Abstract
BACKGROUND AND AIM: Outdoor air pollution and airborne particulate matter (PM) have been classified as Group 1 carcinogens for lung cancer. Previous research on childhood leukemias and adult cancer mortality suggest associations of outdoor air pollutants with blood cancers, which are etiologically diverse. However, detailed examinations of major air pollutants by histologic subtypes of incident adult hematologic cancers are lacking. METHODS: The American Cancer Society Cancer Prevention Study-II Nutrition Cohort was used to examine associations of outdoor air pollutants with risk of incident hematologic cancers. Residential address at enrollment was used to assign census block-group level annual predictions of PM10, PM2.5, NO2, O3, SO2, and CO concentrations. Cox proportional hazard regression was used to estimate multivariable-adjusted hazard ratios (HR) and 95% confidence intervals (CI) for associations per each fifth percentile-mean difference in 1992-2015 average pollutant concentrations with risk of incident Hodgkin lymphoma (HL), non-Hodgkin lymphoma (NHL), myeloid leukemia and eleven specific histologic subtypes. RESULTS: There were 2,659 total incident hematologic cancer cases identified among 108,002 participants followed from 1992-2017. Positive HRs were observed for several residential outdoor air pollutants and incident HL (n=54), with statistically significant elevated HRs observed for both NO2 (HR per 6.4 ppb=1.42; 95% CI=1.05-1.90) and SO2 (HR per 1.6 ppb=1.41, 95% CI 1.07-1.85). There were no clear positive associations observed for either NHL (n=2,276) or myeloid leukemias (n=329) and there was an inverse association observed for the chronic lymphocytic leukemia/small lymphocyte lymphoma subtype. In analyses by gender, the positive associations observed with incident HL strengthened among women. CONCLUSIONS: Overall, there were few positive associations of outdoor particulate or gas residential air pollution concentrations and incident adult hematologic cancers observed. However, subtype analyses revealed some evidence for positive associations with HL, particularly among women, which require further investigation. KEYWORDS: outdoor air pollution, particulate matter, lymphoma, leukemia
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