男性中多种农药作为非霍奇金淋巴瘤风险因素的综合评估。
Integrative assessment of multiple pesticides as risk factors for non-Hodgkin's lymphoma among men.
作者信息
De Roos A J, Zahm S H, Cantor K P, Weisenburger D D, Holmes F F, Burmeister L F, Blair A
机构信息
Division of Cancer Epidemiology and Genetics, National Cancer Institute/NIH, Bethesda, MD, USA.
出版信息
Occup Environ Med. 2003 Sep;60(9):E11. doi: 10.1136/oem.60.9.e11.
BACKGROUND
An increased rate of non-Hodgkin's lymphoma (NHL) has been repeatedly observed among farmers, but identification of specific exposures that explain this observation has proven difficult.
METHODS
During the 1980s, the National Cancer Institute conducted three case-control studies of NHL in the midwestern United States. These pooled data were used to examine pesticide exposures in farming as risk factors for NHL in men. The large sample size (n = 3417) allowed analysis of 47 pesticides simultaneously, controlling for potential confounding by other pesticides in the model, and adjusting the estimates based on a prespecified variance to make them more stable.
RESULTS
Reported use of several individual pesticides was associated with increased NHL incidence, including organophosphate insecticides coumaphos, diazinon, and fonofos, insecticides chlordane, dieldrin, and copper acetoarsenite, and herbicides atrazine, glyphosate, and sodium chlorate. A subanalysis of these "potentially carcinogenic" pesticides suggested a positive trend of risk with exposure to increasing numbers.
CONCLUSION
Consideration of multiple exposures is important in accurately estimating specific effects and in evaluating realistic exposure scenarios.
背景
农民中非霍奇金淋巴瘤（NHL）的发病率不断上升，这一现象已被多次观察到，但要确定能解释这一现象的具体暴露因素却很困难。
方法
在20世纪80年代，美国国立癌症研究所在美国中西部开展了三项关于NHL的病例对照研究。这些汇总数据用于检验农业中的农药暴露作为男性患NHL的风险因素。大样本量（n = 3417）使得能够同时分析47种农药，在模型中控制其他农药的潜在混杂因素，并根据预先设定的方差调整估计值，使其更稳定。
结果
报告使用几种特定农药与NHL发病率增加有关，包括有机磷酸酯类杀虫剂蝇毒磷、二嗪农和地虫硫磷，杀虫剂氯丹、狄氏剂和乙酰亚砷酸铜，以及除草剂阿特拉津、草甘膦和氯酸钠。对这些“潜在致癌”农药的亚分析表明，随着暴露农药数量的增加，风险呈上升趋势。
结论
在准确估计特定影响和评估实际暴露情况时，考虑多种暴露因素很重要。
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