Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA.
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
Environ Health Perspect. 2021 Jul;129(7):77005. doi: 10.1289/EHP7797. Epub 2021 Jul 28.
Some pesticides are immunotoxic and have been associated with an increased risk of immune-mediated diseases. The risk of shingles, the clinical reactivation of varicella-zoster virus, increases with aging and immunosuppression; little is known about its associations with pesticides.
We examined the use of agricultural pesticides in relation to incident shingles in a prospective cohort of licensed pesticide applicators.
The study sample included 12,820 (97% male) farmers (enrolled in 1993-1997 in North Carolina and Iowa), who were followed for a median of 12 y (interquartile range: 11-13). Shingles was self-reported at enrollment and at follow-up. We evaluated ever-use of 48 agricultural pesticides reported at study enrollment in relation to shingles risk and considered exposure-response for intensity-weighted lifetime days (IWLDs) of use. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models, adjusting for state, and allowing estimates to vary by median attained age (60 y).
Incident shingles was reported by 590 participants. Associations were positive () for ever- vs. never-use of eight insecticides, three fumigants, two fungicides, and five herbicides, and exposure-response trends were seen across increasing quartiles (Q3 and ) or tertiles (T3 and ) of IWLDs for four insecticides [permethrin (crops), coumaphos, malathion, and lindane], two fumigants (carbon tetrachloride/carbon disulfide and methyl bromide), and three herbicides [alachlor, trifluralin () and 2,4-dichlorophenoxyacetic acid]. Shingles was not associated with total years or days per year mixed or applied any pesticides, but in older participants, shingles was associated with a history of a high pesticide exposure event [ (95% CI: 1.45, 2.45)].
Several specific pesticides were associated with increased risk of shingles in farmers, especially at higher levels of cumulative use. These novel findings, if replicated in other populations, could have broader implications for the potential effects of pesticides on vaccine efficacy and susceptibility to other infections. https://doi.org/10.1289/EHP7797.
一些农药具有免疫毒性，并与免疫介导性疾病的风险增加有关。带状疱疹（水痘-带状疱疹病毒的临床再激活）的风险随着年龄的增长和免疫抑制而增加；但关于其与农药的关联知之甚少。
我们在北卡罗来纳州和爱荷华州的一项前瞻性农药施用者队列中，研究了农业农药的使用与带状疱疹发病的关系。
研究样本包括 12820 名（97%为男性）农民（1993-1997 年入组），中位随访时间为 12 年（四分位距：11-13 年）。入组时和随访时报告带状疱疹。我们评估了研究入组时报告的 48 种农业农药的既往使用情况与带状疱疹风险的关系，并考虑了强度加权终生天数（IWLDs）的暴露-反应关系。使用 Cox 比例风险模型计算风险比（HRs）和 95%置信区间（CIs），调整州别，并允许估计值随中位数达到年龄（60 岁）而变化。
590 名参与者报告了带状疱疹发病。与从不使用相比，八种杀虫剂、三种熏蒸剂、两种杀真菌剂和五种除草剂的既往使用与带状疱疹发病呈正相关（），并且在四个杀虫剂（拟除虫菊酯（作物）、考马斯磷、马拉硫磷和林丹）、两种熏蒸剂（四氯化碳/二硫化碳和甲基溴）和三种除草剂（甲草胺、氟乐灵（）和 2,4-二氯苯氧乙酸）的 IWLDs 四分位数（Q3 和）或三分位数（T3 和）升高时，均观察到暴露-反应趋势。与每年混合或施用任何农药的总年限或天数无关，但在年龄较大的参与者中，带状疱疹发病与高农药暴露事件史有关[（95%CI：1.45，2.45）]。
在农民中，几种特定的农药与带状疱疹发病风险增加有关，尤其是在累积使用水平较高时。这些新发现，如果在其他人群中得到复制，可能会对农药对疫苗效力和对其他感染易感性的潜在影响产生更广泛的影响。
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