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中枢神经系统肿瘤与农业暴露在前瞻性队列 AGRICAN 中。

Central nervous system tumors and agricultural exposures in the prospective cohort AGRICAN.

机构信息

EPICENE team, ISPED, Unit U1219 INSERM, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.

Registre des tumeurs primitives du système nerveux central de la Gironde, ISPED, Centre INSERM U1219, Bordeaux Population Health Research Center, University of Bordeaux, Bordeaux, France.

出版信息

Int J Cancer. 2017 Nov 1;141(9):1771-1782. doi: 10.1002/ijc.30879. Epub 2017 Jul 24.

Abstract

Studies in farmers suggest a possible role of pesticides in the occurrence of Central Nervous System (CNS) tumors but scientific evidence is still insufficient. Using data from the French prospective agricultural cohort AGRICAN (Agriculture & Cancer), we investigated the associations between exposure of farmers and pesticide users to various kinds of crops and animal farming and the incidence of CNS tumors, overall and by subtypes. Over the 2005-2007, 181,842 participants completed the enrollment questionnaire that collected a complete job calendar with lifetime history of farming types. Associations were estimated using proportional hazards models with age as underlying timescale. During a 5.2 years average follow-up, 273 incident cases of CNS tumors occurred, including 126 gliomas and 87 meningiomas. Analyses showed several increased risks of CNS tumors in farmers, especially in pesticide users (hazard ratio = 1.96; 95% confidence interval: 1.11-3.47). Associations varied with tumor subtypes and kinds of crop and animal farming. The main increases in risk were observed for meningiomas in pig farmers and in farmers growing sunflowers, beets and potatoes and for gliomas in farmers growing grasslands. In most cases, more pronounced risk excesses were observed among pesticide applicators. Even if we cannot completely rule out the contribution of other factors, pesticide exposures could be of primary concern to explain these findings.

摘要

研究表明,农民接触农药可能与中枢神经系统(CNS)肿瘤的发生有关,但科学证据仍然不足。本研究利用法国前瞻性农业队列 AGRICAN(农业与癌症)的数据,调查了农民和农药使用者接触各种作物和动物养殖与 CNS 肿瘤(总体和亚型)发病风险之间的关联。在 2005-2007 年期间,有 181842 名参与者完成了入组问卷,该问卷收集了一份完整的职业日历,其中包含了一生的农业类型史。使用年龄作为潜在时间尺度的比例风险模型来估计关联。在平均 5.2 年的随访期间,发生了 273 例 CNS 肿瘤病例,包括 126 例胶质瘤和 87 例脑膜瘤。分析表明,农民尤其是农药使用者患 CNS 肿瘤的风险增加(风险比=1.96;95%置信区间:1.11-3.47)。关联因肿瘤亚型以及各种作物和动物养殖类型而异。在养猪农民和种植向日葵、甜菜和土豆的农民中,脑膜瘤的风险增加幅度最大,在种植草地的农民中,胶质瘤的风险增加幅度最大。在大多数情况下,农药施用者的风险超额更为明显。即使我们不能完全排除其他因素的贡献,农药暴露也可能是解释这些发现的主要关注点。

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