Hodgkin's Disease in Workers in the Wood Industry

Abstract

WTORKERS in the wood industry in upVVstate New York have been found to be at approximately double the normal risk of dying from Hodgkin's disease. However, subsequent examination of registered cases of the disease in an area of England failed to confirm this result. Milham and Hesser (1) analyzed data on death certificates in New York State to determine the workers' risk, while in England Acheson (2) examined registered cases of Hodgkin's disease among residents within the area of the Oxford Regional Hospital Board. Such disagreements, which may well persist through a number of studies, prevent the formulation of definite conclusions about the relative risk for workers in the wood industry of contracting the disease. The relative risk, of course, may actually vary from one area to another. According to Jackson and Parker (3), Hodgkin's disease can be divided into three types, which, in increasing order of malignancy, are paragranuloma, granuloma, and sarcoma. Whether benign lymphogranulomatosis (sarcoidosis) might be included in this continuum seems never to have been discussed. Nevertheless, both the benign and malignant forms of lymphogranulomatosis are found similarly distributed throughout the body, and both conditions are generally associated with an insensitivity to tuberculin (4). The question, therefore, of whether the two diseases are etiologically related can perhaps be legitimately raised. Much interest in recent years has centered around the hypothesis of Cummings and Hudgins (5) that sarcoidosis results from a hypersensitivity induced by pine pollen. While no condition actually resembling sarcoidosis has been observed following injection of pine pollen, in at least a few experiments, injection in normal animals has apparently produced epithelioid cell granulomata (6). Cummings suggests that some of the inconsistency in results might be attributed to the use of different varieties of pine pollen. Thus far, then, Cummings' hypothesis has neither been confirmed nor disproved. In this paper I shall extend the original hypothesis and examine evidence for the postulate that the increased risk to Hodgkin's disease of workers in the wood industry arises from their occupational exposure to pine pollen.