INRA, UMR1089 Xénobiotiques, 180 Chemin de Tournefeuille, BP93173, F-31027 Toulouse Cedex 3, France.
Occup Environ Med. 2011 Sep;68(9):694-702. doi: 10.1136/oemed-2011-100082. Epub 2011 May 23.
The authors performed a meta-analysis of case-control and cohort studies to clarify the possible relationship between exposure to pesticides and childhood cancers.
Two cohort and 38 case-control studies were selected for the first meta-analysis. After evaluating homogeneity among studies using the Cochran Q test, the authors calculated a pooled meta-OR stratified on each cancer site. The authors then constructed a list of variables believed to play an important role in explaining the relation between parental exposure to pesticide and childhood cancer, and performed a series of meta-analyses. The authors also performed a distinct meta-analysis for three cohort studies with RR data.
Meta-analysis of the three cohort studies did not show any positive links between parental pesticide exposure and childhood cancer incidence. However, the meta-analysis of the 40 studies with OR values showed that the risk of lymphoma and leukaemia increased significantly in exposed children when their mother was exposed during the prenatal period (OR=1.53; 95% CI 1.22 to 1.91 and OR=1.48; 95% CI 1.26 to 1.75). The risk of brain cancer was correlated with paternal exposure either before or after birth (OR=1.49; 95% CI 1.23 to 1.79 and OR=1.66; 95% CI 1.11 to 2.49). The OR of leukaemia and lymphoma was higher when the mother was exposed to pesticides (through household use or professional exposure). Conversely, the incidence of brain cancer was influenced by the father's exposure (occupational activity or use of household or garden pesticides).
Despite some limitations in this study, the incidence of childhood cancer does appear to be associated with parental exposure during the prenatal period.
作者对病例对照和队列研究进行了荟萃分析，以阐明接触农药与儿童癌症之间可能存在的关系。
选择了两项队列研究和 38 项病例对照研究进行第一次荟萃分析。在使用 Cochran Q 检验评估研究之间的同质性后，作者按每个癌症部位对汇总荟萃 OR 进行了分层计算。作者随后列出了他们认为对解释父母接触农药与儿童癌症之间关系起着重要作用的变量，并进行了一系列荟萃分析。作者还对具有 RR 数据的三项队列研究进行了单独的荟萃分析。
对三项队列研究的荟萃分析并未显示父母接触农药与儿童癌症发病率之间存在任何正相关关系。然而，对具有 OR 值的 40 项研究的荟萃分析表明，当母亲在产前期间接触农药时，暴露儿童的淋巴瘤和白血病风险显著增加（OR=1.53；95%CI 1.22 至 1.91 和 OR=1.48；95%CI 1.26 至 1.75）。脑癌风险与父亲在出生前后的接触有关（OR=1.49；95%CI 1.23 至 1.79 和 OR=1.66；95%CI 1.11 至 2.49）。当母亲接触农药（通过家庭使用或职业接触）时，白血病和淋巴瘤的 OR 更高。相反，脑癌的发病率受到父亲接触（职业活动或家庭或花园农药使用）的影响。
尽管本研究存在一些局限性，但儿童癌症的发病率似乎确实与产前期间父母的接触有关。
