Home pesticide exposures and risk of childhood leukemia: Findings from the childhood leukemia international consortium
Home pesticide exposures and risk of childhood leukemia: Findings from the childhood leukemia international consortium
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DOI：
10.1002/ijc.29631
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发表时间：
2015-12-01
影响因子：
6.4
通讯作者：
Schuez, Joachim
中科院分区：
文献类型：
--
作者：
Bailey, Helen D.;Infante-Rivard, Claire;Schuez, Joachim
之前的一些研究表明，出生前和儿童早期接触家庭农药可能会增加儿童患白血病的风险。为了进一步研究这一点，我们汇集了儿童白血病国际联盟 12 项病例对照研究的个体水平数据。曝光数据已统一为兼容的格式。使用多变量非条件逻辑回归进行汇总分析。与受孕前不久、怀孕期间和出生后任何农药接触相关的急性淋巴细胞白血病 (ALL) 的比值比 (OR) 分别为 1.39（95% 置信区间 [CI]：1.25, 1.55）（使用 2,785 例病例和 3,635 名对照）、1.43（95% CI：1.32, 1.54）（5,055 例病例和 1.54 例）。 7,370 名对照）和 1.36（95% CI：1.23，1.51）（4,162 例病例和 5,179 名对照）。急性髓系白血病 (AML) 风险的相应 OR 分别为 1.49（95% CI：1.02、2.16）（173 例病例和 1,789 名对照）、1.55（95% CI：1.21、1.99）（344 例病例和 4,666 名对照）和 1.08（95% CI：0.76， 1.53）（198 例病例和 2,655 例对照）。所用农药类型差异不大。白血病类型、时间段和农药类型之间 OR 的相对相似性可以通过 ALL 和 AML 中不同时间段的相似暴露模式和影响、参与者接触多种农药或回忆偏差来解释。尽管可能存在一些回忆偏差，但在找到更好的研究设计来调查同等大样本中家庭杀虫剂使用与儿童白血病之间的关联之前，在怀孕前、怀孕期间以及儿童期限制家庭杀虫剂的使用似乎是谨慎的做法。
Some previous studies have suggested that home pesticide exposure before birth and during a child's early years may increase the risk of childhood leukemia. To further investigate this, we pooled individual level data from 12 case-control studies in the Childhood Leukemia International Consortium. Exposure data were harmonized into compatible formats. Pooled analyses were undertaken using multivariable unconditional logistic regression. The odds ratio (ORs) for acute lymphoblastic leukemia (ALL) associated with any pesticide exposure shortly before conception, during pregnancy and after birth were 1.39 (95% confidence interval [CI]: 1.25, 1.55) (using 2,785 cases and 3,635 controls), 1.43 (95% CI: 1.32, 1.54) (5,055 cases and 7,370 controls) and 1.36 (95% CI: 1.23, 1.51) (4,162 cases and 5,179 controls), respectively. Corresponding ORs for risk of acute myeloid leukemia (AML) were 1.49 (95% CI: 1.02, 2.16) (173 cases and 1,789 controls), 1.55 (95% CI: 1.21, 1.99) (344 cases and 4,666 controls) and 1.08 (95% CI: 0.76, 1.53) (198 cases and 2,655 controls), respectively. There was little difference by type of pesticide used. The relative similarity in ORs between leukemia types, time periods and pesticide types may be explained by similar exposure patterns and effects across the time periods in ALL and AML, participants' exposure to multiple pesticides, or recall bias. Although some recall bias is likely, until a better study design can be found to investigate the associations between home pesticide use and childhood leukemia in an equally large sample, it would appear prudent to limit the use of home pesticides before and during pregnancy, and during childhood.