Parent Marie-Elise, Désy Marie, Siemiatycki Jack
Epidemiology and Biostatistics Unit, INRS-Institut Armand-Frappier, 531, Boul. des Prairies, Laval, Quebec, Canada.
Mcgill J Med. 2009 Jan;12(1):70-7.
Several studies suggest that farmers may be at increased risk of prostate cancer. The present analysis, based on a large population-based case-control study conducted among men in the Montreal area in the early 1980's, aim at identifying occupational chemicals which may be responsible for such increases. The original study enrolled 449 prostate cancer cases, nearly 4,000 patients with other cancers, as well as 533 population controls. Subjects were interviewed about their occupation histories, and a team of industrial hygienists assigned their past exposures using a checklist of some 300 chemicals. The present analysis was restricted to a study base of men who had worked as farmers earlier in their lives. There were a total of 49 men with prostate cancers, 127 with other cancers and 56 population controls. We created a pool of 183 controls combining the patients with cancers at sites other than the prostate and the population controls. We then estimated the odds ratio for prostate cancer associated with exposure to each of 10 agricultural chemicals, i.e., pesticides, arsenic compounds, acetic acid, gasoline engine emissions, diesel engine emissions, polycyclic aromatic hydrocarbons from petroleum, lubricating oils and greases, alkanes with >or=18 carbons, solvents, and mononuclear aromatic hydrocarbons. Based on a model adjusting for age, ethnicity, education, and respondent status, there was evidence of a two-fold excess risk of prostate cancer among farmers with substantial exposure to pesticides [odds ratio (OR)=2.3, 95% confidence interval (CI) 1.1-5.1], as compared to unexposed farmers. There was some suggestion, based on few subjects, of increased risks among farmers ever exposed to diesel engine emissions (OR=5.7, 95% CI 1.2-26.5). The results for pesticides are particularly noteworthy in the light of findings from previous studies. Suggestions of trends for elevated risks were noted with other agricultural chemicals, but these are largely novel and need further confirmation in larger samples.
多项研究表明,农民患前列腺癌的风险可能更高。本分析基于20世纪80年代初在蒙特利尔地区男性中进行的一项大型基于人群的病例对照研究,旨在确定可能导致这种风险增加的职业化学物质。原研究纳入了449例前列腺癌病例、近4000例其他癌症患者以及533名人群对照。研究对象接受了职业史访谈,一组工业卫生学家使用约300种化学物质的清单来确定他们过去的接触情况。本分析仅限于那些早年曾从事过农民工作的男性研究样本。共有49例前列腺癌患者、127例其他癌症患者和56名人群对照。我们将前列腺以外部位患癌的患者和人群对照合并,组成了一个包含183名对照的样本池。然后,我们估计了与10种农业化学物质(即农药、砷化合物、乙酸、汽油发动机排放物、柴油发动机排放物、石油中的多环芳烃、润滑油和润滑脂、含18个或更多碳原子的烷烃、溶剂和单环芳烃)接触相关的前列腺癌比值比。基于一个对年龄、种族、教育程度和受访者状态进行调整的模型,有证据表明,与未接触农药的农民相比,大量接触农药的农民患前列腺癌的风险高出两倍[比值比(OR)=2.3,95%置信区间(CI)1.1 - 5.1]。基于少量研究对象,有迹象表明曾接触柴油发动机排放物的农民患癌风险增加(OR = 5.7,95% CI 1.2 - 26.5)。鉴于先前研究的结果,农药的研究结果尤其值得关注。对于其他农业化学物质,也注意到了风险升高趋势的迹象,但这些大多是新发现,需要在更大样本中进一步证实。