Pesticides and atopic and nonatopic asthma among farm women in the Agricultural Health Study.
Hoppin-JA; Umbach-DM; London-SJ; Henneberger-PK; Kullman-GJ; Alavanja-MCR; Sandler-DP
Am J Respir Crit Care Med 2008 Jan; 177(1):11-18
Rationale: Risk factors for asthma among farm women are understudied. Objectives: We evaluated pesticide and other occupational exposures as risk factors for adult-onset asthma. Methods: Studying 25,814 farm women in the Agricultural Health Study, we used self-reported history of doctor-diagnosed asthma with or without eczema and/or hay fever to create two case groups: patients with atopic asthma and those with nonatopic asthma. We assessed disease-exposure associations with polytomous logistic regression. Measurements and Main Results: At enrollment (1993-1997), 702 women (2.7%) reported a doctor's diagnosis of asthma after age 19 years (282 atopic, 420 nonatopic). Growing up on a farm (61% of all farm women) was protective for atopic asthma (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.43-0.70) and, to a lesser extent, for nonatopic asthma (OR, 0.83; 95%CI, 0.68-1.02; P value for difference = 0.008). Pesticide use was almost exclusively associated with atopic asthma. Any use of pesticides on the farm was associated only with atopic asthma (OR, 1.46; 95% CI, 1.14-1.87). This association with pesticides was strongest among women who had grown up on a farm. Women who grew up on farms and did not apply pesticides had the lowest overall risk of atopic asthma (OR, 0.41; 95% CI, 0.27-0.62) compared with women who neither grew up on farms nor applied pesticides. A total of 7 of 16 insecticides, 2 of 11 herbicides, and 1 of 4 fungicides were significantly associated with atopic asthma; only permethrin use on crops was associated with nonatopic asthma. Conclusions: These findings suggest that pesticides may contribute to atopic asthma, but not nonatopic asthma, among farm women.
Agricultural-chemicals; Agricultural-workers; Women; Pesticides; Allergies; Organo-phosphorus-pesticides; Farmers; Bronchial-asthma; Risk-factors; Statistical-analysis; Demographic-characteristics; Respiratory-system-disorders; Herbicides; Insecticides; Carbamates; Organo-chlorine-compounds; Fumigants; Fungicides
Jane A. Hoppin, Sc.D., NIEHS Epidemiology Branch, MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709-2233
Agriculture, Forestry and Fishing
American Journal of Respiratory and Critical Care Medicine