• Catherine Bulka, Loretta J Nastoupil, Jean L Koff, Leon Bernal-Mizrachi, Kevin C Ward, Jessica N Williams, A Rana Bayakly, Jeffrey M Switchenko, Lance A Waller, and Christopher R Flowers.
• From the Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health, Chicago, the University of Texas MD Anderson Cancer Center, Houston, the Departments of Hematology and Oncology and Biostatistics and Bioinformatics Shared Resource, Winship Cancer Institute, and the Departments of Epidemiology and Biostatistics and Bioinformatics, Rollins School of Public Health, Emory University, Atlanta, Georgia, and the Georgia Department of Public Health, Atlanta.
• South. Med. J. 2016 Oct 1; 109 (10): 606-614.

ObjectivesExamining the spatial patterns of diffuse large B-cell lymphoma (DLBCL) incidence and residential proximity to toxic release locations may provide insight regarding environmental and sociodemographic risk factors.MethodsWe linked and geocoded cancer incidence data for the period 1999-2008 from the Georgia Comprehensive Cancer Registry with population data from the US Census and the Environmental Protection Agency's Toxics Release Inventory. We conducted cluster analyses and constructed Poisson regression models to assess DLBCL incidence as a function of mean distance to the toxic release sites.ResultsIn total, 3851 incident DLBCL cases occurred among adults residing in Georgia between 1999 and 2008. Significant focal clustering was observed around 57% of ethylene oxide sites, 5% of benzene sites, 9% of tetrachloroethylene sites, 7% of styrene sites, 10% of formaldehyde sites, 5% of trichloroethylene sites, and 10% of all release sites. Mean distance to sites was significantly associated with DLBCL risk for all chemicals.ConclusionsProximity to Toxics Release Inventory sites can be linked to increased DLBCL risk as assessed through focal clustering and Poisson regression, and confirmatory studies using geospatial mapping can aid in further specifying risk factors for DLBCL.

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