Institute for Studies in Collective Health, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil.
Int J Hyg Environ Health. 2011 Mar;214(2):151-5. doi: 10.1016/j.ijheh.2010.11.002. Epub 2010 Dec 14.
Several studies suggest that agricultural workers are at higher risk to develop and die by certain types of cancer. Esophageal cancer is not commonly listed among these types. However, some recent studies indicated that if there is an association between agricultural working and esophageal cancer, it s more likely to be observed among workers highly exposed to pesticides. In the present study, the magnitude of the association between agricultural working and esophageal cancer mortality was evaluated in a high pesticide use area in Brazil, through a death certificate-based case-control study. Cases were individuals from both genders, 30-59 years old, for whom basic cause of death was ascertained as cancer of the esophagus. For each case, one control was randomly selected from all possible controls for which the basic cause of death was ascertained as different from neoplasm and diseases of the digestive system. In addition, controls matched their cases by sex, age, year of death, and state of residence. Crude and adjusted odds ratios were then calculated to estimate the magnitude of the risk. Results showed that, in general, agricultural workers were at significantly higher risk to die by esophageal cancer, when compared to non-agricultural workers. Stratified analysis also revealed that the magnitude of such risk was slightly higher among illiterate agricultural workers, and simultaneous adjustment for several covariates showed that the risk was quantitatively higher among younger southern agricultural workers. These results suggest the esophageal cancer may be included among those types of cancer etiologically associated to agricultural working.
几项研究表明，农业工人患某些类型癌症的风险更高，且死亡率也更高。食管癌通常并不包含在这些类型之中。然而，一些最近的研究表明，如果农业工作与食管癌之间存在关联，那么这种关联更可能发生在高度暴露于农药的工人中。在本研究中，通过基于死亡证明的病例对照研究，在巴西一个高农药使用地区评估了农业工作与食管癌死亡率之间的关联程度。病例是年龄在 30-59 岁之间的男女两性个体，其基本死因被确定为食管癌。对于每个病例，从所有可能的对照中随机选择一个对照，其基本死因被确定为非肿瘤和消化系统疾病。此外，对照与病例通过性别、年龄、死亡年份和居住地相匹配。然后计算了粗比值比和调整比值比，以估计风险的大小。结果表明，与非农业工人相比，农业工人总体上死于食管癌的风险显著更高。分层分析还表明，文化程度较低的农业工人的这种风险略高，同时调整了几个协变量后表明，年轻的南部农业工人的风险在数量上更高。这些结果表明，食管癌可能属于与农业工作有关的那些癌症类型。
