Quintana Penelope J E, Delfino Ralph J, Korrick Susan, Ziogas Argyrios, Kutz Frederick W, Jones Ellen L, Laden Francine, Garshick Eric
San Diego State University Graduate School of Public Health, 5500 Campanile Drive, San Diego, CA 92182-4162, USA.
Environ Health Perspect. 2004 Jun;112(8):854-61. doi: 10.1289/ehp.6726.
In this nested case-control study we examined the relationship between non-Hodgkin's lymphoma (NHL) and organochlorine pesticide exposure. We used a data set originally collected between 1969 and 1983 in the U.S. Environmental Protection Agency National Human Adipose Tissue Survey. Adipose samples were randomly collected from cadavers and surgical patients, and levels of organochlorine pesticide residues were determined. From the original study population, 175 NHL cases were identified and matched to 481 controls; 173 controls were selected from accident victims, and 308 from cases with a diagnosis of myocardial infarction. Cases and controls were mainly from cadavers (> 96%) and were matched on sex, age, region of residence within the United States, and race/ethnicity. Conditional logistic regression showed the organochlorine pesticide residue heptachlor epoxide to be significantly associated with NHL [compared with the lowest quartile: third quartile odds ratio (OR) = 1.82, 95% confidence interval (CI), 1.01-3.28; fourth quartile OR = 3.41, 95% CI, 1.89-6.16]. The highest quartile level of dieldrin was also associated with elevated NHL risk (OR = 2.70; 95% CI, 1.58-4.61), as were higher levels of oxychlordane, p,p'-DDE [p,p'-1,1-dichloro-2,2-bis(p-chlorophenyl)ethylene], and ss-benzene hexachloride (ORs = 1.79, 1.99, and 2.47, respectively). The p-values for trends for these associations were significant. In models containing pairs of pesticides, only heptachlor epoxide and dieldrin remained significantly associated with risk of NHL. Limitations of this study include collection of samples after diagnosis and a lack of information on variables affecting organochlorine levels such as diet, occupation, and body mass index. Given the persistence of pesticides in the environment, these findings are still relevant today.
在这项巢式病例对照研究中,我们考察了非霍奇金淋巴瘤(NHL)与有机氯农药暴露之间的关系。我们使用了一个最初于1969年至1983年期间在美国环境保护局国家人体脂肪组织调查中收集的数据集。脂肪样本是从尸体和手术患者中随机采集的,并测定了有机氯农药残留水平。在原始研究人群中,识别出175例NHL病例,并与481名对照进行匹配;173名对照选自事故受害者,308名对照选自诊断为心肌梗死的病例。病例和对照主要来自尸体(>96%),并根据性别、年龄、美国居住地区以及种族/民族进行匹配。条件逻辑回归显示,有机氯农药残留七氯环氧显著与NHL相关[与最低四分位数相比:第三四分位数比值比(OR)=1.82,95%置信区间(CI),1.01 - 3.28;第四四分位数OR = 3.41,95%CI,1.89 - 6.16]。狄氏剂的最高四分位数水平也与NHL风险升高相关(OR = 2.70;95%CI,1.58 - 4.61),环氧七氯、p,p'-滴滴伊[p,p'-1,1 - 二氯 - 2,2 - 双(对氯苯基)乙烯]和β - 六六六的较高水平也与NHL风险升高相关(OR分别为1.79、1.99和2.47)。这些关联的趋势p值具有显著性。在包含成对农药的模型中,只有七氯环氧和狄氏剂仍与NHL风险显著相关。本研究的局限性包括在诊断后采集样本以及缺乏关于影响有机氯水平的变量(如饮食、职业和体重指数)的信息。鉴于农药在环境中的持久性,这些发现如今仍然具有相关性。