Risk factors

A retrospective study of 285 cases of MGUS matched with 570 controls assessed risk factors for MGUS. MGUS was significantly increased in farmers (P < 0.005) and industry workers (P < 0.025), and in those with occupational exposure to asbestos, fertilizers, mineral oils and petroleum, paints and related products, and pesticides (P < 0.05). Chronic immune-stimulating conditions, when considered as a group, presented a significant (P < 0.025) risk of MGUS, but no specific disease has been significantly associated.29 A retrospective study from the Nurses' Health Study showed that MGUS is not increased in women with breast implants.30 Among 6737 atomic bomb survivors, 112 developed MGUS between 1985 and 2001. The crude incidence rate was 164/100,000 person-years in the overall study population, with a sharp increase in incidence after age 60. Among 75 patients with MGUS detected in 1985, 50 patients (67%) had died by 2001, and 16 (21%) of these deaths were due to MM. Transformation from MGUS to MM was faster in exposed persons than in non-exposed persons, though that was not statistically significant.31

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