University of Nebraska Medical Center, Nebraska Medical Center, Omaha, NE68198-3020, USA.
Am J Epidemiol. 2010 Feb 15;171(4):455-64. doi: 10.1093/aje/kwp404. Epub 2010 Jan 8.
Thyroid disease is common, and evidence of an association between organochlorine exposure and thyroid disease is increasing. The authors examined the cross-sectional association between ever use of organochlorines and risk of hypothyroidism and hyperthyroidism among female spouses (n = 16,529) in Iowa and North Carolina enrolled in the Agricultural Health Study in 1993-1997. They also assessed risk of thyroid disease in relation to ever use of herbicides, insecticides, fungicides, and fumigants. Prevalence of self-reported clinically diagnosed thyroid disease was 12.5%, and prevalence of hypothyroidism and hyperthyroidism was 6.9% and 2.1%, respectively. There was an increased odds of hypothyroidism with ever use of organochlorine insecticides (adjusted odds ratio (OR(adj)) = 1.2 (95% confidence interval (CI): 1.0, 1.6) and fungicides (OR(adj) = 1.4 (95% CI: 1.1, 1.8) but no association with ever use of herbicides, fumigants, organophosphates, pyrethroids, or carbamates. Specifically, ever use of the organochlorine chlordane (OR(adj) = 1.3 (95% CI: 0.99, 1.7), the fungicides benomyl (OR(adj) = 3.1 (95% CI: 1.9, 5.1) and maneb/mancozeb (OR(adj) = 2.2 (95% CI: 1.5, 3.3), and the herbicide paraquat (OR(adj) = 1.8 (95% CI: 1.1, 2.8) was significantly associated with hypothyroidism. Maneb/mancozeb was the only pesticide associated with both hyperthyroidism (OR(adj) = 2.3 (95% CI: 1.2, 4.4) and hypothyroidism. These data support a role of organochlorines, in addition to fungicides, in the etiology of thyroid disease among female spouses enrolled in the Agricultural Health Study.
甲状腺疾病很常见,有机氯暴露与甲状腺疾病之间关联的证据也在不断增加。作者在 1993-1997 年期间,对爱荷华州和北卡罗来纳州参加农业健康研究的女性配偶(n=16529)进行了横断面研究,以检验有机氯使用与甲状腺功能减退症和甲状腺功能亢进症风险之间的关系。他们还评估了与除草剂、杀虫剂、杀真菌剂和熏蒸剂的使用有关的甲状腺疾病风险。自我报告的临床诊断甲状腺疾病的患病率为 12.5%,甲状腺功能减退症和甲状腺功能亢进症的患病率分别为 6.9%和 2.1%。曾使用有机氯杀虫剂(调整后的比值比(OR(adj))=1.2(95%置信区间(CI):1.0,1.6)和杀真菌剂(OR(adj))=1.4(95%CI:1.1,1.8)与甲状腺功能减退症的发生风险增加有关,但与除草剂、熏蒸剂、有机磷、拟除虫菊酯或氨基甲酸酯的使用无关。具体而言,曾使用有机氯氯丹(OR(adj))=1.3(95%CI:0.99,1.7)、杀菌剂苯菌灵(OR(adj))=3.1(95%CI:1.9,5.1)和代森锰锌(OR(adj))=2.2(95%CI:1.5,3.3)以及除草剂百草枯(OR(adj))=1.8(95%CI:1.1,2.8)与甲状腺功能减退症显著相关。代森锰锌是唯一与甲状腺功能亢进症(OR(adj))=2.3(95%CI:1.2,4.4)和甲状腺功能减退症均相关的农药。这些数据支持有机氯类化合物除了杀真菌剂以外,在农业健康研究中招募的女性配偶的甲状腺疾病病因学中起作用。