Miligi Lucia, Costantini Adele Seniori, Veraldi Angela, Benvenuti Alessandra, Vineis Paolo
Environmental and Occupational Epidemiology Unit, Centre for Study and Prevention of Cancer, Istituto Toscano Tumori, 50135 Florence, Italy.
Ann N Y Acad Sci. 2006 Sep;1076:366-77. doi: 10.1196/annals.1371.036.
Exposure to pesticides is recognized as an important environmental risk factor associated with development of cancer. Epidemiological studies, although sometimes contradictory, have linked phenoxy acid herbicides with non-Hodgkin's lymphoma (NHL) and Soft Tissue Sarcoma (STS); organochlorine insecticides with STS, NHL, and leukemia; organophosphorous compounds with NHL and leukemia; and triazine herbicides with ovarian cancer. Exposure assessment is a crucial point in studying the association between cancer and pesticides. In order to investigate the association between hematolymphopoietic malignancies and occupational exposures, including pesticides, a population-based case-control study was carried out in Italy in 11 areas, 9 of which are agricultural or mixed areas. All newly diagnosed cases of hematolymphopoietic malignancies were collected in a 3-year period (1991-1993). The control group consisted of a random sample of the population residing in each area. The approach to infer exposures in agriculture was based on: the use of an agricultural questionnaire with 24 crop-specific questionnaires; expert agronomists who reviewed the collected information for each subject and translated it into pesticides histories. In total, 1925 cases and 1232 controls were interviewed in the nine agricultural areas. Increased risk was observed for some specific classes of pesticides. Furthermore, a nonstatistically significant increased risk of NHL was observed for subjects who were exposed to phenoxy herbicides not using protective equipment and a significant increased risk for exposure to 2, 4-dichlorophenoxy acetic acid (2,4-D).
接触农药被认为是与癌症发生相关的一个重要环境风险因素。流行病学研究虽然有时相互矛盾，但已将苯氧基酸除草剂与非霍奇金淋巴瘤（NHL）和软组织肉瘤（STS）联系起来；有机氯杀虫剂与STS、NHL和白血病联系起来；有机磷化合物与NHL和白血病联系起来；以及三嗪除草剂与卵巢癌联系起来。接触评估是研究癌症与农药之间关联的关键环节。为了调查血液淋巴系统恶性肿瘤与职业接触（包括农药接触）之间的关联，1991年在意大利的11个地区开展了一项基于人群的病例对照研究，其中9个是农业或混合地区。在3年期间（1991 - 1993年）收集了所有新诊断的血液淋巴系统恶性肿瘤病例。对照组由居住在每个地区的人群随机样本组成。推断农业接触情况的方法基于：使用一份包含24份特定作物问卷的农业调查问卷；由专家农学家审查每个受试者收集的信息并将其转化为农药接触史。在9个农业地区总共对1925例病例和1232名对照进行了访谈。观察到某些特定种类农药的风险增加。此外，未使用防护设备接触苯氧基除草剂的受试者患NHL的风险有非统计学意义的增加，而接触2,4 - 二氯苯氧基乙酸（2,4 - D）的风险有显著增加。
