Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA; Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Environ Res. 2013 Oct;126:31-42. doi: 10.1016/j.envres.2013.06.001. Epub 2013 Aug 2.
Depression in women is a public health problem. Studies have reported positive associations between pesticides and depression, but few studies were prospective or presented results for women separately.
We evaluated associations between pesticide exposure and incident depression among farmers' wives in the Agricultural Health Study, a prospective cohort study in Iowa and North Carolina.
We used data on 16,893 wives who did not report physician-diagnosed depression at enrollment (1993-1997) and who completed a follow-up telephone interview (2005-2010). Among these wives, 1054 reported physician diagnoses of depression at follow-up. We collected information on potential confounders and on ever use of any pesticide, 11 functional and chemical classes of pesticides, and 50 specific pesticides by wives and their husbands via self-administered questionnaires at enrollment. We used inverse probability weighting to adjust for potential confounders and to account for possible selection bias induced by the death or loss of 10,639 wives during follow-up. We used log-binomial regression models to estimate risk ratios and 95% confidence intervals.
After weighting for age at enrollment, state of residence, education level, diabetes diagnosis, and drop out, wives' incident depression was positively associated with diagnosed pesticide poisoning, but was not associated with ever using any pesticide. Use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' depression. Among wives who never used pesticides, husbands' ever use of individual pesticides or functional or chemical classes of pesticides was generally not associated with wives' incident depression.
Our study adds further evidence that high level pesticide exposure, such as pesticide poisoning, is associated with increased risk of depression and sets a lower bound on the level of exposure related to depression, thereby providing reassurance that the moderate levels of pesticide exposure experienced by farmers' wives likely do not increase risk.
女性抑郁症是一个公共卫生问题。研究报告称，杀虫剂与抑郁症之间存在正相关关系，但很少有前瞻性研究或分别针对女性的研究报告结果。
我们评估了在爱荷华州和北卡罗来纳州进行的一项前瞻性队列研究——农业健康研究中，农药暴露与农妇新发抑郁症之间的关系。
我们使用了 16893 名在入组时未报告医生诊断为抑郁症（1993-1997 年）且完成了随访电话访谈（2005-2010 年）的农妇的数据。在这些农妇中，有 1054 人在随访时报告了医生诊断为抑郁症。我们通过自填问卷收集了潜在混杂因素以及妻子和丈夫使用任何农药、11 种功能和化学类农药和 50 种特定农药的信息。我们使用逆概率加权来调整潜在混杂因素，并考虑到随访期间 10639 名农妇死亡或失联造成的选择偏倚。我们使用对数二项式回归模型来估计风险比和 95%置信区间。
在加权考虑入组时的年龄、居住州、教育程度、糖尿病诊断和失访后，妻子新发抑郁症与诊断性农药中毒呈正相关，但与使用任何农药无关。使用个别农药或功能或化学类农药与妻子的抑郁症无关。在从未使用过农药的妻子中，丈夫使用个别农药或功能或化学类农药与妻子新发抑郁症无关。
我们的研究进一步证明，高水平的农药暴露，如农药中毒，与抑郁症风险增加相关，并为与抑郁症相关的暴露水平设定了下限，从而保证了农妇所经历的中等水平的农药暴露不太可能增加风险。
