Baris D, Zahm S H, Cantor K P, Blair A
Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892-7364, USA.
Occup Environ Med. 1998 Aug;55(8):522-7. doi: 10.1136/oem.55.8.522.
The objective of this pooled analysis was to examine whether exposure to DDT was associated with the risk of non-Hodgkin's lymphoma among male farmers.
Data from three case-control studies from four midwestern states in the United States (Nebraska, Iowa, Minnesota, Kansas) were pooled to carry out analyses of 993 cases and 2918 controls. Information on use of agricultural pesticides and other risk factors was based on interviews. Non-farmers (people who had never lived or worked on a farm) were used as a reference category.
There were 161 cases and 340 controls who reported use of DDT on animals or crops, or on both, yielding an odds ratio (OR) of 1.2 (95% confidence intervals (95% CI) 1.0 to 1.6). Farmers who had used DDT for > or = 15 years had an OR of 1.5 (95% CI 1.0 to 2.3). Adjustment for respondent status and use of other pesticides resulted in slightly reduced ORs. Analyses by the number of days of use a year was limited to the Nebraska data. The most notable increase was found among farmers who used DDT for > or = 5 days a year (OR 2.6, 95% CI 1.1 to 5.9); however, additional adjustment for use of organophosphates, phenoxyacetic acids, and the individual pesticides lindane, malathion, and atrazine reduced the ORs to 1.0, 0.9, 1.1, 1.6, and 1.9 respectively.
No strong consistent evidence was found for an association between exposure to DDT and risk of non-Hodgkin's lymphoma. It seems that the excess risk initially found may be explained by use of other pesticides.
本汇总分析的目的是研究男性农民接触滴滴涕(DDT)是否与非霍奇金淋巴瘤风险相关。
汇总来自美国中西部四个州(内布拉斯加州、爱荷华州、明尼苏达州、堪萨斯州)三项病例对照研究的数据,对993例病例和2918例对照进行分析。关于农业杀虫剂使用情况及其他风险因素的信息基于访谈。非农民(从未在农场生活或工作过的人)作为参照类别。
有161例病例和340例对照报告在动物或作物上使用过DDT,或两者都使用过,比值比(OR)为1.2(95%置信区间[95%CI]为1.0至1.6)。使用DDT≥15年的农民OR为1.5(95%CI为1.0至2.3)。对受访者状态和其他杀虫剂使用情况进行调整后,OR略有降低。按每年使用天数进行的分析仅限于内布拉斯加州的数据。在每年使用DDT≥5天的农民中发现增幅最为显著(OR为2.6,95%CI为1.1至5.9);然而,对有机磷、苯氧基乙酸以及个别杀虫剂林丹、马拉硫磷和莠去津的使用情况进行进一步调整后,OR分别降至1.0、0.9、1.1、1.6和1.9。
未发现接触DDT与非霍奇金淋巴瘤风险之间存在强有力的一致证据。最初发现的额外风险似乎可以用其他杀虫剂的使用来解释。