cancer Registry (1980–1984)—case-control study of incident stomach cancer cases vs remainder of 19,904 men with any incident cancer | Reif et al., 1989 | ||
| Forestry workers (n = 134) | Herbicides | ||
| 4 | 0.7 (0.3–1.8) | ||
| THE NETHERLANDS | |||
| Dutch Licensed Herbicide Sprayers—1,341 | |||
| certified before 1980 | |||
| Through 2000 | 2 | 0.7 (0.1–2.4) | Swaen et al., 2004 |
| UNITED STATES | |||
| 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 | 191 | 0.6 (0.5–0.7) | |
| Commercial applicators | 16 | 0.2 (0.7–1.9) | |
| Spouses | 29 | 0.6 (0.4–0.9) | |
| Enrollment through 2002 | Samanic et al., 2006 | ||
| Dicamba—lifetime days exposure | |||
| None | 43 | 1.0 | |
| 1– < 20 | 6 | 0.5 (0.2–1.3) | |
| 20– < 56 | 9 | 0.7 (0.3–1.4) | |
| 56– < 116 | 6 | 0.6 (0.3–1.5) | |
| ≥ 116 | 8 | 0.8 (0.4–1.9) | |
| p-trend = 0.66 | |||
| Enrollment through 2002 | Alavanja et al., 2005 | ||
| Private applicators | 184 | 0.7 (0.6–0.8) | |
| Spouses of private applicators (> 99% women) | 17 | 0.7 (0.4–1.1) | |
| Commercial applicators | 13 | 1.1 (0.6–1.8) | |
| Mortality | |||
| Enrollment through 2007, vs state rates | Waggoner et al., 2011 | ||
| Applicators (n = 1,641) | 35 | 0.6 (0.4–0.8) | |
| Spouses (n = 676) | 9 | 0.8 (0.4–1.6) | |
| Enrollment through 2000, vs state rates | Blair et al., 2005a | ||
| Private applicators (men and women) | 7 | 0.4 (0.1–0.7) | |
| Spouses of private applicators (> 99% women) | 2 | 0.8 (0.1–2.7) | |
| US Department of Agriculture Workers—nested case-control study of white men dying 1970–1979 of NHL | Herbicides | ||
| Agricultural extension agents | 8 | 0.7 (0.4–1.4) | Alavanja et al., 1988 |
| Forest conservationists | p- trend < over years worked | Alavanja et al., 1989 | |
| 8 | 0.8 (0.3–1.6) | ||
| Florida Licensed Pesticide Applicators (common phenoxy use assumed but not documented; had been listed by Blair et al., 1983) | Herbicides | ||
| Pesticide applicators in Florida licensed 1965–1966 (n = 3,827)—mortality through 1976 | Herbicides | Blair et al., 1983 | |
| Any pesticide (dose–response by length of licensure) | Expected exposed cases | ||
| 3 | 1.6 (nr) | ||
| White Male Residents of Iowa—NHL cancer on death certificate, usual occupation: farmers vs not | Herbicides | ||
| > 20 yrs old when died 1971–1978—PMR | 274 | 0.9 (nr) | Burmeister, 1981 |
| 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 | 3 | 1.4 (0.5–4.5) | Pesatori et al., 2009 |
| Zone B | 17 | 1.3 (0.8–2.2) | |
| Zone R | 84 | 0.9 (0.8–1.2) | |
| 10-yr followup to 1991—men | Pesatori et al., 1992 | ||
| Zone A, B | 10 | 1.6 (0.9–3.1) | |
| Zone R | 39 | 1.0 (0.7–1.4) | |
| 10-yr followup to 1991—women | |||
| Zone A, B | 1 | 0.9 (0.1–6.8) | |
| Zone R | 4 | 0.6 (0.2–1.5) | |
| Mortality | |||
| 25-yr followup to 2001—men and women | Consonni et al., 2008 | ||
| Zone A | 1 | 1.0 (0.2–7.4) | |
| Zone B | 6 | 0.9 (0.4–2.0) | |
| Zone R | 42 | 0.9 (0.6–1.2) | |
| 20-yr followup to 1996 | Bertazzi et al., 2001 | ||
| Zones A and B—men | 6 | 1.2 (0.5–2.7) | |
| 15-yr followup to 1991—men | Bertazzi et al., 1998 | ||
| Zone B | 1 | 2.4 (0.3–16.8) | |
| Zone R | 21 | 0.9 (0.6–1.5) | |
| 15-yr followup to 1991—women | Bertazzi et al., 1998 | ||
| Zone B | 3 | 0.9 (0.3–3.0) | |
| Zone R | 4 | 0.6 (0.2–1.8) | |
| Ecological Study of Residents of Chapaevsk, Russia | Dioxin | Revich et al., 2001 | |
| Mortality—1995–1998 (SMR vs regional rates) | |||
| Men | 31 | 2.6 (1.7–3.6) | |
| Women | 17 | 0.8 (0.5–1.3) | |
| Other International Environmental Studies | |||
| FINLAND | |||
| Finnish community exposed to chlorophenol contamination (men and women)—incidence | Chlorophenol | Lampi et al., 1992 | |
| 14 | 1.0 (0.6–1.9) | ||
| SWEDEN | |||
| Swedish fishermen (high consumption of fish with persistent organochlorines) | Organochlorine compounds | Svensson et al., 1995 | |
| Incidence | |||
| East coast | 10 | 0.7 (0.4–1.3) | |
| West coast | 55 | 0.9 (0.7–1.1) | |
| Mortality | |||
| East coast | 5 | 1.3 (0.4–3.1) | |
| West coast | 20 | 1.0 (0..6–1.6) | |
NOTE: 2,4-D, 2,4-dichlorophenoxyacetic acid; 2,4-DP, dichlorprop; 2,4,5-T, 2,4,5-trichlorophenoxyacetic acid; 2,4,5-TCP, 2,4,5-trichlorophenol; 2,5-DCP, 2,5-dichlorophenol; CATI, computer-assisted telephone interviewing; CDC, Centers for Disease Control and Prevention; 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; MCPP, methylchlorophenoxypropionic acid; NHL, non-Hodgkin lymphoma; 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; PMR, proportional mortality ratio; SEA, Southeast Asia; SIR, standardized incidence ratio; SMR, standardized mortality rate; 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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