Shearer Joseph J, Sandler Dale P, Andreotti Gabriella, Murata Kazunori, Shrestha Srishti, Parks Christine G, Liu Danping, Alavanja Michael C, Landgren Ola, Beane Freeman Laura E, Hofmann Jonathan N
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle, NC, USA.
Environ Res. 2021 Aug;199:111276. doi: 10.1016/j.envres.2021.111276. Epub 2021 May 11.
Pesticides have been reported to be associated with malignant and non-malignant kidney disease. Few studies have examined the relationship between individual pesticides and kidney dysfunction.
We evaluated the associations of pesticide use with measured kidney function among male pesticide applicators in the Biomarkers of Exposure and Effect in Agriculture (BEEA) study, a subcohort in the Agricultural Health Study.
Serum creatinine was measured in 1545 BEEA participants and estimated glomerular filtration rate (eGFR) was calculated with the chronic kidney disease epidemiology collaboration (CKD-EPI) equation. Using reported information on lifetime use of 41 pesticides, multivariable linear and logistic regression was used to examine associations with eGFR modeled continuously and with CKD (eGFR <60 mL/min/1.73 m), respectively. Models were adjusted for possible confounding factors related to kidney function and correlated pesticides.
Lower eGFR was observed among pesticide applicators who ever used the herbicides pendimethalin (-3.7%, 95% confidence interval (CI): 5.8%, -1.5%), atrazine (-3.7%, 95% CI: 6.9%, -0.4%), and dicamba (-2.8%, 95% CI: 5.3%, -0.2%) compared with never users of each pesticide. Ever use of pendimethalin (odds ratio (OR)=1.6, 95% CI: 1.1, 2.2) and atrazine (OR=1.8, 95% CI: 1.0, 3.0) was also associated with elevated odds of CKD, with an exposure-response association between intensity-weighted lifetime days of pendimethalin use and CKD among active farmers (N=1302; p=0.04). Atrazine use within the last year was associated with lower eGFR and elevated odds of CKD when compared with never users, and we observed exposure-response associations with intensity-weighted lifetime days among recent users. Use of several other pesticides was associated with higher eGFR.
These results suggest that two widely used herbicides, pendimethalin and atrazine, may be associated with altered kidney function among pesticide applicators. Our findings for these herbicides are consistent with observed associations with end-stage renal disease in the Agricultural Health Study.
据报道，农药与恶性和非恶性肾脏疾病有关。很少有研究探讨单一农药与肾功能障碍之间的关系。
在农业健康研究的一个子队列——农业接触与效应生物标志物（BEEA）研究中，我们评估了男性农药施用者使用农药与测量的肾功能之间的关联。
对1545名BEEA参与者测量血清肌酐，并使用慢性肾脏病流行病学合作组（CKD-EPI）方程计算估计肾小球滤过率（eGFR）。利用报告的41种农药终身使用信息，分别采用多变量线性回归和逻辑回归分析与连续建模的eGFR以及慢性肾脏病（eGFR<60 mL/min/1.73 m²）的关联。模型针对与肾功能和相关农药有关的可能混杂因素进行了调整。
与从未使用过每种农药的人相比，曾经使用过除草剂二甲戊灵（-3.7%，95%置信区间（CI）：-5.8%，-1.5%）、莠去津（-3.7%，95%CI：-6.9%，-0.4%）和麦草畏（-2.8%，95%CI：-5.3%，-0.2%）的农药施用者的eGFR较低。曾经使用二甲戊灵（优势比（OR）=1.6，95%CI：1.1，2.2）和莠去津（OR=1.8，95%CI：1.0，3.0）也与慢性肾脏病的较高发病几率相关，在活跃农民（N=1302；p=0.04）中，二甲戊灵使用的强度加权终身天数与慢性肾脏病之间存在暴露-反应关联。与从未使用者相比，过去一年使用莠去津与较低的eGFR和较高的慢性肾脏病发病几率相关，并且我们在近期使用者中观察到了与强度加权终身天数的暴露-反应关联。使用其他几种农药与较高的eGFR相关。
这些结果表明，两种广泛使用的除草剂，二甲戊灵和莠去津，可能与农药施用者的肾功能改变有关。我们对这些除草剂的研究结果与农业健康研究中观察到的与终末期肾病的关联一致。
