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法国孕妇暴露于农药与儿童淋巴瘤风险的关系:ESCASE 和 ESTELLE 研究(SFCE)的汇总分析。

Maternal exposure to pesticides and risk of childhood lymphoma in France: A pooled analysis of the ESCALE and ESTELLE studies (SFCE).

机构信息

CRESS, Université de Paris, INSERM UMR-1153, Epidemiology of childhood and adolescent cancers team, Villejuif, France.

Department of Tumor Pediatrics, Institut Curie, Paris, France.

出版信息

Cancer Epidemiol. 2020 Oct;68:101797. doi: 10.1016/j.canep.2020.101797. Epub 2020 Sep 1.

DOI:10.1016/j.canep.2020.101797
PMID:32882568
Abstract

BACKGROUND

Few studies have assessed the relation between maternal prenatal pesticides use and childhood lymphoma risk, some reporting a positive association with non-Hodgkin lymphoma (NHL). We investigated the association between maternal exposure to pesticides during pregnancy and childhood Hodgkin (HL) and non-Hodgkin lymphoma.

METHODS

We pooled data from the two French national population-based case-control studies ESCALE (2003-2004) and ESTELLE (2010-2011). Data on domestic and occupational exposures to pesticides during pregnancy were obtained through standardised maternal interviews. Logistic regression models were used to compute odds ratios (OR) and 95% confidence intervals (CI) for HL and NHL, by pesticide category adjusted for potential confounders. Analyses by histological subtypes were also performed.

RESULTS

We included 328 H L, 305 non-Hodgkin NHL and 2,415 controls. Around 40% of control mothers reported having used pesticides during index pregnancy, of whom 95% reported insecticides use. Maternal use of herbicides and fungicides occurred mostly in combination with insecticides. Insecticides use was more frequently reported in cases than controls (OR = 1.6 [95%CI 1.3-2.1], p = 0.0001; OR = 1.3 [95%CI 1.0-1.7], p = 0.03). This association appeared more marked for Burkitt lymphoma and mixed cellularity classical HL. No obvious association was observed with occupational pesticides exposure during pregnancy.

CONCLUSION

These results suggest that maternal domestic use of insecticides during pregnancy might be related to both childhood NHL and HL. Further larger studies are urgently needed.

摘要

背景

很少有研究评估孕妇产前接触农药与儿童淋巴瘤风险之间的关系,一些研究报告称非霍奇金淋巴瘤(NHL)与这种风险呈正相关。我们调查了孕妇在怀孕期间接触农药与儿童霍奇金(HL)和非霍奇金淋巴瘤之间的关系。

方法

我们合并了两项法国全国性基于人群的病例对照研究 ESCALE(2003-2004 年)和 ESTELLE(2010-2011 年)的数据。通过标准化的母亲访谈获取了怀孕期间家庭和职业接触农药的数据。使用逻辑回归模型,按农药类别调整了潜在混杂因素后,计算了 HL 和 NHL 的比值比(OR)和 95%置信区间(CI)。还进行了组织学亚型的分析。

结果

我们纳入了 328 例 HL、305 例非霍奇金 NHL 和 2415 例对照。约 40%的对照母亲报告在指数妊娠期间使用过农药,其中 95%报告使用了杀虫剂。除草剂和杀菌剂的使用主要与杀虫剂结合使用。病例组比对照组更频繁地报告使用杀虫剂(OR=1.6 [95%CI 1.3-2.1],p=0.0001;OR=1.3 [95%CI 1.0-1.7],p=0.03)。这种关联在 Burkitt 淋巴瘤和混合细胞性经典 HL 中更为明显。怀孕期间职业性接触农药与这两种疾病均无明显关联。

结论

这些结果表明,孕妇在怀孕期间家庭中使用杀虫剂可能与儿童 NHL 和 HL 都有关。迫切需要进一步更大规模的研究。

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