Dennis Leslie K, Lynch Charles F, Sandler Dale P, Alavanja Michael C R
Department of Epidemiology, College of Public Health, University of Iowa, Iowa City, Iowa 52242, USA.
Environ Health Perspect. 2010 Jun;118(6):812-7. doi: 10.1289/ehp.0901518. Epub 2010 Feb 17.
Melanoma rates continue to increase; however, few risk factors other than sun sensitivity and ultraviolet radiation (including sun exposure) have been identified. Although studies of farmers have shown an excess risk of melanoma and other skin cancers, it is unclear how much of this is related to sun exposure compared with other agricultural exposures.
We examined dose-response relationships for 50 agricultural pesticides and cutaneous melanoma incidence in the Agricultural Health Study cohort of licensed pesticide applicators, along with ever use of older pesticides that contain arsenic. Logistic regression was used to examine odds ratios (ORs) and 95% confidence intervals (CIs) associated with pesticide exposure adjusted for age, sex, and other potential confounders.
We found significant associations between cutaneous melanoma and maneb/mancozeb (>or= 63 exposure days: OR = 2.4; 95% CI, 1.2-4.9; trend p = 0.006), parathion (>or= 56 exposure days: OR = 2.4; 95% CI, 1.3-4.4; trend p = 0.003), and carbaryl (>or= 56 exposure days: OR = 1.7; 95% CI, 1.1-2.5; trend p = 0.013). Other associations with benomyl and ever use of arsenical pesticides were also suggested.
Most previous melanoma literature has focused on host factors and sun exposure. Our research shows an association between several pesticides and melanoma, providing support for the hypotheses that agricultural chemicals may be another important source of melanoma risk.
黑色素瘤发病率持续上升；然而，除了对阳光敏感和紫外线辐射（包括日晒）外，几乎没有发现其他风险因素。尽管对农民的研究表明，他们患黑色素瘤和其他皮肤癌的风险更高，但与其他农业暴露相比，尚不清楚其中有多少与日晒有关。
我们在农业健康研究队列中，对有执照的农药施用者，研究了50种农业杀虫剂与皮肤黑色素瘤发病率之间的剂量反应关系，以及是否曾使用过含砷的旧农药。采用逻辑回归分析来检验经年龄、性别和其他潜在混杂因素调整后的与接触农药相关的优势比（OR）和95%置信区间（CI）。
我们发现皮肤黑色素瘤与代森锰锌（暴露天数≥63天：OR = 2.4；95% CI，1.2 - 4.9；趋势p = 0.006）、对硫磷（暴露天数≥56天：OR = 2.4；95% CI，1.3 - 4.4；趋势p = 0.003）和西维因（暴露天数≥56天：OR = 1.7；95% CI，1.1 - 2.5；趋势p = 0.013）之间存在显著关联。还提示了与苯菌灵和曾使用含砷农药的其他关联。
以往大多数关于黑色素瘤的文献都集中在宿主因素和日晒方面。我们的研究表明几种农药与黑色素瘤之间存在关联，为农业化学品可能是黑色素瘤风险的另一个重要来源这一假说提供了支持。
