Pesticide Use & Breast Cancer Risk in Large Cohort of Female Agriculture Workers

农药使用

• 批准号: 7872901
• 负责人: JAYA M SATAGOPAN
• 金额: $ 9.48万
• 依托单位: SLOAN-KETTERING INST CAN RESEARCH
• 依托单位国家: 美国
• 财政年份: 2009
• 资助国家: 美国
• 起止时间: 2009-07-01 至 2013-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7872901
• 关键词: Accounting; Address; Agricultural Workers; Agriculture; Animal Model; Animals; Area; Benefits and Risks; Breast; Breast Cancer Risk Factor; Cancer Etiology; Carcinogens; Chemicals; Chlorinated Hydrocarbons; Clothing; Cohort Studies; Communities; Consumption; Cox Proportional Hazards Models; Data; Decision Making; Development; Diagnostic; Diet; Enrollment; Epidemiologic Studies; Etiology; Exhibits; Exposure to; Farming environment; Female; General Population; Goals; Health; Home environment; Human; Husband; In Vitro; Individual; Interview; Knowledge; Life Style; Link; Malignant - descriptor; Malignant Neoplasms; Mammary Neoplasms; Mammary gland; Menopausal Status; Nature; Occupational; Occupations; Participant; Pesticides; Physical activity; Policy Maker; Population; Property; Public Health; Public Policy; Recording of previous events; Relative Risks; Reporting; Reproductive History; Research; Risk; Role; Route; Sample Size; Source; Spouses; Testing; Time; Water; Wife; Woman; Work; abstracting; base; cancer risk; cohort; cost; disease diagnosis; epidemiologic data; farmer; follow-up; male; malignant breast neoplasm; neoplasm registry; organochlorine pesticide; pesticide exposure; population based; prospective; public health relevance; residence

DESCRIPTION (provided by applicant): ABSTRACT The possible role of pesticides in the etiology of breast cancer remains largely unresolved and continues to be a cause of serious concern in the general public. This is due in part to important limitations and/or the narrow focus of previous epidemiologic studies. The long-term goal of the proposed study is to identify the cancer risks associated with individual pesticides in order to better inform public policy and individual decision-making. The objective of this application is to identify any elevated risk of breast cancer associated with individual pesticides among a cohort of highly exposed women, specifically spouses in the NIH-administered Agricultural Health Study cohort, a well-characterized, prospective, multi-state cohort that includes approximately 51,000 male farmers and 32,000 wives. This is an excellent population in which to address this objective because of its large size, high rate of follow-up, and availability of detailed pesticide use, occupational, demographic, lifestyle, physical activity, dietary, and reproductive history information collected from both the farmers and their wives at enrollment in the mid-1990s and again in a 5-year follow-up interview. Importantly, several of the most commonly used pesticides in this cohort are or were widely used by the general public. The central hypothesis is that pesticides implicated as mammary carcinogens in animals or in vitro or previously linked to breast cancer in epidemiologic studies will be associated with breast cancer risk in such a highly exposed population of women. This hypothesis will be tested via two specific aims: 1) Identify any increased risk of malignant breast cancer associated with use of specific pesticides; and 2) Identify any increased risk of malignant breast cancer related to sources of non-specific pesticide exposure often found in agricultural communities. Under the first aim, breast cancer risk will be examined in relation to use of individual pesticides. Use by the woman and her husband will be considered separately to account for differences in the nature and extent of resulting exposure. Under the second aim, breast cancer risk will be investigated in relation to factors that increase opportunity for exposure to pesticides generally, including consumption of potentially contaminated well water, washing of clothes worn during pesticide application, and storage of pesticides in or near the home. Analyses will be based on the 31,531 women with no history of cancer at enrollment, with an estimated 805 incident cases of breast cancer identified through 2006 via population-based cancer registries. Relative risks will be estimated using data from both interviews (pre-diagnostic only), via Cox proportional hazards models including the full cohort, as well as separately by menopausal status and state of residence. Potential confounders, including demographic, lifestyle, dietary, and reproductive factors, will be accounted for. The proposed study offers an unusual opportunity to investigate, in a cost- and time-efficient manner, the effects of individual pesticides on breast cancer risk. This research is significant because it is expected to advance our understanding of the role of individual pesticides in the etiology of breast cancer and to do so in a methodologically rigorous manner not previously possible. PUBLIC HEALTH RELEVANCE: PROJECT NARRATIVE This area of research has potentially important public health implications, given the ubiquity of exposure to pesticides through diet, occupation, residential use, and other routes. Animal studies and very limited epidemiologic research suggest that certain commonly used pesticides may be risk factors for breast cancer. However, this risk in humans remains unknown or highly uncertain. The proposed study will help address these important gaps in our knowledge and help to inform the debate among policy makers and individuals concerning the risks and benefits of these chemicals.

描述（由申请人提供）： 摘要农药在乳腺癌病因学中的可能作用在很大程度上仍未得到解决，并继续成为公众严重关注的原因。这部分是由于重要的局限性和/或以前的流行病学研究的焦点狭窄。拟议研究的长期目标是确定与个别农药相关的癌症风险，以便更好地为公共政策和个人决策提供信息。本申请的目的是在NIH管理的农业健康研究队列中，在一组高度接触农药的女性（特别是配偶）中确定与个别农药相关的乳腺癌风险升高，该队列是一个特征良好的、前瞻性的、多州队列，其中包括大约51，000名男性农民和32，000名妻子。这是一个很好的人群，以解决这一目标，因为它的大规模，高随访率，并提供详细的农药使用，职业，人口，生活方式，体力活动，饮食和生殖史的信息收集从农民和他们的妻子在20世纪90年代中期登记，并再次在5年的随访采访。重要的是，这一群体中最常用的几种农药现在或曾经被公众广泛使用。核心假设是，在动物体内或体外试验中被认为是乳腺癌致癌物的农药，或在流行病学研究中与乳腺癌有关的农药，将与如此高暴露量的妇女群体患乳腺癌的风险有关。这一假设将通过两个具体目标进行检验：1）确定与使用特定农药相关的恶性乳腺癌风险增加; 2）确定与农业社区中常见的非特定农药接触源相关的恶性乳腺癌风险增加。根据第一个目标，将审查与使用个别杀虫剂有关的乳腺癌风险。将分别考虑妇女及其丈夫的使用情况，以说明所导致的接触性质和程度的差异。根据第二个目标，将调查乳腺癌风险与增加接触农药机会的因素的关系，包括消费可能受污染的井水，在施用农药期间洗涤衣服，以及在家中或附近储存农药。分析将基于31,531名在登记时没有癌症病史的妇女，估计到2006年通过基于人群的癌症登记确定了805例乳腺癌病例。将使用来自两次访谈（仅诊断前）的数据，通过包括全队列的考克斯比例风险模型，以及分别按绝经状态和居住州估计相对风险。将考虑潜在混杂因素，包括人口统计学、生活方式、饮食和生殖因素。这项拟议中的研究提供了一个不寻常的机会，以成本和时间效益的方式调查个别农药对乳腺癌风险的影响。这项研究意义重大，因为它有望促进我们对个别农药在乳腺癌病因学中的作用的理解，并以一种以前不可能的严格的方法学方式这样做。 公共卫生相关性： 鉴于通过饮食、职业、住宅使用和其他途径暴露于农药的普遍性，该研究领域具有潜在的重要公共卫生意义。动物研究和非常有限的流行病学研究表明，某些常用的杀虫剂可能是乳腺癌的危险因素。然而，人类的这种风险仍然未知或高度不确定。拟议的研究将有助于填补我们知识中的这些重要空白，并有助于为决策者和个人就这些化学品的风险和惠益开展的辩论提供信息。