American Journal of Industrial Medicine 14319-330 (1988) zy Leukemias and Occupation in Sweden: A Registry-Based Analysis Martha S. Linet, MD, Hans S.R. Malker, MA, Joseph K. McLaughlin, PhD, Jan A. Weiner, PF, B.J. Stone, PhD, William J. Blot, PhD, Jan L.E. Ericsson, MD, and Joseph F. Fraumeni, Jr., MD zyxwvu A linked-registry was used to examine systematically, on a national basis, the leukemia incidence in Swedish men by industry and occupation. New associations were observed for chronic lymphocytic leukemia among cloth and pattern cutters and for chronic myelocytic leukemia among brewery workers and motor mechanics. A number of additional findings were consistent with previous observations in other countries. Although etiologic inferences are limited when using linked-registry data, this hypothesis-generating study may provide new clues to the occupationaldeterminants of specific forms of leukemia. Key words: acute lymphocytic leukemia, chronic lymphocytic leukemia, acute nonlymphocytic leukemia, chronic myelocytic leukemia, linked-registry data, industry INTRODUCTION There is little information on occupational exposures as determinants of the subgroups of leukemia except for studies of workers exposed to radiation or benzene. A number of earlier occupational mortality and incidence surveys reported excess risks for leukemia, usually as a single entity or by diagnostic classifications no longer used [Milham, 1976; DecouflC et al, 1977; Registrar General, 1978; Petersen and Milham, 1980; Dubrow and Wegman, 1984; Morton and Marjanovic, 1984; Olsen and Jensen, 19871. To date, few occupational surveys have employed the specific leukemia categories of acute lymphocytic leukemia (ALL), chronic lymphocytic leukemia (CLL), acute nonlymphocytic leukemia (ANLL), and chronic myelocytic leukemia (CML) [Linet, 19851. To provide new occupational leads to causes of leukemia and to add information on previously reported associations, we have utilized the Swedish Cancer-Environment Registry (CER), which links cancer incidence and employment information. Epidemiology and Biostatistics Program, Division of Cancer Etiology, National Cancer Institute, Bethesda, Maryland (M.S.L., J.K.M., B.J.S., W.J.B., J.F.F.). National Board of Occupational Safety and Health, Solna, Sweden (H.S.R.M., J.A.W.). National Board of Health and Welfare, Stockholm, Sweden (J.L.E.E.). Address Reprint requests to M.S. Linet, Epidemiology and Biostatistics Program, National Cancer Institute, Executive Plaza North, Room 415B, Bethesda, MD 20892. Accepted for publication April zyxwvut 5, 1988. zyxwvu 0 1988 Alan R. Liss, Inc.