McDuffie H H, Pahwa P, McLaughlin J R, Spinelli J J, Fincham S, Dosman J A, Robson D, Skinnider L F, Choi N W
Centre for Agricultural Medicine, University of Saskatchewan, Saskatoon, Saskatchewan.
Cancer Epidemiol Biomarkers Prev. 2001 Nov;10(11):1155-63.
Our objective in the study was to investigate the putative associations of specific pesticides with non-Hodgkin's Lymphoma [NHL; International Classification of Diseases, version 9 (ICD-9) 200, 202]. We conducted a Canadian multicenter population-based incident, case (n = 517)-control (n = 1506) study among men in a diversity of occupations using an initial postal questionnaire followed by a telephone interview for those reporting pesticide exposure of 10 h/year or more, and a 15% random sample of the remainder. Adjusted odds ratios (ORs) were computed using conditional logistic regression stratified by the matching variables of age and province of residence, and subsequently adjusted for statistically significant medical variables (history of measles, mumps, cancer, allergy desensitization treatment, and a positive history of cancer in first-degree relatives). We found that among major chemical classes of herbicides, the risk of NHL was statistically significantly increased by exposure to phenoxyherbicides [OR, 1.38; 95% confidence interval (CI), 1.06-1.81] and to dicamba (OR, 1.88; 95% CI, 1.32-2.68). Exposure to carbamate (OR, 1.92; 95% CI, 1.22-3.04) and to organophosphorus insecticides (OR, 1.73; 95% CI, 1.27-2.36), amide fungicides, and the fumigant carbon tetrachloride (OR, 2.42; 95% CI, 1.19-5.14) statistically significantly increased risk. Among individual compounds, in multivariate analyses, the risk of NHL was statistically significantly increased by exposure to the herbicides 2,4-dichlorophenoxyacetic acid (2,4-D; OR, 1.32; 95% CI, 1.01-1.73), mecoprop (OR, 2.33; 95% CI, 1.58-3.44), and dicamba (OR, 1.68; 95% CI, 1.00-2.81); to the insecticides malathion (OR, 1.83; 95% CI, 1.31-2.55), 1,1,1-trichloro-2,2-bis (4-chlorophenyl) ethane (DDT), carbaryl (OR, 2.11; 95% CI, 1.21-3.69), aldrin, and lindane; and to the fungicides captan and sulfur compounds. In additional multivariate models, which included exposure to other major chemical classes or individual pesticides, personal antecedent cancer, a history of cancer among first-degree relatives, and exposure to mixtures containing dicamba (OR, 1.96; 95% CI, 1.40-2.75) or to mecoprop (OR, 2.22; 95% CI, 1.49-3.29) and to aldrin (OR, 3.42; 95% CI, 1.18-9.95) were significant independent predictors of an increased risk for NHL, whereas a personal history of measles and of allergy desensitization treatments lowered the risk. We concluded that NHL was associated with specific pesticides after adjustment for other independent predictors.
我们这项研究的目的是调查特定农药与非霍奇金淋巴瘤[NHL;国际疾病分类,第9版(ICD - 9)200、202]之间的假定关联。我们在加拿大开展了一项基于多中心人群的发病情况研究,以病例(n = 517)对照(n = 1506)的形式,研究对象为从事多种职业的男性。首先通过邮寄问卷进行调查,对于报告每年农药暴露时长达到或超过10小时的人群,随后进行电话访谈,对其余人群抽取15%进行随机抽样访谈。使用条件逻辑回归计算调整后的比值比(OR),并按年龄和居住省份的匹配变量进行分层,随后对具有统计学意义的医学变量(麻疹、腮腺炎、癌症病史、过敏脱敏治疗以及一级亲属的癌症阳性病史)进行调整。我们发现,在主要化学类别的除草剂中,接触苯氧基除草剂[OR,1.38;95%置信区间(CI),1.06 - 1.81]和麦草畏(OR,1.88;95% CI,1.32 - 2.68)会使患NHL的风险在统计学上显著增加。接触氨基甲酸酯(OR,1.92;95% CI,1.22 - 3.04)、有机磷杀虫剂(OR,1.73;95% CI,1.27 - 2.36)、酰胺类杀菌剂以及熏蒸剂四氯化碳(OR,2.42;95% CI,1.19 - 5.14)会使风险在统计学上显著增加。在个体化合物中,多变量分析显示,接触除草剂2,4 - 二氯苯氧乙酸(2,4 - D;OR,1.32;95% CI,1.01 - 1.73)、麦草畏(OR,2.33;95% CI,1.58 - 3.44)和麦草畏(OR,1.68;95% CI,1.00 - 2.81);杀虫剂马拉硫磷(OR,1.83;95% CI,1.31 - 2.55)、1,1,1 - 三氯 - 2,2 - 双(4 - 氯苯基)乙烷(滴滴涕)、西维因(OR,2.11;95% CI,1.21 - 3.69)、艾氏剂和林丹;以及杀菌剂克菌丹和硫化合物会使患NHL的风险在统计学上显著增加。在其他多变量模型中,纳入了接触其他主要化学类别或个体农药、个人既往癌症史、一级亲属的癌症病史,接触含有麦草畏(OR,1.96;95% CI,1.40 - 2.75)或麦草畏(OR,2.22;95% CI,1.49 - 3.29)以及艾氏剂(OR,3.42;95% CI,1.18 - 9.95)的混合物是NHL风险增加的显著独立预测因素,而个人麻疹病史和过敏脱敏治疗史则会降低风险。我们得出结论,在对其他独立预测因素进行调整后,NHL与特定农药有关。