Occupational Pesticide Exposure of Parents and Brain Tumor Risk in Children

描述(由申请人提供)： 父母的职业是可能影响儿童脑瘤(CBT)风险的暴露来源之一。尽管父母的暴露与CBT有关，但还没有确定令人信服的危险因素，可能是因为样本量小、病例组不同以及暴露评估粗略。我们建议使用从一项大型病例对照研究中收集的数据来研究父母的职业和CBT，该研究仅限于一个肿瘤组织学组，并收集了详细的工作信息。我们假设母亲和父亲接触三类杀虫剂(杀虫剂、除草剂和杀菌剂)会增加患髓母细胞瘤/原始神经外胚层肿瘤(MB/PNET)的风险。我们还将假设工作活动的角色，如焊接、油漆和脱脂，这是先前报道的与特定职业和行业的关联所建议的。作为次要目标，我们将调查接触动物和动物产品的情况。样本包括318名病例母亲、318名对照母亲、272名病例父亲和258名对照父亲的信息，这些信息来自儿童肿瘤学小组在幼儿中进行的MB/PNET研究。对于父亲，收集从18岁到参考日期的工作信息，包括就业日期、使用的物质和工具、活动和任务，对于60多个工作，有一个为具体工作量身定做的模块。对于杀虫剂，两名专家将根据父母提供的详细工作信息、广泛的工业卫生文献综述汇编以及他们自己的经验和专业知识进行暴露评估。对于动物暴露，两位专家将利用父母提供的详细工作信息和他们自己的专业知识来分配暴露。农药暴露的数据分析将包括暴露的强度和概率以及评分者对任务的信心，并将包括敏感性分析，以确定评价者之间的差异可能产生的影响。对于工作活动的分析，我们将考虑是否进行过该活动，以及在该活动上花费的时间。每一次接触和活动都将考虑人口统计和其他混杂因素。父母的职业很可能仍然是CBT和儿童癌症总体研究的重点。这项研究的结果将为进一步研究暴露和方法提供基础，值得进一步关注。在暴露方面，我们将确定杀虫剂或动物暴露更有可能解释所报道的与农业有关的情况，以及哪一类杀虫剂最值得关注。工作活动的结果将表明需要进一步研究的风险。就方法而言，农药暴露的方法也可以适用于其他暴露。对工作任务的评估在职业暴露和儿童癌症的研究中很少使用，甚至根本没有使用。拟议的研究将提供关于这些方法的有用性的信息。

DESCRIPTION (provided by applicant): Parents' occupations are one source of exposures that may influence the risk of childhood brain tumors (CBT). Although parental exposure has been studied in relation to CBT, no convincing risk factors have been identified, perhaps because of small sample sizes, heterogeneous case groups, and crude exposure assessment. We propose to study parental occupation and CBT using already collected data from a large case-control study that was limited to one histologic group of tumors and collected detailed job information. We hypothesize that maternal and paternal exposure to three classes of pesticides (insecticides, herbicides, and fungicides) increase the risk of medulloblastoma/ primitive neuroectodermal tumor (MB/PNET). We will also hypothesize a role for job activities, such as welding, painting, and degreasing, suggested by previously reported associations with specific occupations and industries. As secondary aims, we will investigate exposure to animals and animal products. The sample consists of information on 318 case mothers, 318 control mothers, 272 case fathers, and 258 control fathers from a study of MB/PNET in young children conducted by the Children's Oncology Group. For fathers, information on jobs from age 18 until the reference date was collected including dates of employment, substances and tools used, activities and tasks, and for more than 60 jobs, a module tailored to the specific job. For pesticides, two experts will perform the exposure assessment based on the detailed job information provided by the parents, a compilation of an extensive industrial hygiene literature review, and their own experience and expertise. For animal exposure, the two experts will use the detailed job information from the parents and their own expertise to assign exposure. Data analysis for pesticide exposure will include intensity and probability of exposure and the rater's confidence in the assignment and will include sensitivity analyses to determine the likely effect of interrater variability. For the analysis of job activities, we will consider ever versus never performed the activity as well as time spent at it. Demographic and other confounders will be considered for each exposure and activity. Parental occupation is likely to remain a focus of research on CBT and childhood cancer generally. The results of this study will provide the basis for further research in terms of both exposures and methods worthy of further attention. In terms of exposures, we will determine whether pesticide or animal exposure is more likely to explain the reported association with agriculture, and which pesticide class deserves the most attention. The results for job activities will suggest exposures to study further. In terms of methods, the approach to pesticide exposure can be applied to other exposures as well. The assessment of job tasks has been used little or not at all in studies of occupational exposure and childhood cancer. The proposed study will provide information on the usefulness of these approaches.