Maternal residential pesticide use and risk of childhood leukemia in Costa Rica.
Maternal residential pesticide use and risk of childhood leukemia in Costa Rica.
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DOI：
10.1002/ijc.31522
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发表时间：
2018-09-15
影响因子：
6.4
通讯作者：
Mora AM
中科院分区：
文献类型：
--
作者：
Hyland C;Gunier RB;Metayer C;Bates MN;Wesseling C;Mora AM
有证据表明，儿童早期在家中接触杀虫剂可能与儿童白血病有关，但来自拉丁美洲国家的数据有限。在哥斯达黎加儿童白血病研究（CRCLS）中，我们研究了自我报告的母亲在孩子出生前后使用住宅农药和附近使用农药是否与急性淋巴细胞白血病（ALL）有关，这是一项基于人群的病例对照研究（2001 - 2003）。病例（n = 251例ALL）在1995年至2000年间被诊断出来（诊断时年龄<15岁），并通过哥斯达黎加癌症登记处和国家儿童医院确定。人口控制（n = 577）来自国家出生登记处。我们拟合了经儿童性别、出生年份和社会经济地位调整后的无条件逻辑回归模型，以估计暴露-结果的关联，并按儿童性别分层。我们观察到，自我报告的母亲在怀孕前一年、怀孕期间和母乳喂养期间在家中使用杀虫剂与男孩患ALL的几率增加有关[调整后的优势比（aOR）分别= 1.63（95%可信区间[95% CI]: 1.05-2.53）、1.75（1.13-2.73）和1.75（1.12-2.73）。我们还发现，母亲在家中更频繁地使用杀虫剂与男孩和女孩患ALL的几率增加之间存在暴露-反应关系。孕妇报告在怀孕期间或任何时期在家附近的农场或公司施用农药也与ALL有关。我们在哥斯达黎加的研究强调了教育的必要性，以尽量减少家庭内部和周围的农药暴露，特别是在怀孕和哺乳期间。有什么新鲜事吗?哥斯达黎加是世界上儿童白血病发病率最高的国家之一。农药的使用在中国很普遍，这引发了人们的疑问：农药接触是否在一定程度上导致了该国儿童白血病发病率的上升。在这里，哥斯达黎加男孩的急性淋巴细胞白血病（ALL）与母亲在家中使用杀虫剂以及在孩子出生前后在附近农场喷洒杀虫剂有关。在男孩和女孩中，ALL风险增加与母亲在家使用杀虫剂的频率相关。研究结果为降低儿童白血病风险的可能干预领域提供了见解。
Evidence suggests that early‐life exposure to pesticides inside the home may be associated with childhood leukemia, however data from Latin American countries are limited. We examined whether self‐reported maternal residential pesticide use and nearby pesticide applications–before and after child's birth–were associated with acute lymphoblastic leukemia (ALL) in the Costa Rican Childhood Leukemia Study (CRCLS), a population‐based case‐control study (2001‐2003). Cases (n = 251 ALL) were diagnosed between 1995 and 2000 (age <15 years at diagnosis) and were identified through the Costa Rican Cancer Registry and National Children's Hospital. Population controls (n = 577) were drawn from the National Birth Registry. We fitted unconditional logistic regression models adjusted for child sex, birth year, and socioeconomic status to estimate the exposure‐outcome associations and also stratified by child sex. We observed that self‐reported maternal insecticide use inside the home in the year before pregnancy, during pregnancy, and while breastfeeding was associated with increased odds of ALL among boys [adjusted Odds Ratio (aOR) = 1.63 (95% confidence interval [95% CI]: 1.05–2.53), 1.75 (1.13–2.73), and 1.75 (1.12–2.73), respectively. We also found evidence of exposure‐response relationships between more frequent maternal insecticide use inside the home and increased odds of ALL among boys and girls combined. Maternal report of pesticide applications on farms or companies near the home during pregnancy and at any time period were also associated with ALL. Our study in Costa Rica highlights the need for education to minimize pesticide exposures inside and around the home, particularly during pregnancy and breastfeeding. What's new? Costa Rica has one of the highest incidence rates of childhood leukemia worldwide. Pesticide use is widespread there, raising questions about whether pesticide exposure is in part responsible for the country's elevated childhood leukemia incidence. Here, acute lymphoblastic leukemia (ALL) in Costa Rican boys was associated with maternal insecticide use in the home as well as with pesticide spraying on nearby farms before and after the child's birth. Among both boys and girls, ALL risk increased in association with frequency of maternal in‐home insecticide use. The results offer insight into possible areas of intervention to reduce childhood leukemia risk.
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影响因子：
10.4
作者：
Ma X;Buffler PA;Gunier RB;Dahl G;Smith MT;Reinier K;Reynolds P
通讯作者：
Reynolds P
影响因子：
2.6
作者：
Ballard, Olivia;Morrow, Ardythe L.
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Morrow, Ardythe L.
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6.4
作者：
Bailey, Helen D.;Infante-Rivard, Claire;Schuez, Joachim
通讯作者：
Schuez, Joachim
影响因子：
2.5
作者：
Binns, Colin;Lee, MiKyung;Low, Wah Yun
通讯作者：
Low, Wah Yun
影响因子：
26.1
作者：
Amitay, Efrat L.;Keinan-Boker, Lital
通讯作者：
Keinan-Boker, Lital