Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
University of Nebraska Medical Center, Omaha, NE, USA.
Environ Int. 2018 Sep;118:282-292. doi: 10.1016/j.envint.2018.05.041. Epub 2018 Jun 13.
Little is known about modifiable risk factors for thyroid disease. Several pesticides have been implicated in thyroid disruption, but clinical implications are not clear.
We assessed associations between pesticide use and other farm exposures and incident hypothyroidism and hyperthyroidism in female spouses of farmers in the Agricultural Health Study (AHS).
We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals for risk of thyroid disease in 24,092 spouses who completed at least one follow-up questionnaire.
We identified 1627 hypothyroid and 531 hyperthyroid cases over 20 years of follow-up. The fungicides benomyl, maneb/mancozeb, and metalaxyl, the herbicide pendimethalin, and among those over 60 years of age the insecticides parathion and permethrin (applied to crops) were associated with elevated hypothyroidism risk, with HR ranging from 1.56-2.44. Conversely, the insecticide phorate, and the herbicides imazethapyr and metolachlor were associated with decreased risk (HR ranging 0.63-0.73), as were long-term farm residence and other farm-related activities (HR ranging 0.69-0.84). For hyperthyroidism, the insecticide diazinon, the fungicides maneb/mancozeb, and the herbicide metolachlor were associated with increased risk (HR ranging 1.35-2.01) and the herbicide trifluralin with decreased risk (HR: 0.57).
Several individual pesticides were associated with increased risk of hypothyroidism and hyperthyroidism, although some pesticides were associated with decreased risk. Some of the findings, specifically associations with fungicides, are consistent with results from an earlier analysis of prevalent diseases in AHS spouses.
人们对甲状腺疾病的可改变风险因素知之甚少。一些农药已被认为与甲状腺功能紊乱有关，但临床意义尚不清楚。
我们评估了女性配偶在农业健康研究（AHS）中使用农药和其他农场接触与甲状腺功能减退症和甲状腺功能亢进症的发病风险之间的关系。
我们使用 Cox 比例风险模型来估计至少完成一次随访问卷调查的 24092 名配偶中甲状腺疾病的风险比（HR）和 95%置信区间。
在 20 年的随访中，我们共发现了 1627 例甲状腺功能减退症和 531 例甲状腺功能亢进症病例。杀菌剂苯菌灵、代森锰锌和金属axyl，除草剂地乐酚，以及 60 岁以上的杀虫剂对硫磷和氯菊酯与甲状腺功能减退症风险升高相关，HR 范围为 1.56-2.44。相反，杀虫剂甲拌磷，除草剂咪唑乙烟酸和甲草氯与降低风险相关（HR 范围 0.63-0.73），长期农场居住和其他与农场相关的活动也是如此（HR 范围 0.69-0.84）。对于甲状腺功能亢进症，杀虫剂二嗪磷、杀菌剂代森锰锌和除草剂甲草氯与风险增加相关（HR 范围 1.35-2.01），而除草剂氟乐灵与风险降低相关（HR：0.57）。
几种单独的农药与甲状腺功能减退症和甲状腺功能亢进症的风险增加有关，尽管有些农药与风险降低有关。一些发现，特别是与杀菌剂的关联，与 AHS 配偶中早期分析的流行疾病结果一致。
