Distribution of different occupations in multiple myeloma patients- a hospital based study at a tertiary care hospital, Guwahati, Assam, India

Background: Several studies have shown that people who have been exposed to radiation or to asbestos, benzene, pesticides, and other chemicals used in rubber manufacturing may be at higher risk for developing multiple myeloma (MM). Those exposed to wood products, such as carpenters, furniture makers, and paper makers, are also at higher risk of developing this disease. Most occupational cohort studies lack statistical power for rare outcomes such as MM and many case–control studies suffer from small numbers of exposed subjects in specific occupation, job title or chemical exposure categories. This study aimed to investigate the distribution of MM among different occupational groups. Methods: A total of 100 cases were studied in the out patient department (OPD) of the Clinical Haematology Department, Gauhati Medical College and Hospital, and Guwahati, Assam, India.  It was a hospital based cross-sectional descriptive study. The proforma was prepared based on universal standard protocols for evaluation of MM which contains separate history, examination and investigation parts. The International Myeloma Working Group (IMWK) criteria for classification of monoclonal gammopathy, multiple myeloma and related disorders were used for diagnosis of the disease. Data were analyzed using statistical package and results and observations were presented in tabular form. Statistical tests were applied wherever required. Results: Statistical analysis suggested that farmers and housewives were more vulnerable to MM and the prevalence was significantly high (p>0.00001) among farmers followed by housewives; prevalence of MM was significantly high (p>0.00001) among the farmers working in agriculture as compared to those in farms; there was some difference (p<0.00001) in relation to risk of pesticide exposure between cultivation of crops and vegetable. Pesticide exposure was relatively high with cultivation of crops than vegetable; among the farmers working in farms, those who work in farm with furred animals are more vulnerable (p<0.00001) to the prevalence of MM than the others; frequency of pesticide exposure had no effect (p=0.354) on the prevalence of MM; prevalence of MM was significantly high (p=0.0005) among farmers who expose to pesticides for more than 5 years as compared to those exposing for less time and prevalence of multiple myeloma is very insignificant (p<0.00001) among the fruit and pesticide sellers. Conclusions: Prevalence of MM was significantly high (p=0.0005) among farmers who expose to pesticides for more than 5 years and carpenters who worked for more than 4 years.