Case-cohort analysis of agricultural pesticide applications near maternal residence and selected causes of fetal death
Case-cohort analysis of agricultural pesticide applications near maternal residence and selected causes of fetal death
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DOI：
10.1093/aje/154.8.702
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发表时间：
2001-10-15
影响因子：
5
通讯作者：
Beaumont, JJ
中科院分区：
文献类型：
--
作者：
Bell, EM;Hertz-Picciotto, I;Beaumont, JJ
1984 年，在加利福尼亚州 10 个县对胎儿死亡与居住地靠近农业杀虫剂使用之间的潜在关联进行了调查。病例队列分析利用了除先天性异常之外的 319 例选定的胎儿死亡原因和 611 例非病例。全州范围内所有受限制农药应用的数据库与母亲地址相关联； 1 英里（1.6 公里）内的住宅邻近度提供了日常暴露的替代指标。农药按化学类别和乙酰胆碱酯酶抑制机制进行分组。使用时间相关暴露变量的多变量比例风险模型适合每个农药分组。总体而言，农药与胎儿死亡没有很强的关联。妊娠中期居住在使用卤代烃、氨基甲酸酯、雌激素农药和氨基甲酸酯乙酰胆碱酯酶抑制剂附近的女性的风险略有升高，风险比为 1.3（95% 置信区间 (CI)：1.0、1.8）、1.3（95% CI：1.0、1.8）、1.4（95% CI：0.8、分别为 2.5) 和 1.3 (95% CI: 1.0, 1.8)。在逐月分析中，当妊娠第 3 个月和第 4 个月接触氨基甲酸酯和氨基甲酸酯抑制剂以及妊娠第 4 个月和第 5 个月接触卤代烃时，观察到风险升高。由于以前的研究依赖于个人对接触的回忆，因此本研究的主要优点是环境农药接触评估的客观来源以及接触时间数据的使用。
The potential association between fetal death and residential proximity to agricultural pesticide applications was examined in 10 California counties for 1984. A case-cohort analysis utilized 319 cases of selected causes of fetal death other than congenital anomalies and 611 noncases. A statewide database of all applications of restricted pesticides was linked to maternal address; residential proximity within 1 mile (1.6 km) provided a surrogate for daily exposure. Pesticides were grouped by chemical class and mechanism of acetylcholinesterase inhibition. Multivariate proportional hazards models using time-dependent exposure variables were fit for each pesticide grouping. Overall, pesticides showed no strong association with fetal death. Slightly elevated risks were observed for women who resided near applications of halogenated hydrocarbons, carbamates, estrogenic pesticides, and carbamate acetylcholinesterase inhibitors during the second trimester, with hazard ratios of 1.3 (95% confidence interval (CI): 1.0, 1.8), 1.3 (95% CI: 1.0, 1.8), 1.4 (95% CI: 0.8, 2.5), and 1.3 (95% CI: 1.0, 1.8), respectively. In a month-by-month analysis, elevated risks were observed when exposure occurred during gestational months 3 and 4 for carbamates and carbamate inhibitors and during months 4 and 5 for halogenated hydrocarbons. Since previous studies have relied on personal recall of exposure, major strengths of this study were the objective source for environmental pesticide exposure assessment and the use of data on the timing of exposure.