农业健康研究中农民的农药使用与慢性支气管炎
Pesticide use and chronic bronchitis among farmers in the Agricultural Health Study.
作者信息
Hoppin Jane A, Valcin Martin, Henneberger Paul K, Kullman Greg J, Umbach David M, London Stephanie J, Alavanja Michael C R, Sandler Dale P
机构信息
Epidemiology Branch, National Institute of Environmental Health Sciences, NIH, DHHS, Research Triangle Park, North Carolina 27709-2233, USA.
出版信息
Am J Ind Med. 2007 Dec;50(12):969-79. doi: 10.1002/ajim.20523.
BACKGROUND
Farmers have increased risk for chronic bronchitis. Few investigators have considered pesticides.
METHODS
We evaluated pesticides as risk factors for chronic bronchitis using the Agricultural Health Study enrollment data on lifetime pesticide use and history of doctor-diagnosed chronic bronchitis from 20,908 private pesticide applicators, primarily farmers.
RESULTS
A total of 654 farmers (3%) reported chronic bronchitis diagnosed after age 19. After adjustment for correlated pesticides as well as confounders, 11 pesticides were significantly associated with chronic bronchitis. Heptachlor use had the highest odds ratio (OR=1.50, 95% Confidence Interval (CI)=1.19, 1.89). Increased prevalence for chronic bronchitis was also seen for individuals who had a history of a high pesticide exposure event (OR=1.85, 95% CI=1.51, 2.25) and for those who also applied pesticides in off-farm jobs (OR=1.40, 95% CI=1.04, 1.88). Co-morbid asthma and current farm activities did not explain these results.
CONCLUSIONS
These results provide preliminary evidence that pesticide use may increase chronic bronchitis prevalence.
背景
农民患慢性支气管炎的风险增加。很少有研究者考虑过农药因素。
方法
我们利用农业健康研究的登记数据，评估农药作为慢性支气管炎风险因素的情况。这些数据来自20908名主要为农民的私人农药施用者，涉及他们一生的农药使用情况以及医生诊断的慢性支气管炎病史。
结果
共有654名农民（3%）报告在19岁以后被诊断患有慢性支气管炎。在对相关农药以及混杂因素进行调整后，有11种农药与慢性支气管炎显著相关。使用七氯的比值比最高（比值比=1.50，95%置信区间=1.19，1.89）。有农药高暴露事件史的个体（比值比=1.85，95%置信区间=1.51，2.25）以及在农场外工作中也施用农药的个体（比值比=1.40，95%置信区间=1.04，1.88），慢性支气管炎的患病率也有所增加。合并哮喘和当前的农场活动并不能解释这些结果。
结论
这些结果提供了初步证据，表明使用农药可能会增加慢性支气管炎的患病率。
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