Chen Dazhe, Parks Christine G, Hofmann Jonathan N, Beane Freeman Laura E, Sandler Dale P
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, NC, USA.
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Rockville, MD, USA.
Environ Res. 2024 May 15;249:118464. doi: 10.1016/j.envres.2024.118464. Epub 2024 Feb 12.
Pesticide exposure has been linked to some autoimmune diseases and colorectal cancer, possibly via alteration of gut microbiota or other mechanisms. While pesticides have been linked to gut dysbiosis and inflammation in animal models, few epidemiologic studies have examined pesticides in relation to inflammatory bowel disease (IBD).
We evaluated use of pesticides and incident IBD in 68,480 eligible pesticide applicators and spouses enrolled in the Agricultural Health Study.
Self-reported IBD cases were identified from follow-up questionnaires between enrollment (1993-1997) and 2022. We evaluated IBD incidence in relation to self-reported ever use of 50 pesticides among applicators and spouses. We also explored associations with intensity-weighted lifetime days (IWLD) of pesticide use among male applicators. Covariate-adjusted hazard ratios (HR) and 95% confidence intervals (CI) were calculated using Cox regression.
We identified 454 IBD cases, including 227 among male applicators. In analyses with applicators and spouses combined, associations were positive (HR > 1.2) for ever vs. never use of five organochlorine insecticides, three organophosphate insecticides, one fungicide, and five herbicides. HRs were highest for dieldrin (HR = 1.59, 95%CI: 1.03, 2.44), toxaphene (HR = 1.61, 95%CI: 1.17, 2.21), parathion (HR = 1.42, 95%CI: 1.03, 1.95), and terbufos (HR = 1.53, 95%CI: 1.19, 1.96). We had limited power in many IWLD of pesticide use analyses and did not find clear evidence of exposure-response trends; however, we observed elevated HRs in all tertiles of IWLD use of terbufos compared to never use (T1 vs. never use HR = 1.52, 95%CI: 1.03, 2.24; T2 vs. never use HR = 1.53, 95%CI: 1.04, 2.26; T3 vs. never use HR = 1.51, 95%CI: 1.03, 2.23).
Exposure to specific pesticides was associated with elevated hazards of IBD. These findings may have public health importance given the widespread use of pesticides and the limited number of known modifiable environmental risk factors for IBD.
农药暴露可能通过改变肠道微生物群或其他机制与某些自身免疫性疾病和结直肠癌相关联。虽然在动物模型中农药已与肠道菌群失调和炎症相关，但很少有流行病学研究调查农药与炎症性肠病（IBD）的关系。
我们评估了参与农业健康研究的68480名符合条件的农药施用者及其配偶中农药的使用情况与IBD发病情况。
从入组（1993 - 1997年）至2022年的随访问卷中识别出自我报告的IBD病例。我们评估了施用者及其配偶中自我报告的曾使用50种农药与IBD发病率的关系。我们还探讨了男性施用者中农药使用的强度加权终生天数（IWLD）与IBD的关联。使用Cox回归计算协变量调整后的风险比（HR）和95%置信区间（CI）。
我们识别出454例IBD病例，其中男性施用者中有227例。在综合施用者及其配偶的分析中，曾使用与未使用五种有机氯杀虫剂、三种有机磷杀虫剂、一种杀菌剂和五种除草剂的关联为阳性（HR > 1.2）。狄氏剂（HR = 1.59，95%CI：1.03，2.44）、毒杀芬（HR = 1.61，95%CI：1.17，2.21）、对硫磷（HR = 1.42，95%CI：1.03，1.95）和特丁硫磷（HR = 1.53，95%CI：1.19，1.96）的HR最高。在许多农药使用的IWLD分析中我们的效能有限，未发现明确的暴露 - 反应趋势证据；然而，与从未使用相比，我们观察到在特丁硫磷IWLD使用的所有三分位数中HR均升高（T1与从未使用相比HR = 1.52，95%CI：1.03，2.24；T2与从未使用相比HR = 1.53，95%CI：1.04，2.26；T3与从未使用相比HR = 1.51，95%CI：1.03，2.23）。
接触特定农药与IBD风险升高相关。鉴于农药的广泛使用以及IBD已知的可改变环境风险因素数量有限，这些发现可能具有公共卫生重要性。
