INSERM, UMR 1086 ANTICIPE, Caen, France.
Centre de Lutte Contre le Cancer François Baclesse, Caen, France.
Occup Environ Med. 2018 Nov;75(11):776-785. doi: 10.1136/oemed-2017-104976. Epub 2018 Sep 5.
Farmers are considered at lower risk of lung cancer. However, specific tasks can expose them to hazardous air contaminants such as pesticides, diesel exhaust and mineral dust. This study aimed to assess the associations between various crops and related tasks and the risk of lung cancer, overall and by histological subtypes.
AGRIculture and CANcer is a prospective French cohort of individuals affiliated to the agricultural health insurance scheme. Incident lung cancers (n=897) were identified by cancer registries from enrolment (2005-2007) to 2013. Data on crop and livestock exposure during lifetime were obtained from the enrolment questionnaire. We used a Cox model with attained age as timescale, adjusted for gender, smoking history and exposure to cattle and horses. Effects of duration and surface were assessed and analyses stratified on gender and smoking status were performed.
Winegrowers were at higher risk of adenocarcinoma (HR=1.27 (95% CI 0.94 to 1.72)). We also found an association between pea growing and small cell lung cancer: significant effect of duration (p=0.04) and the suggestion of a surface-effect relationship (p=0.06); increased risk (HR=2.38 (95% CI 1.07 to 5.28)) for pesticide users; and significant effect of duration (p=0.01) for harvesters. The risk of squamous cell carcinoma was increased for sunflower growing (HR=1.59 (95% CI 0.97 to 2.62), fruit-tree pruning (HR=1.44 (95% CI 0.92 to 2.27)) and pesticide use on beets (HR=1.47 (95% CI 0.92 to 2.34)). Corn and/or wheat/barley growers were at lower risk of lung cancer.
Our results suggest associations between lung cancer and several crop-related tasks, even if we cannot rule out some chance findings due to multiple comparisons.
农民患肺癌的风险较低。然而，特定的工作任务可能会使他们接触到危险的空气污染物，如农药、柴油废气和矿物粉尘。本研究旨在评估各种作物及其相关工作与肺癌总体风险以及组织学亚型风险之间的关系。
AGRIculture and CANcer 是一项前瞻性法国队列研究，研究对象为参加农业健康保险计划的个体。通过癌症登记系统，从入组（2005-2007 年）到 2013 年，共确定了 897 例新发肺癌病例。通过入组问卷，获得了一生中与作物和牲畜接触的相关数据。我们使用 Cox 模型，以实际年龄为时间尺度，调整了性别、吸烟史以及与牛和马的接触情况。评估了暴露时间和暴露面积的影响，并根据性别和吸烟状况进行了分层分析。
葡萄种植者患腺癌的风险较高（HR=1.27（95%CI 0.94 至 1.72））。我们还发现豌豆种植与小细胞肺癌之间存在关联：暴露时间存在显著影响（p=0.04），且提示存在暴露面积效应关系（p=0.06）；农药使用者患小细胞肺癌的风险增加（HR=2.38（95%CI 1.07 至 5.28））；收割者的暴露时间存在显著影响（p=0.01）。种植向日葵（HR=1.59（95%CI 0.97 至 2.62））、修剪果树（HR=1.44（95%CI 0.92 至 2.27））和甜菜上使用农药（HR=1.47（95%CI 0.92 至 2.34））与患鳞状细胞癌的风险增加有关。种植玉米和/或小麦/大麦的人患肺癌的风险较低。
我们的研究结果表明，肺癌与某些与作物相关的工作任务之间存在关联，尽管由于多次比较，我们不能排除一些偶然发现的可能性。
