Background: Cadmium (Cd) and lead (Pb) are hypothesised to be risk factors for non-Hodgkin’s lymphoma (NHL), a
group of haematological malignancies with a suspected environmental aetiology. Within the EnviroGenoMarkers
study we utilised pre-diagnostic erythrocyte concentrations of Cd and Pb to determine whether exposure was
associated with risk of B-cell NHL and multiple myeloma.
Methods: 194 incident cases of B-cell NHL and 76 cases of multiple myeloma diagnosed between 1990 and 2006
were identified from two existing cohorts; EPIC-Italy and the Northern Sweden Health and Disease Study. Cases
were matched to healthy controls by centre, age, gender and date of blood collection. Cd and Pb were measured in
blood samples provided at recruitment using inductively coupled plasma-mass spectrometry. Logistic regression was
applied to assess the association with risk. Analyses were stratified by cohort and gender and by subtype where
possible.
Results: There was little evidence of an increased risk of B-cell NHL or multiple myeloma with exposure to Cd (B-cell
NHL: OR 1.09 95%CI 0.61, 1.93, MM: OR 1.16 95% CI: 0.40, 3.40 ) or Pb (B-cell NHL: 0.93 95% CI 0.43, 2.02,
multiple myeloma: OR 1.63 95%CI 0.45, 5.94) in the total population when comparing the highest to the lowest
quartile of exposure. However, gender and cohort specific differences in results were observed. In females the risk of
B-cell NHL was more than doubled in those with a body burden of Cd >1µg/L (OR 2.20 95%CI; 1.04, 4.65).
Conclusions: This nested case-control study does not support a consistent positive association between Cd or Pb
and NHL, but there is some indication of a gender specific effect suggesting further research is warranted.