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农业健康研究中癌症发病率与甲草胺使用情况:最新进展

Cancer incidence and metolachlor use in the Agricultural Health Study: An update.

作者信息

Silver Sharon R, Bertke Steven J, Hines Cynthia J, Alavanja Michael C R, Hoppin Jane A, Lubin Jay H, Rusiecki Jennifer A, Sandler Dale P, Beane Freeman Laura E

机构信息

Division of Surveillance, Hazard Evaluations and Field Studies, National Institute for Occupational Safety and Health, Cincinnati, OH.

Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD.

出版信息

Int J Cancer. 2015 Dec 1;137(11):2630-43. doi: 10.1002/ijc.29621. Epub 2015 Jun 25.

Abstract

Metolachlor, a widely used herbicide, is classified as a Group C carcinogen by the U.S. Environmental Protection Agency based on increased liver neoplasms in female rats. Epidemiologic studies of the health effects of metolachlor have been limited. The Agricultural Health Study (AHS) is a prospective cohort study including licensed private and commercial pesticide applicators in Iowa and North Carolina enrolled 1993-1997. We evaluated cancer incidence through 2010/2011 (NC/IA) for 49,616 applicators, 53% of whom reported ever using metolachlor. We used Poisson regression to evaluate relations between two metrics of metolachlor use (lifetime days, intensity-weighted lifetime days) and cancer incidence. We saw no association between metolachlor use and incidence of all cancers combined (n = 5,701 with a 5-year lag) or most site-specific cancers. For liver cancer, in analyses restricted to exposed workers, elevations observed at higher categories of use were not statistically significant. However, trends for both lifetime and intensity-weighted lifetime days of metolachor use were positive and statistically significant with an unexposed reference group. A similar pattern was observed for follicular cell lymphoma, but no other lymphoma subtypes. An earlier suggestion of increased lung cancer risk at high levels of metolachlor use in this cohort was not confirmed in this update. This suggestion of an association between metolachlor and liver cancer among pesticide applicators is a novel finding and echoes observation of increased liver neoplasms in some animal studies. However, our findings for both liver cancer and follicular cell lymphoma warrant follow-up to better differentiate effects of metolachlor use from other factors.

摘要

甲草胺是一种广泛使用的除草剂,基于雌性大鼠肝脏肿瘤增多,美国环境保护局将其归类为C组致癌物。关于甲草胺对健康影响的流行病学研究一直有限。农业健康研究(AHS)是一项前瞻性队列研究,纳入了1993年至1997年在爱荷华州和北卡罗来纳州获得许可的私人和商业农药施用者。我们评估了49616名施用者截至2010/2011年(北卡罗来纳州/爱荷华州)的癌症发病率,其中53%的人报告曾使用过甲草胺。我们使用泊松回归来评估甲草胺使用的两个指标(终生使用天数、强度加权终生使用天数)与癌症发病率之间的关系。我们未发现甲草胺使用与所有癌症合并发病率(n = 5701,有5年滞后)或大多数特定部位癌症之间存在关联。对于肝癌,在仅限于暴露工人的分析中,在较高使用类别中观察到的升高无统计学意义。然而,与未暴露的参照组相比,甲草胺使用的终生天数和强度加权终生天数的趋势均为阳性且具有统计学意义。滤泡性细胞淋巴瘤也观察到类似模式,但其他淋巴瘤亚型未观察到。该队列中早期提出的在高剂量甲草胺使用时肺癌风险增加的观点在本次更新中未得到证实。农药施用者中甲草胺与肝癌之间存在关联的这一观点是一项新发现,与一些动物研究中肝脏肿瘤增多的观察结果相呼应。然而,我们关于肝癌和滤泡性细胞淋巴瘤的研究结果都需要后续跟进,以更好地区分甲草胺使用的影响与其他因素。

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