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职业性农药暴露与男性农药施用者亚临床甲状腺功能减退症。

Occupational pesticide exposure and subclinical hypothyroidism among male pesticide applicators.

机构信息

Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA.

Environmental Working Group, Washington, DC, USA.

出版信息

Occup Environ Med. 2018 Feb;75(2):79-89. doi: 10.1136/oemed-2017-104431. Epub 2017 Aug 3.

Abstract

OBJECTIVES

Animal studies suggest that exposure to pesticides may alter thyroid function; however, few epidemiologic studies have examined this association. We evaluated the relationship between individual pesticides and thyroid function in 679 men enrolled in a substudy of the Agricultural Health Study, a cohort of licensed pesticide applicators.

METHODS

Self-reported lifetime pesticide use was obtained at cohort enrolment (1993-1997). Intensity-weighted lifetime days were computed for 33 pesticides, which adjusts cumulative days of pesticide use for factors that modify exposure (eg, use of personal protective equipment). Thyroid-stimulating hormone (TSH), thyroxine (T4), triiodothyronine (T3) and antithyroid peroxidase (anti-TPO) autoantibodies were measured in serum collected in 2010-2013. We used multivariate logistic regression to estimate ORs and 95% CIs for subclinical hypothyroidism (TSH >4.5 mIU/L) compared with normal TSH (0.4-4.5 mIU/L) and for anti-TPO positivity. We also examined pesticide associations with TSH, T4 and T3 in multivariate linear regression models.

RESULTS

Higher exposure to the insecticide aldrin (third and fourth quartiles of intensity-weighted days vs no exposure) was positively associated with subclinical hypothyroidism (OR=4.15, 95% CI 1.56 to 11.01, OR=4.76, 95% CI 1.53 to 14.82, p <0.01), higher TSH (p=0.01) and lower T4 (p=0.04). Higher exposure to the herbicide pendimethalin was associated with subclinical hypothyroidism (fourth quartile vs no exposure: OR=2.78, 95% CI 1.30 to 5.95, p=0.02), higher TSH (p=0.04) and anti-TPO positivity (p=0.01). The fumigant methyl bromide was inversely associated with TSH (p=0.02) and positively associated with T4 (p=0.01).

CONCLUSIONS

Our results suggest that long-term exposure to aldrin, pendimethalin and methyl bromide may alter thyroid function among male pesticide applicators.

摘要

目的

动物研究表明,接触农药可能会改变甲状腺功能;然而,很少有流行病学研究对此关联进行了研究。我们评估了 679 名参加农业健康研究子研究的男性中,个人农药暴露与甲状腺功能之间的关系,该研究是一个持牌农药施用者队列。

方法

在队列登记时(1993-1997 年)获得了终生农药使用情况的自我报告。为 33 种农药计算了强度加权终生天数,该天数调整了累积的农药使用天数,以适应暴露因素(例如,使用个人防护设备)。2010-2013 年采集血清,测量促甲状腺激素(TSH)、甲状腺素(T4)、三碘甲状腺原氨酸(T3)和抗甲状腺过氧化物酶(anti-TPO)自身抗体。我们使用多变量逻辑回归来估计亚临床甲状腺功能减退症(TSH>4.5mIU/L)与正常 TSH(0.4-4.5mIU/L)和抗 TPO 阳性的比值比(OR)和 95%置信区间(CI)。我们还在多变量线性回归模型中检查了农药与 TSH、T4 和 T3 的关系。

结果

更高的杀虫剂 aldrin(强度加权天数的第三和第四四分位数与无暴露相比)暴露与亚临床甲状腺功能减退症(OR=4.15,95%CI 1.56 至 11.01,OR=4.76,95%CI 1.53 至 14.82,p<0.01)、更高的 TSH(p=0.01)和更低的 T4(p=0.04)相关。更高的除草剂 pendimethalin 暴露与亚临床甲状腺功能减退症(第四四分位数与无暴露相比:OR=2.78,95%CI 1.30 至 5.95,p=0.02)、更高的 TSH(p=0.04)和抗 TPO 阳性(p=0.01)相关。熏蒸剂甲基溴与 TSH(p=0.02)呈负相关,与 T4(p=0.01)呈正相关。

结论

我们的结果表明,男性农药施用者长期接触 aldrin、pendimethalin 和甲基溴可能会改变甲状腺功能。

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