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职业性接触农药与中枢神经系统肿瘤:CERENAT 病例对照研究结果。

Occupational exposure to pesticides and central nervous system tumors: results from the CERENAT case-control study.

机构信息

Univ. Bordeaux, INSERM U1219, EPICENE Team, 146 rue Léo Saignat, 33076, Bordeaux, France.

Department of Occupational and Environmental Medicine, CHU Bordeaux, 33000, Bordeaux, France.

出版信息

Cancer Causes Control. 2021 Jul;32(7):773-782. doi: 10.1007/s10552-021-01429-x. Epub 2021 Apr 19.

Abstract

BACKGROUND

The etiology of the central nervous system (CNS) tumors remains largely unknown. The role of pesticide exposure has been suggested by several epidemiological studies, but with no definitive conclusion.

OBJECTIVE

To analyze associations between occupational pesticide exposure and primary CNS tumors in adults in the CERENAT study.

METHODS

CERENAT is a multicenter case-control study conducted in France in 2004-2006. Data about occupational pesticide uses-in and outside agriculture-were collected during detailed face-to-face interviews and reviewed by experts for consistency and exposure assignment. Odds ratios (ORs) and 95% confidence intervals (95% CI) were estimated with conditional logistic regression.

RESULTS

A total of 596 cases (273 gliomas, 218 meningiomas, 105 others) and 1 192 age- and sex-matched controls selected in the general population were analyzed. Direct and indirect exposures to pesticides in agriculture were respectively assigned to 125 (7.0%) and 629 (35.2%) individuals and exposure outside agriculture to 146 (8.2%) individuals. For overall agricultural exposure, we observed no increase in risk for all brain tumors (OR 1.04, 0.69-1.57) and a slight increase for gliomas (OR 1.37, 0.79-2.39). Risks for gliomas were higher when considering agricultural exposure for more than 10 years (OR 2.22, 0.94-5.24) and significantly trebled in open field agriculture (OR 3.58, 1.20-10.70). Increases in risk were also observed in non-agricultural exposures, especially in green space workers who were directly exposed (OR 1.89, 0.82-4.39), and these were statistically significant for those exposed for over 10 years (OR 2.84, 1.15-6.99).

DISCUSSION

These data support some previous findings regarding the potential role of occupational exposures to pesticides in CNS tumors, both inside and outside agriculture.

摘要

背景

中枢神经系统(CNS)肿瘤的病因在很大程度上仍不清楚。几项流行病学研究表明,农药接触可能与之有关,但尚无明确结论。

目的

分析 CERENAT 研究中成人职业性农药暴露与原发性 CNS 肿瘤之间的关联。

方法

CERENAT 是 2004-2006 年在法国进行的一项多中心病例对照研究。通过详细的面对面访谈收集职业性农药使用(包括农业内外)的数据,并由专家进行一致性和暴露评估。使用条件逻辑回归估计比值比(OR)和 95%置信区间(95%CI)。

结果

共分析了 596 例病例(273 例胶质瘤、218 例脑膜瘤、105 例其他肿瘤)和 1192 例年龄和性别匹配的一般人群对照。直接和间接接触农业用农药分别分配给 125(7.0%)和 629(35.2%)人,而接触农业外农药的有 146(8.2%)人。对于整体农业暴露,我们没有观察到所有脑肿瘤的风险增加(OR 1.04,0.69-1.57),而胶质瘤的风险略有增加(OR 1.37,0.79-2.39)。当考虑超过 10 年的农业暴露时,胶质瘤的风险更高(OR 2.22,0.94-5.24),而在露天农业中则显著增加了三倍(OR 3.58,1.20-10.70)。非农业暴露也观察到风险增加,特别是直接暴露于绿地工作的人(OR 1.89,0.82-4.39),并且这些在暴露超过 10 年的人中具有统计学意义(OR 2.84,1.15-6.99)。

讨论

这些数据支持了一些关于职业性农药暴露在 CNS 肿瘤中的潜在作用的先前发现,包括农业内外。

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