THE AGRICULTURAL HEALTH STUDY - FIELD STATIONS

农业健康研究（AHS）是一项重大努力，旨在评估农药和其他农业因素与癌症和其他疾病风险之间的关系。这项研究的招募对象包括来自爱荷华州和北卡罗来纳州的大约9万名男性和女性。从1993年至1997年，通过自填问卷获得详细信息，从1998年至2003年9月，并再次从2004年至2010年，计算机辅助电话访谈更新了在入组时收集的信息。电话访谈包括关于所使用的农药和其他农业暴露、生活方式因素、疾病病史和家族史以及饮食的问题。我们还收集口腔细胞样本作为GXE研究和表观遗传机制研究的基因组DNA来源。对癌症发病率和其他慢性疾病的分析仍在继续，目前已发表了一些关注癌症发病率的文章，包括前列腺癌、结直肠癌、胰腺癌、肺癌、乳腺癌和黑色素瘤。NHL和白血病的分析正在进行中。前列腺癌分析的结果表明，许多杀虫剂与前列腺癌风险有关。有前列腺癌家族史的人患前列腺癌的风险特别高。《农业健康研究》还分析了使用毒死蜱、甲草胺、莠去津、草甘膦、马拉硫磷、甲草胺、麦草畏、氟氯磷、甲拌磷和其他一些广泛使用和具有毒理学意义的农药的农药施用者患癌症的情况。一项嵌套在AHS内的生物标志物研究[玉米农民研究]正在评估一组爱荷华州玉米农民和一个未接触玉米种植的对照组在一个日历年内免疫系统的扰动，预计2011-2012年将得出一些结果。前列腺癌的巢式分子病例对照研究在2007年开始，GXE结果和表观遗传学结果预计在2011年。2009年发表的一项关于农药和MGUS（多发性骨髓瘤的前体）的横断面研究显示，与普通人群相比，AHS队列成员患MGUS的风险是普通人群的两倍。作为这项调查的结果，2010年开始了一项新的研究，有1600名研究对象，以确定导致MGUS频率升高的暴露。预计在2014年取得结果。在一项与农业健康研究嵌套的病例对照研究中，视网膜变性与接触杀真菌剂和选定的杀虫剂显著相关，目前正在进行进一步的分析。高农药暴露事件（HPEE）导致症状的风险在农场财务状况不佳的农民中比那些农场不好的农民和风险接受度较低的农民更明显。HPEE与神经系统和呼吸系统症状有关。已发表了几篇分析与农场作业有关的机械伤害的文章。已发表的几篇文章分析了呼吸性哮鸣，表明柴油拖拉机的使用、家禽饲养工作和暴露于几种农药是呼吸性哮鸣的危险因素。这些横断面研究将随访2011-2014年肺部健康研究的额外纵向分析。一项嵌套在农业健康研究中的帕金森病研究目前正处于研究的数据分析阶段。其他几个评估农药暴露致癌风险的项目也已公布。对非霍奇金淋巴瘤病例对照研究数据的分析指出，林丹的农业使用与林丹有关，但与滴滴涕无关。另一项病例对照研究表明，非霍奇金淋巴瘤的化疗影响器官氯的血液水平，这可能导致对暴露的错误分类和扭曲结果。一项针对24个州死亡率的研究发现，农民患前列腺癌的风险较高。然而，与早期的调查相反，墨西哥城妇女患乳腺癌的风险与血清中滴滴涕水平无关。一项比较真空吸尘器袋灰尘样本中农药含量的方法学研究，这是一种比HVSS更简单、更便宜的方法，为家庭灰尘上的农药含量提供了可靠的指标。已经在移民和季节性农场工人中进行了几项可行性研究，以确定在这一未充分研究的群体中进行流行病学调查的适当方法。这项工作的结果将在不久的将来发表在《美国工业医学杂志》的特刊上。对文献进行了审查，表明农药可能在儿童和成人癌症的发展中发挥作用。内布拉斯加州脑癌和胃癌的病例对照研究提供了一个机会，以评估农业，一般环境和生活方式因素在这些肿瘤的发展中的作用。对30名施用除草剂2，4-D的人进行了血、尿测定，发现2，4-D和有丝分裂指数存在剂量-反应梯度。在一项单独的研究中，结果表明，与其他类型的NHL相比，农场暴露与（14，18）易位NHL的相关性更强。在另一项研究中，结果表明，母亲职业性接触农业化学品可能会增加生育肢体缺陷儿童的风险。

The Agricultural Health Study (AHS) is a major effort which is designed to evaluate the relationship between pesticides and other agricultural factors and the risk of cancer and other diseases. Enrollment in this study includes about 90,000 men and women from Iowa and North Carolina. From 1993-1997 detailed information was obtained by self-administered questionnaire and from 1998 through September 2003 and again from 2004 through 2010 computer assisted telephone interviews have updated the information collected at enrollment. Telephone interviews include questions on pesticides used and other agricultural exposures, lifestyle factors, medical and family history of disease, and diet. We are also collecting buccal cell samples as a source of genomic DNA for GXE studies and studies of epigenetic mechanisms. Analyses on cancer incidence and other chronic diseases is continuing and a number of manuscripts focusing on cancer incidence overall, prostate cancer, colorectal cancer, pancreatic cancer, lunch cancer, breast cancer, and melanoma are now published. Analysis of NHL and leukemia is now underway. Findings from the prostate cancer analysis suggest a number of pesticides are associated with a prostate cancer risk. The risk of prostate cancer is particularly strong among those with a family history of prostate cancer. The Agricultural Health Study has also analyzed the cancer experience of pesticide applicators that have used chlorpyrifos, alachlor, atrazine, glyphosate, malathion, metoachlor, dicamba, fonofos, phorate and a number of other pesticides of wide-spread use and toxicologic interest. A biomarker study [The Corn Farmer Study], nested within the AHS is assessing perturbations in the immune system of a group of Iowa corn farmers and a control group not exposed to corn farming, during a calendar year, some result are expected in 2011-2012. A nested molecular case-control study of prostate cancer behan in 2007 and GXE results and epigenetic results are expected in 2011. A cross-sectional study of pesticides and MGUS (a precursor of multiple myeloma) was published in 2009 showing AHS cohort members to be at twice the risk of MGUS compared to the general population. As a result of this investigation a new study with 1, 600 study subjects was initiated in 2010 to identify the exposures responsible for an elevated MGUS frequency. Results are expected in 2014. In a case-control study nested with the Agricultural Health Study, retinal degeneration was significantly associated with exposure to fungicides and selected insecticides, further analyses are now being conducted. The risk of a high pesticide exposure event (HPEE) resulting in symptoms is more pronounced among farmers whose farms were in poor financial condition compared to those whose farms were not and among those with a lower risk acceptance. HPEE has been associated with neurologic and respiratory symptoms. Several manuscripts with analyses of mechanical injury associated operating farm have been published. Several manuscripts with analysis of respiratory wheeze have been published indicating that diesel tractor use, work in poultry operations and exposure to several pesticides are risk factors for respiratory wheeze. These cross-sectional studies will be follow-up with additional longitudinal analyses from the Lung Health Study in 2011-2014. A study of Parkinson's disease nested within the Agricultural Health Study is now in the data analysis phase of the study. Several other projects to evaluate the cancer risk from pesticide exposure are published. Analysis of data from case-control studies of non-Hodgkin's lymphoma noted an association with agricultural use of lindane, but not with DDT. Another case-control study indicated that chemotherapy for non-Hodgkin's Lymphoma affects blood levels of organ chlorines, which could result in misclassification of exposure and distort findings. Farmers were found to be at elevated risk for prostate cancer in a study of mortality in 24 states. Contrary to earlier investigations, however, the risk of breast cancer was not associated with serum levels of DDT among women in Mexico City. A methodological study to compare pesticide levels in dust samples from vacuum cleaner bags, which is a simpler and less expensive approach than the HVSS, provides a reliable indication of pesticide levels on dust in homes. Several feasibility studies have been conducted among migrant and seasonal farm workers to determine appropriate methods for epidemiologic investigations in this understudied group. Results from this effort appear in a special volume of the American Journal of Industrial Medicine in the near future. A review of the literature was conducted which suggested that pesticides may play a role in the development of childhood and adult cancers. Case-control studies of cancers of the brain and stomach in Nebraska provide an opportunity to assess the role of agricultural, general environmental, and lifestyle factors in the development of these tumors. Blood and urine have been collected from 30 applicators applying the herbicide 2, 4-D to relate dose to possible biologic effects, and dose-response gradient was found for 2,4-D and mitotic index. In a separate study, results suggest that farm exposures are more strongly associated with NHL with a (14, 18) translocation than other types of NHL. In yet another study, results suggest that maternal occupational exposure to agricultural chemicals may increase the risk of giving birth to a child with limb defects.