Zheng T, Zahm S H, Cantor K P, Weisenburger D D, Zhang Y, Blair A
Yale University School of Public Health, USA.
J Occup Environ Med. 2001 Jul;43(7):641-9. doi: 10.1097/00043764-200107000-00012.
Recent epidemiological studies have suggested an increased risk of non-Hodgkin lymphoma (NHL) from carbamate insecticide use among farmers. To further explore the possible relationships, we conducted a pooled analysis of three population-based case-control studies conducted in four midwestern states in the United States. A total of 985 white male subjects and 2895 control subjects were included in this analysis. Unconditional logistic regression was used to estimate the association and control for confounding. Compared with nonfarmers, farmers who had ever used carbamate pesticides had a 30% to 50% increased risk of NHL, whereas farmers without carbamate pesticide use showed no increased risk. Analyses for individual carbamate pesticides found a more consistent association with Sevin but not carbofuran, butylate, or S-ethyl dipropylthiocarbamate plus protectant. Among farmers using Sevin, the risk of NHL was limited to those who personally handled the product, those who first used the product for > or = 20 years before their disease diagnosis, and those who used the product for a longer period. These associations persisted after adjusting for other major classes of pesticides. These results suggest an increased risk of NHL associated with carbamate pesticide use, particularly Sevin. Further investigation of the association is warranted.
近期的流行病学研究表明,农民使用氨基甲酸酯类杀虫剂会增加患非霍奇金淋巴瘤(NHL)的风险。为了进一步探究可能存在的关系,我们对在美国中西部四个州开展的三项基于人群的病例对照研究进行了汇总分析。该分析共纳入了985名白人男性受试者和2895名对照受试者。采用非条件逻辑回归来估计关联并控制混杂因素。与非农民相比,曾使用氨基甲酸酯类杀虫剂的农民患NHL的风险增加了30%至50%,而未使用氨基甲酸酯类杀虫剂的农民则未显示出风险增加。对个别氨基甲酸酯类杀虫剂的分析发现,与西维因的关联更为一致,但与克百威、丁草胺或S - 乙基二丙基硫代氨基甲酸酯加保护剂无关。在使用西维因的农民中,患NHL的风险仅限于那些亲自处理该产品的人、那些在疾病诊断前首次使用该产品超过或等于20年的人以及那些使用该产品时间更长的人。在对其他主要类别的杀虫剂进行调整后,这些关联仍然存在。这些结果表明,使用氨基甲酸酯类杀虫剂,尤其是西维因,会增加患NHL的风险。有必要对这种关联进行进一步调查。