Hoppin Jane A, Umbach David M, London Stephanie J, Lynch Charles F, Alavanja Michael C R, Sandler Dale P
Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, US Department of Health and Human Services, Research Triangle Park, NC 27709-2233, USA.
Am J Epidemiol. 2006 Jun 15;163(12):1129-37. doi: 10.1093/aje/kwj138. Epub 2006 Apr 12.
Pesticides are potential risk factors for respiratory disease among farmers, but farmers are also exposed to other respiratory toxicants. To explore the association of pesticides with wheeze in a population without other farming exposures, the authors analyzed data from 2,255 Iowa commercial pesticide applicators enrolled in the Agricultural Health Study. Controlling for age, smoking status, asthma and atopy history, and body mass index, the authors calculated odds ratios for the relationship between wheeze and 36 individual pesticides participants had used during the year before enrollment (1993-1997). Eight of 16 herbicides were associated with wheeze in single-agent models; however, the risk was almost exclusively associated with the herbicide chlorimuron-ethyl (odds ratio (OR) = 1.62, 95% confidence interval (CI): 1.25, 2.10). Inclusion of chlorimuron-ethyl in models for the other herbicides virtually eliminated the associations. The odds ratios for four organophosphate insecticides (terbufos, fonofos, chlorpyrifos, and phorate) were elevated when these chemicals were modeled individually and remained elevated, though attenuated somewhat, when chlorimuron-ethyl was included. The association for dichlorvos, another organophosphate insecticide, was not attenuated by chlorimuron-ethyl (OR = 2.48, 95% CI: 1.08, 5.66). Dose-response trends were observed for chlorimuron-ethyl, chlorpyrifos, and phorate; the strongest odds ratio was for applying chlorpyrifos on more than 40 days per year (OR = 2.40, 95% CI: 1.24, 4.65). These results add to the emerging literature linking organophosphate insecticides and respiratory health and suggest a role for chlorimuron-ethyl.
农药是农民患呼吸道疾病的潜在风险因素,但农民也会接触到其他呼吸道有毒物质。为了探究在没有其他农业接触因素的人群中农药与喘息之间的关联,作者分析了参与农业健康研究的2255名爱荷华州商业农药施用者的数据。在控制了年龄、吸烟状况、哮喘和特应性病史以及体重指数后,作者计算了喘息与参与者在入组前一年(1993 - 1997年)使用的36种单一农药之间关系的比值比。在单因素模型中,16种除草剂中有8种与喘息相关;然而,风险几乎完全与除草剂氯嘧磺隆乙酯相关(比值比(OR)= 1.62,95%置信区间(CI):1.25,2.10)。在其他除草剂模型中纳入氯嘧磺隆乙酯后,这种关联几乎消失。当单独对四种有机磷杀虫剂(特丁硫磷、地虫硫磷、毒死蜱和甲拌磷)进行建模时,其比值比升高,当纳入氯嘧磺隆乙酯后,虽然有所减弱,但仍保持升高。另一种有机磷杀虫剂敌敌畏的关联未被氯嘧磺隆乙酯减弱(OR = 2.48,95% CI:1.08,5.66)。观察到氯嘧磺隆乙酯、毒死蜱和甲拌磷存在剂量 - 反应趋势;每年施用毒死蜱超过40天的比值比最高(OR = 2.40,95% CI:1.24,4.65)。这些结果进一步丰富了将有机磷杀虫剂与呼吸道健康联系起来的新文献,并表明氯嘧磺隆乙酯也有一定作用。