Hu Liqin, Luo Dan, Zhou Tingting, Tao Yun, Feng Jingwen, Mei Surong
Key Laboratory of Environment and Health, Ministry of Education, Ministry of Environmental Protection, State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China.
Key Laboratory of Environment and Health, Ministry of Education, Ministry of Environmental Protection, State Key Laboratory of Environment Health (Incubation), School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, #13 Hangkong Road, Wuhan, Hubei, 430030, China.
Environ Pollut. 2017 Dec;231(Pt 1):319-328. doi: 10.1016/j.envpol.2017.08.028. Epub 2017 Aug 12.
Several epidemiological studies show the association between organophosphate pesticides (OPs) and the risk of non-Hodgkin lymphoma (NHL), yet various research results remain controversial. To explore the hazard of OPs exposure to human health, three kinds of OPs (Terbufos, Malathion, and Diazinon) that are non-halogenated aliphatic compounds were included in the meta-analysis. We searched PubMed and Web of Science Databases for articles published from 1985 to February 2017. The databases were also searched for eligible studies through a manual references search. The random-effect model was utilized to compute the odds ratios (ORs) and 95% confident intervals (CIs). A total of ten observational studies (five cohort, four case-control, and one nested case-control) were included in our meta-analysis, with a pooled OR of 1.22 (95% CI 1.04 to 1.43) of Malathion, Terbufos and Diazinion. The general heterogeneity for OR was moderate (P = 0.032, I = 41.2%). The OR estimates in the subset analyses were utilized to compare the association between the three kinds of OPs and NHL; Terbufos (OR = 1.07, 95% CI 0.85 to 1.36) and Malathion (OR = 1.17, 95% CI 0.82 to 1.67) had a statistically non-significant relationship, whereas Diazinon (OR = 1.39, 95% CI 1.11 to 1.73) was significantly associated with an increased NHL risk. Because immune dysfunction was thought to increase NHL risk, the toxicity levels in the immune system of the three types of OPs were compared. Malathion attacked immune cells via a direct effect and Diazinon disrupted the neuro-immune system, which involves the cholinergic system of lymphocytes via indirect immune damage, whereas an immunotoxic effect involving Terbufos was not reported. Overall, the present meta-analysis indicated a statistically significant association between Diazinon exposure and NHL risk.
多项流行病学研究表明有机磷农药（OPs）与非霍奇金淋巴瘤（NHL）风险之间存在关联，但各种研究结果仍存在争议。为探究OPs暴露对人体健康的危害，本荟萃分析纳入了三种非卤代脂肪族化合物的OPs（特丁硫磷、马拉硫磷和二嗪农）。我们在PubMed和科学网数据库中检索了1985年至2017年2月发表的文章。还通过手动参考文献检索在数据库中查找符合条件的研究。采用随机效应模型计算比值比（ORs）和95%置信区间（CIs）。我们的荟萃分析共纳入了十项观察性研究（五项队列研究、四项病例对照研究和一项巢式病例对照研究），马拉硫磷、特丁硫磷和二嗪农的合并OR为1.22（95%CI为1.04至1.43）。OR的总体异质性为中度（P = 0.032，I = 41.2%）。亚组分析中的OR估计值用于比较三种OPs与NHL之间的关联；特丁硫磷（OR = 1.07，95%CI为0.85至1.36）和马拉硫磷（OR = 1.17，95%CI为0.82至1.67）的关系在统计学上无显著意义，而二嗪农（OR = 1.39，95%CI为1.11至1.73）与NHL风险增加显著相关。由于免疫功能障碍被认为会增加NHL风险，因此比较了这三种OPs在免疫系统中的毒性水平。马拉硫磷通过直接作用攻击免疫细胞，二嗪农通过间接免疫损伤破坏神经免疫系统，这涉及淋巴细胞的胆碱能系统，而未报告特丁硫磷有免疫毒性作用。总体而言，本荟萃分析表明二嗪农暴露与NHL风险之间存在统计学上的显著关联。
