Department of Health Science, College of Life Sciences, Brigham Young University, Provo, Utah, USA.
Environ Health Perspect. 2011 Nov;119(11):1610-5. doi: 10.1289/ehp.1103413. Epub 2011 Jul 13.
An association may exist between pesticide exposure and suicide.
We sought to evaluate the existence of an association between pesticide use and suicide using data from the Agricultural Health Study (AHS), a prospective cohort study of licensed pesticide applicators and their spouses in Iowa and North Carolina.
Via linkage to state mortality files and the National Death Index, we identified 110 suicides occurring between enrollment in the AHS (from 1993 to 1997) and 31 May 2009, among 81,998 cohort members contributing 1,092,943 person-years of follow-up. The average length of follow-up was 13.3 years. AHS participants provided data on pesticide use and potential confounders via self-administered questionnaires at enrollment. We evaluated several measures of pesticide use: use of any pesticide, ever use of 50 specific pesticides, cumulative lifetime days of use and intensity-adjusted cumulative lifetime days of use of 22 specific pesticides, and ever use of 10 functional and chemical classes of pesticides. We used Cox proportional hazards regression models to estimate adjusted hazard ratios and 95% confidence intervals.
After adjusting for age at enrollment, sex, number of children in family, frequency of alcohol consumption during the past 12 months, and smoking status, we found no association between prior pesticide use and suicide in applicators and their spouses. Results were the same for applicators and spouses together or for applicators alone and were consistent across several measures of pesticide use.
Our findings do not support an association between moderate pesticide use and suicide.
农药暴露与自杀之间可能存在关联。
我们试图利用爱荷华州和北卡罗来纳州的农药施用者及其配偶参加的前瞻性队列研究——农业健康研究(AHS)的数据来评估农药使用与自杀之间的关联。
通过与州死亡档案和国家死亡索引的链接,我们在 AHS 注册(1993 年至 1997 年)和 2009 年 5 月 31 日之间确定了 110 例自杀事件,这些自杀事件发生在 81998 名队列成员中,他们提供了 1092943 人年的随访。平均随访时间为 13.3 年。AHS 参与者通过注册时的自我管理问卷提供了农药使用和潜在混杂因素的数据。我们评估了几种农药使用的衡量标准:使用任何农药、曾经使用过 50 种特定农药、累计终生使用天数和 22 种特定农药的强度调整后的终生使用天数、曾经使用过 10 种功能和化学类别的农药。我们使用 Cox 比例风险回归模型来估计调整后的危险比和 95%置信区间。
在校正了登记时的年龄、性别、家庭中的孩子数量、过去 12 个月的饮酒频率和吸烟状况后,我们发现施用者及其配偶过去的农药使用与自杀之间没有关联。施用者及其配偶的结果相同,或者仅施用者的结果也相同,这与几种农药使用的衡量标准一致。
我们的研究结果不支持中度农药使用与自杀之间的关联。