Am J Epidemiol. 2013 Oct 1;178(7):1051-8. doi: 10.1093/aje/kwt089. Epub 2013 Jul 12.
Pesticides are ubiquitous neurotoxicants, and several lines of evidence suggest that exposure may be associated with depression. Epidemiologic evidence has focused largely on organophosphate exposures, while research on other pesticides is limited. We collected detailed pesticide use history from farmers recruited in 1998-2000 in France. Among 567 farmers aged 37-78 years, 83 (14.6%) self-reported treatment or hospitalization for depression. On the basis of the reported age at the first such instance, we used adjusted Cox proportional hazards models to estimate hazard ratios and 95% confidence intervals for depression (first treatment or hospitalization) by exposure to different pesticides. The hazard ratio for depression among those who used herbicides was 1.93 (95% confidence interval (CI): 0.95, 3.91); there was no association with insecticides or fungicides. Compared with nonusers, those who used herbicides for <19 years and ≥19 years (median for all herbicide users, 19 years) had hazard ratios of 1.51 (95% CI: 0.62, 3.67) and 2.31 (95% CI: 1.05, 5.10), respectively. Similar results were found for total hours of use. Results were stronger when adjusted for insecticides and fungicides. There is widespread use of herbicides by the general public, although likely at lower levels than in agriculture. Thus, determining whether similar associations are seen at lower levels of exposure should be explored.
农药是普遍存在的神经毒素,有几条证据表明,接触农药可能与抑郁症有关。流行病学证据主要集中在有机磷农药的暴露上,而其他农药的研究则有限。我们从 1998 年至 2000 年在法国招募的农民中收集了详细的农药使用史。在 567 名年龄在 37 至 78 岁的农民中,有 83 人(14.6%)自述因抑郁接受治疗或住院治疗。根据首次出现这种情况的报告年龄,我们使用调整后的 Cox 比例风险模型,根据接触不同农药的情况,估计抑郁(首次治疗或住院)的风险比和 95%置信区间。使用除草剂的人患抑郁症的风险比为 1.93(95%置信区间:0.95,3.91);与杀虫剂或杀菌剂无关。与非使用者相比,使用除草剂<19 年和≥19 年(所有除草剂使用者的中位数为 19 年)的人的风险比分别为 1.51(95%置信区间:0.62,3.67)和 2.31(95%置信区间:1.05,5.10)。使用除草剂的总小时数也有类似的结果。在调整了杀虫剂和杀菌剂的影响后,结果更明显。尽管公众可能使用的除草剂水平低于农业,但除草剂的使用范围很广。因此,应该探讨在较低暴露水平下是否也存在类似的关联。