Cancer Epidemiology Research Programme, Institut Català d'Oncologia (IDIBELL), L'Hospitalet de Llobregat, 08908 Barcelona, Spain.
Centro de Investigación Biomédica en Red: Epidemiología y Salud Pública (CIBERESP), 28001 Madrid, Spain.
Int J Environ Res Public Health. 2020 Jul 17;17(14):5174. doi: 10.3390/ijerph17145174.
We aimed to study the association between occupational exposure to pesticides and chronic lymphocytic leukemia (CLL) in Spain. Occupational exposure to pesticides (four insecticides, four herbicides and two fungicides) was evaluated using a job-exposure matrix for the Spanish population (MatEmESp) among 302 CLL cases and 1567 population controls in five regions of Spain, 2010-2013. Cumulative exposure scores (CES) were obtained by summing across the exposed jobs the product of prevalence, intensity and duration of exposure to each active substance. Principal components analysis (PCA) and logistic regression models adjusted for age, sex, region, education and occupational exposure to solvents were used. Around 20% of controls and 29% of cases were exposed to one or more pesticides. Compared to non-exposed, subjects in the highest tertile (3rd tertile) of CES of insecticides, herbicides, fungicides were more likely to have CLL [OR (95% CI), P-trend; 2.10 (1.38; 3.19), 0.002; 1.77 (1.12; 2.80), 0.12; and 1.67 (1.06; 2.64), 0.10, respectively). Following PCA, the first component (PC1, explaining 70% of the variation) equally led by seven active substances (the insecticide pyrethrin, all herbicides, all fungicides) was associated with a 26% higher odds of having CLL for 1-standard deviation increase in PC1 (95% CI: 1.14 to 1.40). These results confirm previous associations between CLL and exposure to pesticides and provide additional evidence by application groups and active substance. However, more research is needed to disentangle independent effects of individual active substances.
我们旨在研究西班牙职业性暴露于杀虫剂与慢性淋巴细胞白血病（CLL）之间的关联。在西班牙五个地区，于 2010 年至 2013 年，使用西班牙人群职业暴露矩阵（MatEmESp），在 302 例 CLL 病例和 1567 名人群对照中评估职业性暴露于杀虫剂（四种杀虫剂、四种除草剂和两种杀菌剂）。通过将暴露于每种活性物质的职业暴露的暴露工作的患病率、强度和持续时间相乘，获得累积暴露评分（CES）。使用主成分分析（PCA）和调整年龄、性别、地区、教育和职业性暴露于溶剂的 logistic 回归模型进行分析。约 20%的对照者和 29%的病例者暴露于一种或多种杀虫剂。与未暴露者相比，CES 杀虫剂、除草剂、杀菌剂最高 tertile（第三 tertile）的受试者更有可能患有 CLL[比值比（95%CI），P-趋势；2.10（1.38；3.19），0.002；1.77（1.12；2.80），0.12；1.67（1.06；2.64），0.10]。在 PCA 之后，第一个成分（PC1，解释 70%的变异）同样由七种活性物质（拟除虫菊酯杀虫剂、所有除草剂、所有杀菌剂）驱动，与 PC1 每增加一个标准差，CLL 的几率增加 26%（95%CI：1.14 至 1.40）。这些结果证实了先前 CLL 与暴露于杀虫剂之间的关联，并通过应用群体和活性物质提供了额外的证据。然而，需要更多的研究来厘清个别活性物质的独立影响。
