Occupational use of insecticides, fungicides and fumigants and risk of non-Hodgkin lymphoma and multiple myeloma in the Agricultural Health Study.
Alavanja-M; Hofmann-J; Lynch-C; Hines-C; Barry-K; Barker-J; Buckman-D; Thomas-K; Sandler-D; Hoppin-J; Koutros-S; Andreotti-G; Lubin-J; Blair-A; Freemen-LB
Occup Environ Med 2014 Jun; 71(Suppl 1):A36
Objectives: Farming and exposure to pesticides have been linked to non-Hodgkin lymphoma (NHL), and multiple myeloma (MM) in previous studies. We evaluated use of insecticides, fungicides and fumigants and risk of NHL, including MM and other NHL sub-types in the Agricultural Health Study, a US-based prospective cohort study. Method: A total of 527 cases occurred among 55 875 pesticide applicators from enrollment (1993-1997) through 2011 in Iowa and 2010 in North Carolina. Information on pesticide use, other agricultural exposures and other factors was obtained from questionnaires at enrollment and follow-up approximately five years later (1999-2005). Information from these questionnaires was used to create lifetime-days and intensity- weighted lifetime-days of pesticide use. Poisson regression and polytomous logit models were used to calculate relative risks (RR) and 95% confidence intervals (CI) to evaluate associations between 26 pesticides and NHL and five NHL-subtypes including multiple myeloma, while adjusting for potential confounding factors. Results: Statistically significant positive exposure-response trends occurred between overall NHL risk and lindane (p-trend = 0.004) and DDT (p-trend = 0.02). In addition, ever use of terbufos was associated with NHL overall (RR=1.2; CI=1.0-1.5), but with no exposure-response trend. In sub-type analyses, terbufos and DDT were associated with small cell lymphoma/ chronic lymphocytic leukaemia/marginal cell lymphoma. In addition, lindane and diazinon were associated with follicular lymphoma and permethrin with MM although tests of homogeneity did not show significant differences in exposure-response among NHL-subtypes for any chemical. Conclusions: These findings are among the first to suggest links between DDT, lindane, permethrin, diazinon and terbufos and specific NHL subtypes.
Chemical-composition; Chemical-properties; Chemical-reactions; Skin; Exposure-levels; Risk-factors; Irritants; Sensitization; Pesticides; Insecticides; Agriculture; Farmers; Agricultural-industry; Carcinogens; Fungicides; Fumigants; Exposure-levels; Humans; Men; Women; Questionnaires; Chemical-properties; Chemical-composition; Chemical-reactions
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Agriculture, Forestry and Fishing
Occupational and Environmental Medicine