Department of Pediatrics, Division of Neonatal and Developmental Medicine, Stanford University, 1265 Welch Road, Room X111, Stanford, CA 94305-5415.
Pediatrics. 2013 Nov;132(5):e1216-26. doi: 10.1542/peds.2013-1429. Epub 2013 Oct 28.
Experimental evidence suggests pesticides may be associated with hypospadias.
Examine the association of hypospadias with residential proximity to commercial agricultural pesticide applications.
The study population included male infants born from 1991 to 2004 to mothers residing in 8 California counties. Cases (n = 690) were ascertained by the California Birth Defects Monitoring Program; controls were selected randomly from the birth population (n = 2195). We determined early pregnancy exposure to pesticide applications within a 500-m radius of mother's residential address, using detailed data on applications and land use. Associations with exposures to physicochemical groups of pesticides and specific chemicals were assessed using logistic regression adjusted for maternal race or ethnicity and age and infant birth year.
Forty-one percent of cases and controls were classified as exposed to 57 chemical groups and 292 chemicals. Despite >500 statistical comparisons, there were few elevated odds ratios with confidence intervals that excluded 1 for chemical groups or specific chemicals. Those that did were for monochlorophenoxy acid or ester herbicides; the insecticides aldicarb, dimethoate, phorate, and petroleum oils; and adjuvant polyoxyethylene sorbitol among all cases; 2,6-dinitroaniline herbicides, the herbicide oxyfluorfen, and the fungicide copper sulfate among mild cases; and chloroacetanilide herbicides, polyalkyloxy compounds used as adjuvants, the insecticides aldicarb and acephate, and the adjuvant nonyl-phenoxy-poly(ethylene oxy)ethanol among moderate and severe cases. Odds ratios ranged from 1.9 to 2.9.
Most pesticides were not associated with elevated hypospadias risk. For the few that were associated, results should be interpreted with caution until replicated in other study populations.
实验证据表明,农药可能与尿道下裂有关。
研究尿道下裂与居住环境临近商业农业农药应用的关系。
研究人群包括 1991 年至 2004 年期间出生于加利福尼亚州 8 个县的男性婴儿。病例(n=690)通过加利福尼亚州出生缺陷监测计划确定;对照(n=2195)从出生人群中随机选择。我们使用有关应用和土地利用的详细数据,确定了母亲居住地址 500 米半径范围内的早期妊娠暴露于农药应用的情况。使用逻辑回归评估了暴露于农药理化组和特定化学物质的相关性,调整了母亲的种族或民族和年龄以及婴儿出生年份。
41%的病例和对照者被归类为接触了 57 种化学物质组和 292 种化学物质。尽管进行了 500 多次统计比较,但置信区间排除 1 的化学物质组或特定化学物质的比值比很少升高。其中包括单氯苯氧基酸或酯类除草剂;杀虫剂涕灭威、乐果、磷和石油油;以及所有病例中的助剂聚氧乙烯山梨醇;2,6-二硝苯胺除草剂、除草剂氟氧氟草醚和杀菌剂硫酸铜;轻度病例中的除草剂草甘膦;以及中度和重度病例中的氯代乙酰胺类除草剂、用作助剂的多烷氧基化合物、杀虫剂涕灭威和乙酰甲胺磷以及助剂壬基酚聚氧乙烯(n-)乙醇。比值比范围为 1.9 至 2.9。
大多数农药与尿道下裂风险升高无关。对于少数相关的农药,结果应谨慎解释,直到在其他研究人群中得到复制。