Weisenburger D D
Department of Pathology and Microbiology, University of Nebraska Medical Center, Omaha 68198.
Am J Ind Med. 1990;18(3):303-5. doi: 10.1002/ajim.4700180310.
The incidence of non-Hodgkin's lymphoma (NHL) is increased in many counties in eastern Nebraska. Histologic analysis has revealed a twofold increase in the clinically aggressive, diffuse large cell subtype of NHL. To investigate the possible association between NHL and agricultural exposures, a population-based case-control study was conducted in eastern Nebraska in 1985. Telephone interviews were conducted with 201 men having histologically confirmed NHL and 725 controls. Among men, the use of the herbicide 2,4-D was associated with a 50% increased risk of NHL (OR 1.5, 95% CI 0.9, 2.4). Personal exposure to 2,4-D more than 20 days per year increased the risk threefold (OR 3.3, 95% CI 0.5, 22.1). Several classes of insecticides were also associated with increased risk: organophosphates (OR 1.9, 95% CI 1.1, 3.1), carbamates (OR 1.8, 95% CI 1.0, 3.2), and chlorinated hydrocarbons (OR 1.4, 95% CI 0.8, 2.3). As a result of intense agrichemical use, extensive contamination of shallow groundwater by nitrate and atrazine has also occurred in eastern Nebraska. A twofold increased incidence of NHL is present in counties with greater than 20% of the wells contaminated by nitrate (greater than 10 ppm) and in counties with intense fertilizer use. These findings suggest that NHL in eastern Nebraska may be related to the use of pesticides and nitrogen fertilizers.
内布拉斯加州东部许多县的非霍奇金淋巴瘤（NHL）发病率有所上升。组织学分析显示，临床上具有侵袭性的弥漫大细胞亚型NHL增加了两倍。为了调查NHL与农业接触之间可能存在的关联，1985年在内布拉斯加州东部开展了一项基于人群的病例对照研究。对201名经组织学确诊患有NHL的男性和725名对照者进行了电话访谈。在男性中，使用除草剂2,4 - D会使患NHL的风险增加50%（比值比1.5，95%置信区间0.9，2.4）。每年个人接触2,4 - D超过20天会使风险增加两倍（比值比3.3，95%置信区间0.5，22.1）。几类杀虫剂也与风险增加有关：有机磷类（比值比1.9，95%置信区间1.1，3.1）、氨基甲酸酯类（比值比1.8，95%置信区间1.0，3.2）和氯代烃类（比值比1.4，95%置信区间0.8，2.3）。由于大量使用农用化学品，内布拉斯加州东部浅层地下水也受到硝酸盐和莠去津的广泛污染。在硝酸盐污染（大于10 ppm）的水井比例超过20%的县以及大量使用化肥的县，NHL发病率增加了两倍。这些发现表明，内布拉斯加州东部的NHL可能与农药和氮肥的使用有关。
