Sorahan Tom
Institute of Occupational and Environmental Medicine, University of Birmingham, Edgbaston, Birmingham B15 2TT, UK.
Int J Environ Res Public Health. 2015 Jan 28;12(2):1548-59. doi: 10.3390/ijerph120201548.
A previous publication of 57,311 pesticide applicators enrolled in the US Agricultural Health Study (AHS) produced disparate findings in relation to multiple myeloma risks in the period 1993-2001 and ever-use of glyphosate (32 cases of multiple myeloma in the full dataset of 54,315 applicators without adjustment for other variables: rate ratio (RR) 1.1, 95% confidence interval (CI) 0.5 to 2.4; 22 cases of multiple myeloma in restricted dataset of 40,719 applicators with adjustment for other variables: RR 2.6, 95% CI 0.7 to 9.4). It seemed important to determine which result should be preferred. RRs for exposed and non-exposed subjects were calculated using Poisson regression; subjects with missing data were not excluded from the main analyses. Using the full dataset adjusted for age and gender the analysis produced a RR of 1.12 (95% CI 0.50 to 2.49) for ever-use of glyphosate. Additional adjustment for lifestyle factors and use of ten other pesticides had little effect (RR 1.24, 95% CI 0.52 to 2.94). There were no statistically significant trends for multiple myeloma risks in relation to reported cumulative days (or intensity weighted days) of glyphosate use. The doubling of risk reported previously arose from the use of an unrepresentative restricted dataset and analyses of the full dataset provides no convincing evidence in the AHS for a link between multiple myeloma risk and glyphosate use.
先前发表的一项研究纳入了参与美国农业健康研究(AHS)的57311名农药施用者,该研究得出了关于1993 - 2001年期间使用草甘膦与多发性骨髓瘤风险的不同结果(在未对其他变量进行调整的54315名施用者的完整数据集中有32例多发性骨髓瘤:率比(RR)为1.1,95%置信区间(CI)为0.5至2.4;在对其他变量进行调整的40719名施用者的受限数据集中有22例多发性骨髓瘤:RR为2.6,95%CI为0.7至9.4)。确定应优先选择哪个结果似乎很重要。使用泊松回归计算暴露组和非暴露组受试者的RR;主要分析中未排除有缺失数据的受试者。使用经年龄和性别调整的完整数据集,草甘膦曾经使用者的分析得出RR为1.12(95%CI为0.50至2.49)。对生活方式因素和其他十种农药的使用进行额外调整影响不大(RR为1.24,95%CI为0.52至2.94)。关于报告的草甘膦使用累积天数(或强度加权天数),多发性骨髓瘤风险没有统计学上的显著趋势。先前报告的风险加倍源于使用了一个不具代表性的受限数据集,对完整数据集的分析在AHS中没有提供令人信服的证据证明多发性骨髓瘤风险与草甘膦使用之间存在联系。