THE AGRICULTURAL HEALTH STUDY - FIELD STATIONS

农业健康研究(AHS)是一项主要工作，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。这项研究的参与者包括来自爱荷华州和北卡罗来纳州的约9万名男性和女性。从1993年至1997年，通过自填式问卷获得详细信息，从1998年至2003年9月，再从2004年至2010年，计算机辅助电话访谈更新了入学时收集的信息。电话采访包括使用的杀虫剂和其他农业接触、生活方式因素、病史和家族病史以及饮食等问题。我们还在收集口腔细胞样本作为基因组DNA的来源，用于GxE研究和表观遗传机制研究。对癌症发病率和其他慢性病的分析仍在继续，现在出版了一些关注癌症总体发病率、前列腺癌、结直肠癌、胰腺癌、午餐癌、乳腺癌和黑色素瘤的手稿。目前正在对非霍奇金淋巴瘤和白血病进行分析。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。在那些有前列腺癌家族史的人中，前列腺癌的风险尤其大。农业健康研究还分析了使用毒死蜱、甲草胺、阿特拉津、草甘膦、马拉硫磷、异丙甲草胺、敌敌畏、敌敌畏、甲拌磷和一些其他广泛使用和毒理学兴趣的杀虫剂的农药施用者的癌症经历。一项嵌套在AHS内的生物标记物研究[玉米农民研究]正在评估一组爱荷华州玉米种植者和一组未从事玉米种植的对照组在一个日历年度内免疫系统的扰动，预计2011-2012年将有一些结果。2007年对前列腺癌Behan进行了一项嵌套的分子病例对照研究，GxE结果和表观遗传学结果预计将在2011年公布。2009年发表的一项关于杀虫剂和MGUS(多发性骨髓瘤的先兆)的横断面研究显示，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年启动了一项新的研究，涉及1600名研究对象，以确定暴露于MGUS频率升高的原因。结果预计将在2014年公布。在一项与农业健康研究嵌套的病例对照研究中，视网膜退化与接触杀菌剂和选定的杀虫剂密切相关，目前正在进行进一步的分析。高农药暴露事件(HPEE)导致症状的风险在那些农场财务状况不佳的农民中比那些农场财务状况不佳的农民和那些风险接受程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操作农场相关的机械损伤的手稿。已经发表了几篇分析呼吸性喘息的手稿，表明使用柴油拖拉机、在家禽作业中工作以及接触几种杀虫剂是呼吸性喘息的危险因素。这些横断面研究将在2011-2014年间进行后续的肺健康研究的其他纵向分析。一项嵌套在农业健康研究中的帕金森氏病研究目前正处于研究的数据分析阶段。还公布了其他几个评估农药暴露致癌风险的项目。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会影响血液中器官氯的水平，这可能会导致接触的错误分类和扭曲的结果。一项对24个州的死亡率进行的研究发现，农民患前列腺癌的风险更高。然而，与早先的调查相反，墨西哥城妇女患乳腺癌的风险与血清DDT水平无关。一项比较吸尘器袋灰尘样本中农药水平的方法学研究，是一种比HVSS更简单、更便宜的方法，为家庭灰尘中的农药水平提供了可靠的指示。在移民和季节性农场工人中进行了几项可行性研究，以确定在这一研究不足的群体中进行流行病学调查的适当方法。这一努力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。对文献进行了综述，认为杀虫剂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评估农业、一般环境和生活方式因素在这些肿瘤发展中的作用的机会。从30名使用除草剂2，4-D的施用者中采集了血液和尿液，以确定剂量与可能的生物效应的关系，并发现2，4-D和有丝分裂指数的剂量-反应梯度。在另一项单独的研究中，结果表明，农场暴露与具有(14，18)易位的NHL的相关性比其他类型的NHL更强。在另一项研究中，结果表明，母亲职业接触农用化学品可能会增加生下有肢体缺陷的孩子的风险。

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.