Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina.
Social & Scientific Systems, Inc., Durham, North Carolina.
Am J Epidemiol. 2018 Feb 1;187(2):214-223. doi: 10.1093/aje/kwx224.
Farming and pesticide exposure may influence risk of rheumatoid arthritis (RA); the role of early-life pesticide exposure is unknown. The Sister Study includes a US national cohort of women aged 35-74 years (enrolled 2004-2009); we examined childhood pesticide exposure in women in this cohort with adult-onset RA. Cases (n = 424) were compared with 48,919 noncases. Data included pesticide use at the longest childhood residence through age 14 years, farm residence of at least 12 months with agricultural pesticide exposure through age 18 years, and maternal farm experience. Odds ratios and 95% confidence intervals were adjusted for age, race or ethnicity, education, smoking, and childhood socioeconomic factors. Cases with RA reported more frequent and direct (personal) residential pesticide use in childhood (for infrequent/indirect pesticide use, odds ratio (OR) = 1.1; for frequent/direct use, OR = 1.8; P for trend = 0.013). Compared with women without residential farm history, odds of having RA increased for those reporting a childhood-only farm residence with personal exposure to pesticides used on crops (OR = 1.8, 95% confidence interval: 1.1, 2.9) or livestock (OR = 2.0, 95% confidence interval: 1.2, 3.3). Our findings suggest adult-onset RA may be related to childhood exposure to residential and agricultural pesticides, and support further investigations of lifetime pesticide use in RA.
农业和农药暴露可能会影响类风湿关节炎（RA）的风险；幼年时农药暴露的作用尚不清楚。姐妹研究包括一个美国全国队列的年龄在 35-74 岁的女性（2004-2009 年招募）；我们研究了该队列中成年发病的 RA 女性的幼年农药暴露情况。病例（n=424）与 48919 名非病例进行了比较。数据包括童年时期在最长居住地址的农药使用情况，在 18 岁之前在农场居住至少 12 个月且有农业农药暴露情况，以及母亲的农场经历。比值比和 95%置信区间根据年龄、种族或民族、教育、吸烟和儿童社会经济因素进行了调整。报告 RA 的病例在童年时期更频繁地直接（个人）使用住宅农药（对于不频繁/间接使用农药，比值比（OR）=1.1；对于频繁/直接使用农药，OR=1.8；P 趋势=0.013）。与没有住宅农场史的女性相比，报告仅在童年时期有农场居住且个人接触到用于作物（OR=1.8，95%置信区间：1.1，2.9）或牲畜（OR=2.0，95%置信区间：1.2，3.3）的农药的女性，患 RA 的几率增加。我们的研究结果表明，成年发病的 RA 可能与幼年时期住宅和农业农药暴露有关，并支持进一步研究 RA 患者的终生农药使用情况。
