National Institute for Occupational Safety and Health, Cincinnati, OH, USA.
Environ Health. 2012 Jun 12;11:39. doi: 10.1186/1476-069X-11-39.
An excess incidence of brain cancer in farmers has been noted in several studies. The National Institute for Occupational Safety and Health developed the Upper Midwest Health Study (UMHS) as a case-control study of intracranial gliomas and pesticide uses among rural residents. Previous studies of UMHS participants, using "ever-never" exposure to farm pesticides and analyzing men and women separately, found no positive association of farm pesticide exposure and glioma risks. The primary objective was to determine if quantitatively estimated exposure of pesticide applicators was associated with an increased risk of glioma in male and female participants.
The study included 798 histologically confirmed primary intracranial glioma cases (45 % with proxy respondents) and 1,175 population-based controls, all adult (age 18-80) non-metropolitan residents of Iowa, Michigan, Minnesota, and Wisconsin. The analyses used quantitatively estimated exposure from questionnaire responses evaluated by an experienced industrial hygienist with 25 years of work on farm pesticide analyses. Odds ratios (ORs) and 95 % confidence intervals (CIs) using unconditional logistic regression modeling were calculated adjusting for frequency-matching variables (10-year age group and sex), and for age and education (a surrogate for socioeconomic status). Analyses were separately conducted with or without proxy respondents.
No significant positive associations with glioma were observed with cumulative years or estimated lifetime cumulative exposure of farm pesticide use. There was, a significant inverse association for phenoxy pesticide used on the farm (OR 0.96 per 10 g-years of cumulative exposure, CI 0.93-0.99). No significant findings were observed when proxy respondents were excluded. Non-farm occupational applicators of any pesticide had decreased glioma risk: OR 0.72, CI 0.52-0.99. Similarly, house and garden pesticide applicators had a decreased risk of glioma: OR 0.79, CI 0.66-0.93, with statistically significant inverse associations for use of 2,4-D, arsenates, organophosphates, and phenoxys.
These results are consistent with our previous findings for UMHS of reported farm pesticide exposure and support a lack of positive association between pesticides and glioma.
几项研究表明，农民患脑瘤的发病率过高。美国国家职业安全与健康研究所开展了中西部健康研究（UMHS），对农村居民的颅内神经胶质瘤和农药使用情况进行了病例对照研究。之前对 UMHS 参与者的研究使用“从不-从无”的农场农药接触情况，并分别对男性和女性进行了分析，结果并未发现农场农药接触与神经胶质瘤风险之间存在正相关关系。本研究的主要目的是确定定量估计的农药施用者的接触是否与男性和女性参与者的胶质瘤风险增加有关。
该研究包括 798 例经组织学证实的原发性颅内神经胶质瘤病例（45%为代理应答者）和 1175 名基于人群的对照者，均为爱荷华州、密歇根州、明尼苏达州和威斯康星州的非大都市成年（18-80 岁）居民。分析使用由具有 25 年农场农药分析工作经验的资深工业卫生学家根据问卷回答进行定量估计的暴露情况。使用无条件逻辑回归模型计算比值比（OR）和 95%置信区间（CI），并进行了频数匹配变量（10 岁年龄组和性别）和年龄与教育（社会经济地位的替代指标）的调整。分析分别在有无代理应答者的情况下进行。
没有观察到累积年数或估计终生累积暴露于农场农药使用与神经胶质瘤之间存在显著的正相关关系。然而，农场中使用的苯氧酸类农药的累积暴露量每增加 10 克年，其风险呈显著下降趋势（OR 0.96，CI 0.93-0.99）。当排除代理应答者时，未发现显著的结果。非农场职业农药施用者的胶质瘤风险降低：OR 0.72，CI 0.52-0.99。同样，家庭和花园农药施用者的胶质瘤风险也降低：OR 0.79，CI 0.66-0.93，其中 2,4-D、砷酸盐、有机磷酸酯和苯氧酸的使用与风险呈显著负相关。
这些结果与我们之前对 UMHS 中报告的农场农药暴露情况的研究结果一致，支持农药与胶质瘤之间不存在正相关关系。
