Jurewicz Joanna, Hanke Wojciech
Department of Environmental Epdemiology, Nofer Institute of Occupational Medicine, Lódź, Poland.
Int J Occup Med Environ Health. 2006;19(3):152-69. doi: 10.2478/v10001-006-0024-7.
In Europe and the United States, cancer is a major cause of death among children aged 5-14 years. The role of environmental exposure to pesticides in carcinogenesis, although strongly postulated, is still unknown. Pesticides have been used since the early days of modern agriculture. They are biologically active compounds, which may pose health risk during or after their use.
Epidemiological studies focused on childhood cancer and exposure to pesticides, conducted over the last seven years, were identified through searching PUBMED, MEDLINE and EBSCO literature bases. From each study, the following information was abstracted: type of cancer, type of exposure, study design, risk estimate, and study population. This review will try to answer the question on whether any further progress in epidemiology of childhood cancer due to pesticide exposure has been made.
Leukemia, brain cancer, non-Hodgkin's lymphoma and neuroblastoma are mentioned as potentially associated with pesticide exposure among children. Despite an increasing evidence in support of this finding, it is still limited because of the weakness of research methodology. The substantial weak points of numerous epidemiological studies of pesticide-related health effects are problems faced in exposure assessment, small numbers of exposed subjects, a limited number of studies focused on the majority of cancers, and difficulties in estimating critical windows of exposure.
In the light of existing, although still limited evidence of adverse effects of pesticide exposure, it is necessary to reduce exposure to pesticides. The literature review suggests a great need to increase awareness among people occupationally or environmentally exposed to pesticides about their potential negative influence on health of their children.
在欧洲和美国,癌症是5至14岁儿童的主要死因。虽然强烈推测环境接触农药在致癌过程中的作用,但仍不清楚。自现代农业早期以来就一直使用农药。它们是生物活性化合物,在使用期间或之后可能会带来健康风险。
通过搜索PUBMED、MEDLINE和EBSCO文献库,确定了过去七年中针对儿童癌症与农药接触情况的流行病学研究。从每项研究中提取了以下信息:癌症类型、接触类型、研究设计、风险估计和研究人群。本综述将试图回答因接触农药导致的儿童癌症流行病学是否有任何进一步进展的问题。
白血病、脑癌、非霍奇金淋巴瘤和神经母细胞瘤被提及可能与儿童接触农药有关。尽管支持这一发现的证据越来越多,但由于研究方法的薄弱,证据仍然有限。许多关于农药相关健康影响的流行病学研究的重大弱点包括接触评估中面临的问题、接触人群数量少、针对大多数癌症的研究数量有限以及估计关键接触窗口期的困难。
鉴于现有关于农药接触不良影响的证据虽然仍然有限,但有必要减少农药接触。文献综述表明,非常需要提高职业或环境接触农药的人群对农药对其子女健康潜在负面影响的认识。