Kaufman D W, Issaragrisil S, Anderson T, Chansung K, Thamprasit T, Sirijirachai J, Piankijagum A, Porapakkham Y, Vannasaeng S, Leaverton P E, Shapiro S, Young N S
Stone Epidemiology Unit, School of Public Health, Boston University School of Medicine, Brookline, MA, USA.
Int J Epidemiol. 1997 Jun;26(3):643-50. doi: 10.1093/ije/26.3.643.
Aplastic anaemia is a severe blood dyscrasia that is more common in Thailand than in Western countries. Its a etiology remains poorly understood.
A case-control study was conducted in Bangkok and two rural regions of Thailand. The effect of household pesticides was evaluated among 253 incident cases of aplastic anaemia and 1174 hospital controls.
A total of 54% of the cases and 61% of the controls were exposed 1-6 months previously. For most individual household pesticides and for groups classified according to chemical type (organophosphates, pyrethrins, and organochlorines), the relative risk (RR) estimates approximated 1.0; upper 95% confidence limits were below 2.0 for many comparisons. A significant association was observed for exposure to combination products containing dichlorvos and propoxur, with an overall RR estimate of 1.7 (95% confidence interval [CI]: 1.1-2.6); the estimate for regular use was 1.6 (95% CI: 0.9-2.9).
The absence of a higher risk for the regular use of dichlorvos/propoxur reduces the credibility of the apparent association, which could well have been an artefact of multiple comparisons. We conclude that most household pesticides used in Thailand do not appear to increase the risk of aplastic anaemia.
再生障碍性贫血是一种严重的血液系统疾病，在泰国比在西方国家更为常见。其病因仍知之甚少。
在泰国曼谷和两个农村地区进行了一项病例对照研究。在253例再生障碍性贫血新发病例和1174例医院对照中评估家用杀虫剂的影响。
共有54%的病例和61%的对照在1 - 6个月前接触过。对于大多数家用杀虫剂个体以及根据化学类型（有机磷、除虫菊酯和有机氯）分类的组，相对风险（RR）估计值接近1.0；许多比较的95%置信区间上限低于2.0。观察到接触含有敌敌畏和残杀威的组合产品有显著关联，总体RR估计值为1.7（95%置信区间[CI]：1.1 - 2.6）；经常使用的估计值为1.6（95% CI：0.9 - 2.9）。
经常使用敌敌畏/残杀威不存在更高风险降低了明显关联的可信度，这很可能是多次比较的假象。我们得出结论，泰国使用的大多数家用杀虫剂似乎不会增加再生障碍性贫血的风险。
