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接触杀虫剂作为非霍奇金淋巴瘤和毛细胞白血病的风险因素:两项瑞典病例对照研究的汇总分析

Exposure to pesticides as risk factor for non-Hodgkin's lymphoma and hairy cell leukemia: pooled analysis of two Swedish case-control studies.

作者信息

Hardell Lennart, Eriksson Mikael, Nordstrom Marie

机构信息

Department of Oncology, Orebro University Hospital, Sweden.

出版信息

Leuk Lymphoma. 2002 May;43(5):1043-9. doi: 10.1080/10428190290021560.

Abstract

Increased risk for non-Hodgkin's lymphoma (NHL) following exposure to certain pesticides has previously been reported. To further elucidate the importance of phenoxyacetic acids and other pesticides in the etiology of NHL a pooled analysis was performed on two case-control studies, one on NHL and another on hairy cell leukemia (HCL), a rare subtype of NHL. The studies were population based with cases identified from cancer registry and controls from population registry. Data assessment was ascertained by questionnaires supplemented over the telephone by specially trained interviewers. The pooled analysis of NHL and HCL was based on 515 cases and 1141 controls. Increased risks in univariate analysis were found for subjects exposed to herbicides (OR 1.75, CI 95% 1.26-2.42), insecticides (OR 1.43, CI 95% 1.08-1.87), fungicides (OR 3.11, CI 95% 1.56-6.27) and impregnating agents (OR 1.48, CI 95% 1.11-1.96). Among herbicides, significant associations were found for glyphosate (OR 3.04, CI 95% 1.08-8.52) and 4-chloro-2-methyl phenoxyacetic acid (MCPA) (OR 2.62, CI 95% 1.40-4.88). For several categories of pesticides the highest risk was found for exposure during the latest decades before diagnosis. However, in multivariate analyses the only significantly increased risk was for a heterogeneous category of other herbicides than above.

摘要

先前已有报告称,接触某些农药会增加患非霍奇金淋巴瘤(NHL)的风险。为了进一步阐明苯氧乙酸和其他农药在NHL病因学中的重要性,对两项病例对照研究进行了汇总分析,一项针对NHL,另一项针对毛细胞白血病(HCL),后者是NHL的一种罕见亚型。这些研究以人群为基础,病例从癌症登记处确定,对照从人口登记处确定。数据评估通过问卷确定,并由经过专门培训的访员通过电话进行补充。NHL和HCL的汇总分析基于515例病例和1141例对照。单因素分析发现,接触除草剂(比值比1.75,95%置信区间1.26 - 2.42)、杀虫剂(比值比1.43,95%置信区间1.08 - 1.87)、杀菌剂(比值比3.11,95%置信区间1.56 - 6.27)和浸渍剂(比值比1.48,95%置信区间1.11 - 1.96)的受试者风险增加。在除草剂中,发现草甘膦(比值比3.04,95%置信区间1.08 - 8.52)和4 - 氯 - 2 - 甲基苯氧乙酸(MCPA)(比值比2.62,95%置信区间1.40 - 4.88)存在显著关联。对于几类农药,在诊断前最近几十年接触时风险最高。然而,在多因素分析中,唯一显著增加的风险是针对上述以外的其他除草剂这一异类。

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