Kato Ikuko, Watanabe-Meserve Hiroko, Koenig Karen L, Baptiste Mark S, Lillquist Patricia P, Frizzera Glauco, Burke Jerome S, Moseson Miriam, Shore Roy E
Department of Environmental Medicine, New York University of School of Medicine, New York, New York, USA.
Environ Health Perspect. 2004 Sep;112(13):1275-81. doi: 10.1289/ehp.7070.
A population-based, incidence case-control study was conducted among women in upstate New York to determine whether pesticide exposure is associated with an increase in risk of non-Hodgkin lymphoma (NHL) among women. The study involved 376 cases of NHL identified through the State Cancer Registry and 463 controls selected from the Medicare beneficiary files and state driver's license records. Information about history of farm work, history of other jobs associated with pesticide exposure, use of common household pesticide products, and potential confounding variables was obtained by telephone interview. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using an unconditional logistic regression model. The risk of NHL was doubled (OR = 2.12; 95% CI, 1.21-3.71) among women who worked for at least 10 years at a farm where pesticides were reportedly used. When both farming and other types of jobs associated with pesticide exposure were combined, there was a progressive increase in risk of NHL with increasing duration of such work (p = 0.005). Overall cumulative frequency of use of household pesticide products was positively associated with risk of NHL (p = 0.004), which was most pronounced when they were applied by subjects themselves. When exposure was analyzed by type of products used, a significant association was observed for mothballs. The associations with both occupational and household pesticides were particularly elevated if exposure started in 1950-1969 and for high-grade NHL. Although the results of this case-control study suggest that exposure to pesticide products may be associated with an increased risk of NHL among women, methodologic limitations related to selection and recall bias suggest caution in inferring causation.
在纽约州北部的女性中开展了一项基于人群的发病率病例对照研究，以确定农药暴露是否与女性非霍奇金淋巴瘤（NHL）风险增加有关。该研究纳入了通过州癌症登记处确定的376例NHL病例，以及从医疗保险受益人档案和州驾照记录中选取的463名对照。通过电话访谈获取了有关农业工作史、与农药接触相关的其他工作史、家用常见农药产品的使用情况以及潜在混杂变量的信息。使用无条件逻辑回归模型估计比值比（OR）和95%置信区间（CI）。在据报道使用农药的农场工作至少10年的女性中，NHL风险增加了一倍（OR = 2.12；95% CI，1.21 - 3.71）。当农业工作和其他与农药接触相关的工作类型合并时，随着此类工作时长增加，NHL风险逐渐升高（p = 0.005）。家用农药产品的总体累计使用频率与NHL风险呈正相关（p = 0.004），当由受试者本人使用时最为明显。按使用的产品类型分析暴露情况时，观察到卫生球有显著关联。如果暴露始于1950 - 1969年以及对于高级别NHL，职业性和家用农药的关联尤其高。尽管这项病例对照研究的结果表明，接触农药产品可能与女性患NHL的风险增加有关，但与选择和回忆偏倚相关的方法学局限性表明，在推断因果关系时应谨慎。
