Zhang Ji, Yang Tubao
Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha 410078, China.
Department of Epidemiology and Health Statistics, School of Public Health, Central South University, Changsha 410078, China; Email:
Zhonghua Liu Xing Bing Xue Za Zhi. 2015 Sep;36(9):1005-9.
To evaluate the association between organophosphorus pesticides and aplastic anemia, and provide scientific evidence for the primary prevention of aplastic anemia.
The published papers of case control studies on the association between organophosphorus pesticides and aplastic anemia from January 1990 to August 2014 were collected from Chinese BioMedical Literature Base (CBM), Chinese National Knowledge Infrastructure (CNKI), PubMed and EMBASE. The papers which met the inclusion criteria were evaluated. The pooled odds ratios (OR) and 95% confidence interval (CI) of organophosphorus pesticides were calculated with software Review Manager 5.0. Subgroup analysis were conducted for different population and different usage of organophosphorus pesticides.
A total of 9 papers were selected, involving 5 833 subjects (1 404 cases and 4 429 controls). The results showed that organophosphorus pesticides could increase the risk of aplastic anemia (OR=1.97, 95% CI: 1.60-2.44) . Subgroup analysis showed that Asian (OR=2.01, 95% CI: 1.52-2.66) had higher risk of aplastic anemia than American or European (OR=1.93, 95% CI: 1.39-2.67) . Using pure organophosphorus pesticides (OR=2.15, 95% CI: 1.60-2.88) was more prone to cause aplastic anemia than using the mixture of organophosphorus pesticides (OR=1.82, 95% CI: 1.34-2.47).
The analysis indicated that organophosphorus pesticides might be a risk factor for aplastic anemia. Reducing organophosphorus pesticides exposure in daily life and industrial or agricultural production could prevent the incidence of aplastic anemia.
评估有机磷农药与再生障碍性贫血之间的关联，为再生障碍性贫血的一级预防提供科学依据。
从中国生物医学文献数据库（CBM）、中国知网（CNKI）、PubMed和EMBASE中收集1990年1月至2014年8月间发表的关于有机磷农药与再生障碍性贫血关联的病例对照研究论文。对符合纳入标准的论文进行评估。使用Review Manager 5.0软件计算有机磷农药的合并比值比（OR）和95%置信区间（CI）。对不同人群和有机磷农药不同使用情况进行亚组分析。
共筛选出9篇论文，涉及5833名受试者（1404例病例和4429名对照）。结果显示，有机磷农药会增加再生障碍性贫血的风险（OR = 1.97，95% CI：1.60 - 2.44）。亚组分析表明，亚洲人（OR = 2.01，95% CI：1.52 - 2.66）患再生障碍性贫血的风险高于美国或欧洲人（OR = 1.93，95% CI：1.39 - 2.67）。使用纯有机磷农药（OR = 2.15，95% CI：1.60 - 2.88）比使用有机磷农药混合物（OR = 1.82，95% CI：1.34 - 2.47）更易引发再生障碍性贫血。
分析表明，有机磷农药可能是再生障碍性贫血的一个危险因素。在日常生活以及工农业生产中减少有机磷农药暴露可预防再生障碍性贫血的发生。
