Gunier Robert B, Kang Alice, Hammond S Katharine, Reinier Kyndaron, Lea C Suzanne, Chang Jeffrey S, Does Monique, Scelo Ghislaine, Kirsch Janice, Crouse Vonda, Cooper Robert, Quinlan Patricia, Metayer Catherine
School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
School of Public Health, University of California, Berkeley, Berkeley, CA, USA.
Environ Res. 2017 Jul;156:57-62. doi: 10.1016/j.envres.2017.03.001. Epub 2017 Mar 19.
Associations between parental occupational pesticide exposure and childhood acute lymphoblastic leukemia (ALL) vary across studies, likely due to different exposure assessment methodologies.
We assessed parental occupational pesticide exposure from the year before pregnancy to the child's third year of life for 669 children diagnosed with ALL and 1021 controls. We conducted expert rating using task-based job modules (JM) to estimate exposure to pesticides among farmer workers, gardeners, agricultural packers, and pesticide applicators. We compared this method to (1) partial JM using job titles and a brief description, but without completing the task-based questionnaire, and (2) job exposure matrix (JEM) linking job titles to the International Standard Classifications of Occupation Codes. We used unconditional logistic regression to calculate odds ratios (OR) and 95% confidence intervals (95% CI) for ALL cancer risk and pesticide exposure adjusting for child's sex, age, race/ethnicity and household income.
Compared to complete JMs, partial JMs and JEM led to 3.1% and 9.4% of parents with pesticide exposure misclassified, respectively. Misclassification was similar in cases and controls. Using complete JMs, we observed an increased risk of ALL for paternal occupational exposure to any pesticides (OR=1.7; 95% CI=1.2, 2.5), with higher risks reported for pesticides to treat nut crops (OR=4.5; 95% CI=0.9, 23.0), and for children diagnosed before five years of age (OR=2.3; 95% CI: 1.3, 4.1). Exposure misclassification from JEM attenuated these associations by about 57%. Maternal occupational pesticide exposure before and after birth was not associated with ALL.
The risk of ALL was elevated in young children with paternal occupational pesticide exposure during the perinatal period, using more detailed occupational information for exposure classification.
不同研究中，父母职业性接触农药与儿童急性淋巴细胞白血病（ALL）之间的关联存在差异，这可能是由于接触评估方法不同所致。
我们评估了669名被诊断为ALL的儿童以及1021名对照儿童从孕前一年到其3岁期间父母的职业性接触农药情况。我们使用基于任务的工作模块（JM）进行专家评级，以估计农民、园艺工人、农产品包装工人和农药施用者接触农药的情况。我们将这种方法与（1）使用职位名称和简要描述但未完成基于任务的问卷的部分JM，以及（2）将职位名称与国际职业分类代码相联系的工作接触矩阵（JEM）进行了比较。我们使用无条件逻辑回归来计算ALL癌症风险和农药接触的比值比（OR）及95%置信区间（95%CI），同时对儿童的性别、年龄、种族/民族和家庭收入进行了校正。
与完整的JM相比，部分JM和JEM分别导致3.1%和9.4%的接触农药的父母被错误分类。病例组和对照组中的错误分类情况相似。使用完整的JM，我们观察到父亲职业性接触任何农药会使ALL风险增加（OR = 1.7；95%CI = 1.2, 2.5），其中用于处理坚果作物的农药风险更高（OR = 4.5；95%CI = 0.9, 23.0），对于5岁前被诊断的儿童风险也更高（OR = 2.3；95%CI：1.3, 4.1）。JEM导致的接触错误分类使这些关联减弱了约57%。母亲在产前和产后的职业性接触农药与ALL无关。
使用更详细的职业信息进行接触分类时，围产期父亲职业性接触农药的幼儿患ALL的风险升高。
