1
|
Iqbal S, Ali S, Ali I. Maternal pesticide exposure and its relation to childhood cancer: an umbrella review of meta-analyses. INTERNATIONAL JOURNAL OF ENVIRONMENTAL HEALTH RESEARCH 2022; 32:1609-1627. [PMID: 33745400 DOI: 10.1080/09603123.2021.1900550] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2020] [Accepted: 03/03/2021] [Indexed: 06/12/2023]
Abstract
This umbrella review summarizes the available meta-analyses elucidating the effects of maternal pesticide exposure on adverse health outcomes in children particularly the risk of childhood cancer. A literature search was conducted on PubMed and Scopus with 10-years temporal restriction and with search terms of ('pesticides') and ('maternal' or 'pregnancy' or 'gestational' or 'perinatal' or 'children' or 'infants' or 'birth weight' or 'gestational age' or 'cancer' or 'tumor' or 'malignancy' or 'carcinoma') and ('meta-analysis' or 'systematic review'). Using relative risk estimates, e.g., odds ratio (OR), relative risk (RR), ß coefficients, and 95% confidence interval (CI) as a prerequisite for inclusion/exclusion criteria a total of 19 eligible meta-analyses were included. The results showed that maternal domestic/occupational pesticide exposure increases the risk for childhood leukaemia. The overall OR regarding the risk of pesticide exposure and leukaemia was 1.23 to 1.57 with heterogeneity I2 values that varied between 12.9% and 73%. Some studies found that exposure to dichlorodiphenyldichloroethylene (p,p´-DDE) and polychlorinated biphenyls (PCB-153) pesticides appears to decrease infant birth weight to some extent [p,p´-DDE (ß = -0.007 to -0.008)] and [PCB-153 (ß = -0.15 to -0.17)]Needing more studies on this relationship, our study found that pesticide exposure is a risk factor for leukaemia in children.
Collapse
Affiliation(s)
- Sehar Iqbal
- Department of Environmental Health, Centre for Public Health, Medical University of Vienna, Vienna, Austria
- Department of Nutrition and Dietetics, National University of Medical Sciences, Rawalpindi, Islamabad
| | - Shahbaz Ali
- Department of Anthropology, PMAS-Arid Agriculture University Rawalpindi, Pakistan
| | - Inayat Ali
- Department of Social and Cultural Anthropology, University of Vienna, Vienna, Austria
| |
Collapse
|
2
|
Feulefack J, Khan A, Forastiere F, Sergi CM. Parental Pesticide Exposure and Childhood Brain Cancer: A Systematic Review and Meta-Analysis Confirming the IARC/WHO Monographs on Some Organophosphate Insecticides and Herbicides. CHILDREN (BASEL, SWITZERLAND) 2021; 8:children8121096. [PMID: 34943292 PMCID: PMC8700205 DOI: 10.3390/children8121096] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 11/16/2021] [Accepted: 11/19/2021] [Indexed: 12/19/2022]
Abstract
Background: Brain tumors are the second most common neoplasm in the pediatric age. Pesticides may play an etiologic role, but literature results are conflicting. This review provides a systematic overview, meta-analysis, and IARC/WHO consideration of data on parental exposure to pesticides and childhood brain tumors. Methods: We searched PubMed, SCOPUS, and Google Scholar for literature (1 January 1966–31 December 2020) that assessed childhood brain tumors and parental exposure to pesticides. We undertook a meta-analysis addressing prenatal exposure, exposure after birth, occupational exposure, and residential exposure. A total of 130 case-control investigations involving 43,598 individuals (18,198 cases and 25,400 controls) were included. Results: Prenatal exposure is associated with childhood brain tumors (odds ratio, OR = 1.32; 95% CI: 1.17–1.49; I2 = 41.1%). The same occurs after birth exposure (OR = 1.22; 95% CI: 1.03–1.45, I2 = 72.3%) and residential exposure to pesticides (OR = 1.31; 95% CI: 1.11–1.54, I2 = 67.2%). Parental occupational exposure is only marginally associated with CBT (OR = 1.17, 95% CI: 0.99–1.38, I2 = 67.0%). Conclusions: There is an association between CBT and parental pesticides exposure before childbirth, after birth, and residential exposure. It is in line with the IARC Monograph evaluating the carcinogenicity of diazinon, glyphosate, malathion, parathion, and tetrachlorvinphos.
Collapse
Affiliation(s)
- Joseph Feulefack
- National “111” Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Hubei University of Technology, Wuhan 430068, China;
- Department of Lab. Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Aiza Khan
- Department of Lab. Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
| | - Francesco Forastiere
- Department of Epidemiology, Regional Health Service of Lazio, 00147 Rome, Italy;
- Institute for Biomedical Research and Innovation (IRIB), National Research Council (CNR), 90146 Palermo, Italy
- Environmental Research Group, School of Public Health, Faculty of Medicine, Imperial College, London SW7 2AZ, UK
| | - Consolato M. Sergi
- National “111” Center for Cellular Regulation and Molecular Pharmaceutics, Key Laboratory of Fermentation Engineering (Ministry of Education), Hubei University of Technology, Wuhan 430068, China;
- Department of Lab. Medicine and Pathology, University of Alberta, Edmonton, AB T6G 2R3, Canada;
- Department of Pediatrics, University of Alberta, Edmonton, AB T6G 2R3, Canada
- Stollery Children’s Hospital, Edmonton, AB T6G 2R3, Canada
- Anatomic Pathology Division, Department of Lab. Medicine and Pathology, Children’s Hospital of Eastern Ontario, Ottawa, ON K1H 8L1, Canada
- Correspondence: ; Tel.: +1-613-737-7600 (ext. 2427); Fax: +1-613-738-4837
| |
Collapse
|
3
|
Hutter HP, Moshammer H. Pesticides Are an Occupational and Public Health Issue. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2018; 15:ijerph15081650. [PMID: 30081501 PMCID: PMC6121267 DOI: 10.3390/ijerph15081650] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/31/2018] [Accepted: 08/01/2018] [Indexed: 12/18/2022]
Affiliation(s)
- Hans-Peter Hutter
- Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria.
| | - Hanns Moshammer
- Department of Environmental Health, Medical University of Vienna, 1090 Vienna, Austria.
| |
Collapse
|
4
|
Van Maele-Fabry G, Gamet-Payrastre L, Lison D. Residential exposure to pesticides as risk factor for childhood and young adult brain tumors: A systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2017. [PMID: 28623811 DOI: 10.1016/j.envint.2017.05.018] [Citation(s) in RCA: 62] [Impact Index Per Article: 8.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/07/2023]
Abstract
BACKGROUND Accumulating evidence suggests a positive association between exposure to non-agricultural pesticides and childhood brain tumors (CBT). OBJECTIVE (1) To conduct a systematic review and meta-analysis of published studies on the association between residential/household/domestic exposure to pesticides and childhood brain tumors. (2) To clarify variables that could impact the results. METHODS Publications in English were identified from a MEDLINE search through 28 February 2017 and from the reference list of identified publications. Risk estimates were extracted from 18 case-control studies published between 1979 and 2016 and study quality assessments were performed. Summary odds ratios (mOR) were calculated according to fixed and random-effect meta-analysis models. Separate analyses were conducted after stratification for study quality, critical exposure period, exposure location, specific exposures, pesticide category, application methods, type of pest treated, type of CBT, child's age at diagnosis and geographic location. RESULTS Statistically significant associations were observed with CBT after combining all studies (mOR: 1.26; 95% CI: 1.13-1.40) without evidence of inconsistency between study results or publication bias. Specifically, increased risks were observed for several groupings and more particularly for gliomas and exposure involving insecticides. Statistical significance was also reached for high quality studies, for all exposure periods, for indoor exposure and, more particularly, during the prenatal period for all stratifications involving insecticides (except for outdoor use), for pet treatments, for flea/tick treatment, for studies from USA/Canada and studies from Europe (borderline) as well as for data from studies including children of up to 10years at diagnosis and of up to 15years. CONCLUSIONS Our findings support an association between residential exposure to pesticides and childhood brain tumors. Although causality cannot be established, these results add to the evidence leading to recommend limiting residential use of pesticides and to support public health policies serving this objective.
Collapse
Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Avenue E. Mounier 53.02, B-1200 Brussels, Belgium.
| | - Laurence Gamet-Payrastre
- Toxalim (Research Centre in Food Toxicology), Université de Toulouse, INRA, ENVT, INP-Purpan, UPS 180 chemin de Tournefeuille, BP 93173 Toulouse, France
| | - Dominique Lison
- Université catholique de Louvain, Louvain Centre for Toxicology and Applied Pharmacology (LTAP), Avenue E. Mounier 53.02, B-1200 Brussels, Belgium
| |
Collapse
|
5
|
Omidakhsh N, Ganguly A, Bunin GR, von Ehrenstein OS, Ritz B, Heck JE. Residential Pesticide Exposures in Pregnancy and the Risk of Sporadic Retinoblastoma: A Report From the Children's Oncology Group. Am J Ophthalmol 2017; 176:166-173. [PMID: 28131887 PMCID: PMC5376525 DOI: 10.1016/j.ajo.2017.01.016] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2016] [Revised: 01/17/2017] [Accepted: 01/18/2017] [Indexed: 11/18/2022]
Abstract
PURPOSE To examine whether parental pesticide exposure contributes to the development of sporadic retinoblastoma. DESIGN Case-control study. METHODS Data were collected by a large multicenter study of sporadic retinoblastoma in which parents of 99 unilateral and 56 bilateral age-matched case-control pairs were interviewed by telephone. Retrospective exposure information was collected on the type, location, timing, and frequency of residential pesticide use. We used conditional logistic regression analyses to estimate odds ratios for maternal pesticide exposure in the month before or during pregnancy and to assess whether the type of product, and the circumstances under which it was applied, were associated with risk of disease. RESULTS Unilateral retinoblastoma was associated with parental insecticide use (odds ratio [OR], 2.8; confidence interval [CI], 1.1-6.7) and the use of professional lawn or landscape services (OR, 2.8; CI, 1.0-8.2). For bilateral disease we observed large point estimates for several exposures but the small number of cases rendered these results uninformative (ie, resulted in wide confidence intervals). Whether parents used the pesticide inside vs outside the home did not appear to modify risk estimates for unilateral retinoblastoma (OR, 2.5; CI, 0.9-7.0 vs OR, 2.5; CI, 1.0-6.5), nor did the type, frequency, timing related to pregnancy, or applicator of pesticide used influence estimates to an appreciable degree for disease. CONCLUSIONS Our results suggest that parental pesticide exposure before or during pregnancy may play a role in the development of childhood retinoblastoma. Retrospectively collected exposure data introduces the possibility of recall bias; therefore, results should be interpreted cautiously until additional studies are conducted.
Collapse
Affiliation(s)
- Negar Omidakhsh
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Arupa Ganguly
- Department of Genetics, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Greta R Bunin
- Division of Oncology and Center for Childhood Cancer Research, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Ondine S von Ehrenstein
- Department of Community Health Sciences, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Beate Ritz
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California
| | - Julia E Heck
- Department of Epidemiology, Fielding School of Public Health, University of California, Los Angeles, Los Angeles, California.
| |
Collapse
|
6
|
Van Maele-Fabry G, Hoet P, Lison D. Parental occupational exposure to pesticides as risk factor for brain tumors in children and young adults: a systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2013; 56:19-31. [PMID: 23567326 DOI: 10.1016/j.envint.2013.02.011] [Citation(s) in RCA: 49] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/06/2012] [Revised: 02/19/2013] [Accepted: 02/22/2013] [Indexed: 05/07/2023]
Abstract
OBJECTIVE To examine the potential association between parental occupational exposure to pesticides and the occurrence of brain tumors in children and young adults. METHODS Studies identified from a MEDLINE search through 15 January 2013 and from the reference lists of identified publications were submitted to a systematic review and meta-analysis. Relative risk estimates were extracted from 20 studies published between 1974 and 2010. Most of the retrieved studies involved farm/agricultural jobs. Summary ratio estimates (SR) were calculated according to fixed and random-effect meta-analysis models. Separate analyses were conducted after stratification for study design, exposure parameters, disease definition, geographic location and age at diagnosis. RESULTS Statistically significant associations were observed for parents potentially exposed to pesticides in occupational settings and the occurrence of brain tumor in their offspring after combining all case-control studies (summary odds ratio [SOR]: 1.30; 95%: 1.11, 1.53) or all cohort studies (summary rate ratio [SRR]: 1.53; 95% CI: 1.20, 1.95). Significantly increased risks were seen for prenatal exposure windows, for either exposed parent, for exposure defined as to pesticides as well as by occupational/industry title, for astroglial brain tumors and after combining case-control studies from North America or cohort studies from Europe. CONCLUSIONS This meta-analysis supports an association between parental occupational exposure to pesticides and brain tumors in children and young adults, and adds to the evidence leading to the recommendation of minimizing (parental) occupational exposure to pesticides. These results must, however, be interpreted with caution because the impact of work-related factors others than pesticide exposure is not known.
Collapse
Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, SSS/IREC/LTAP Louvain Center for Toxicology and Applied Pharmacology, Avenue E. Mounier 52, bte B1.52.12, B-1200 Brussels, Belgium.
| | | | | |
Collapse
|
7
|
Abstract
Children today live in a world that is vastly different from a few generations ago. While industrialization has maximized (for many) children’s opportunities to survive, develop and enjoy high levels of health, education, recreation, and fulfillment, it has also added significant challenges to their development.
Collapse
Affiliation(s)
- Edward A. Laws
- , School of the Coast and Environment, Louisiana State University, Baton Rouge, 70803 Louisiana USA
| |
Collapse
|
8
|
Van Maele-Fabry G, Lantin AC, Hoet P, Lison D. Residential exposure to pesticides and childhood leukaemia: a systematic review and meta-analysis. ENVIRONMENT INTERNATIONAL 2011; 37:280-291. [PMID: 20889210 DOI: 10.1016/j.envint.2010.08.016] [Citation(s) in RCA: 62] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2010] [Revised: 08/17/2010] [Accepted: 08/31/2010] [Indexed: 05/29/2023]
Abstract
OBJECTIVE To conduct a systematic review of published studies on the association between residential/household/domestic exposure to pesticides and childhood leukaemia, and to provide a quantitative estimate of the risk. METHODS Publications in English were searched in MEDLINE (1966-31 December 2009) and from the reference list of identified publications. Extraction of relative risk (RR) estimates was performed independently by 2 authors using predefined inclusion criteria. Meta-rate ratio estimates (mRR) were calculated according to fixed and random-effect models. Separate analyses were conducted after stratification for exposure time windows, residential exposure location, biocide category and type of leukaemia. RESULTS RR estimates were extracted from 13 case-control studies published between 1987 and 2009. Statistically significant associations with childhood leukaemia were observed when combining all studies (mRR: 1.74, 95% CI: 1.37-2.21). Exposure during and after pregnancy was positively associated with childhood leukaemia, with the strongest risk for exposure during pregnancy (mRR: 2.19, 95% CI: 1.92-2.50). Other stratifications showed the greatest risk estimates for indoor exposure (mRR: 1.74, 95% CI: 1.45-2.09), for exposure to insecticides (mRR: 1.73, 95% CI: 1.33-2.26) as well as for acute non-lymphocytic leukaemia (ANLL) (mRR: 2.30, 95% CI: 1.53-3.45). Outdoor exposure and exposure of children to herbicides (after pregnancy) were not significantly associated with childhood leukaemia (mRR: 1.21, 95% CI: 0.97-1.52; mRR: 1.16, 95% CI: 0.76-1.76, respectively). CONCLUSIONS Our findings support the assumption that residential pesticide exposure may be a contributing risk factor for childhood leukaemia but available data were too scarce for causality ascertainment. It may be opportune to consider preventive actions, including educational measures, to decrease the use of pesticides for residential purposes and particularly the use of indoor insecticides during pregnancy.
Collapse
Affiliation(s)
- Geneviève Van Maele-Fabry
- Université catholique de Louvain, Louvain Center for Toxicology and Applied Pharmacology (LTAP), Brussels, Belgium.
| | | | | | | |
Collapse
|
9
|
Van Maele-Fabry G, Lantin AC, Hoet P, Lison D. Childhood leukaemia and parental occupational exposure to pesticides: a systematic review and meta-analysis. Cancer Causes Control 2010; 21:787-809. [PMID: 20467891 DOI: 10.1007/s10552-010-9516-7] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2009] [Accepted: 01/23/2010] [Indexed: 10/19/2022]
Abstract
OBJECTIVE To conduct a systematic review and meta-analysis of published studies on the association between parental occupational exposure to pesticides and childhood leukaemia. METHODS Studies were identified from a MEDLINE search through 31 July 2009 and from the reference lists of identified publications. Relative risk (RR) estimates were extracted from 25 studies published between 1985 and 2008. Meta-rate ratio estimates (mRR) were calculated according to fixed and random-effect meta-analysis models. Separate analyses were conducted after stratification for study design, definition of exposure (employment in a farm/agriculture assuming exposure to pesticides versus exposure to pesticides stipulated), exposed parent, window of exposure, type of leukaemia and biocide category. RESULTS No statistically significant association between childhood leukaemia and parental occupation as farmers/agricultural workers was observed. When exposure to pesticides was stipulated, positive associations were reported for maternal exposure for all studies combined (mRR: 1.62; 95% CI: 1.22-2.16), in all exposure windows considered and for acute non-lymphocytic leukaemia (ANLL). There was no association with paternal exposure when combining all studies (mRR: 1.14; 95% CI: 0.76-1.69). However, significant increased risks were seen for paternal exposure, in some exposure windows as well as for the biocide category. CONCLUSIONS The strongest evidence of an increased risk of childhood leukaemia comes from studies with maternal occupational exposure to pesticides. The associations with paternal exposure were weaker and less consistent. These results add to the evidence leading to recommend minimizing parental occupational exposure to pesticides. Our findings also support the need to rely more on studies that clearly stipulate exposure to pesticides rather than those that assume pesticide exposure because of farm/agriculture employment.
Collapse
Affiliation(s)
- Geneviève Van Maele-Fabry
- Louvain Center for Toxicology and Applied Pharmacology (LTAP), Université catholique de Louvain, Avenue E. Mounier 53.02, 1200, Brussels, Belgium.
| | | | | | | |
Collapse
|
10
|
Carozza SE, Li B, Elgethun K, Whitworth R. Risk of childhood cancers associated with residence in agriculturally intense areas in the United States. ENVIRONMENTAL HEALTH PERSPECTIVES 2008; 116:559-65. [PMID: 18414643 PMCID: PMC2290991 DOI: 10.1289/ehp.9967] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/08/2006] [Accepted: 01/10/2008] [Indexed: 05/17/2023]
Abstract
BACKGROUND The potential for widespread exposure to agricultural pesticides through drift during application raises concerns about possible health effects to exposed children living in areas of high agricultural activity. OBJECTIVES We evaluated whether residence in a county with greater agricultural activity was associated with risk of developing cancer in children < 15 years of age. METHODS Incidence data for U.S. children 0-14 years of age diagnosed with cancer between 1995 and 2001 were provided by member registries of the North American Association of Central Cancer Registries. We determined percent cropland for each county using agricultural census data, and used the overall study distribution to classify agriculturally intense counties. We estimated odds ratios and 95% confidence intervals for all ages and 5-year age groups for total cancers and selected cancer sites using logistic regression. RESULTS Our study results showed statistically significant increased risk estimates for many types of childhood cancers associated with residence at diagnosis in counties having a moderate to high level of agricultural activity, with a remarkably consistent dose-response effect seen for counties having >or= 60% of the total county acreage devoted to farming. Risk for different cancers varied by type of crop. CONCLUSIONS Although interpretation is limited by the ecologic design, in this study we were able to evaluate rarer childhood cancers across a diverse agricultural topography. The findings of this exploratory study support a continued interest in the possible impact of long-term, low-level pesticide exposure in communities located in agriculturally intense areas.
Collapse
Affiliation(s)
- Susan E Carozza
- Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, Texas 77843-1266, USA.
| | | | | | | |
Collapse
|
11
|
Metayer C, Buffler PA. Residential exposures to pesticides and childhood leukaemia. RADIATION PROTECTION DOSIMETRY 2008; 132:212-9. [PMID: 18940823 PMCID: PMC2879096 DOI: 10.1093/rpd/ncn266] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/20/2023]
Abstract
Like many chemicals, carcinogenicity of pesticides is poorly characterised in humans, especially in children, so that the present knowledge about childhood leukaemia risk derives primarily from epidemiological studies. Overall, case-control studies published in the last decade have reported positive associations with home use of insecticides, mostly before the child's birth, while findings for herbicides are mixed. Previous studies relied solely on self-reports, therefore lacking information on active ingredients and effects of potential recall bias. Few series to date have examined the influence of children's genetic susceptibility related to transport and metabolism of pesticides. To overcome these limitations, investigators of the Northern California Childhood Leukaemia Study (NCCLS) have undertaken, in collaboration with a multidisciplinary team, a comprehensive assessment of residential pesticide exposure, including: (1) quality control of self-reports; (2) home pesticide inventory and linkage to the Environmental Protection Agency to obtain data on active ingredients; (3) collection and laboratory analyses of approximately 600 home dust samples for over 60 pesticides and (4) geographic information studies using California environmental databases to assess exposure to agricultural pesticides. The NCCLS is also conducting large-scale genotyping to evaluate the role of genes in xenobiotic pathways relevant to the transport and metabolism of pesticides. A better quantification of children's exposures to pesticides at home is critical to the evaluation of childhood leukaemia risk, especially for future gene-environment interaction studies.
Collapse
Affiliation(s)
- Catherine Metayer
- School of Public Health, University of California, 2150 Shattuck Avenue, Suite 500, Berkeley, CA 94720-7080, USA.
| | | |
Collapse
|
12
|
Rudant J, Menegaux F, Leverger G, Baruchel A, Nelken B, Bertrand Y, Patte C, Pacquement H, Vérité C, Robert A, Michel G, Margueritte G, Gandemer V, Hémon D, Clavel J. Household exposure to pesticides and risk of childhood hematopoietic malignancies: The ESCALE study (SFCE). ENVIRONMENTAL HEALTH PERSPECTIVES 2007; 115:1787-93. [PMID: 18087601 PMCID: PMC2137105 DOI: 10.1289/ehp.10596] [Citation(s) in RCA: 62] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/25/2007] [Accepted: 09/24/2007] [Indexed: 05/05/2023]
Abstract
OBJECTIVES We investigated the role of household exposure to pesticides in the etiology of childhood hematopoietic malignancies. METHODS The national registry-based case-control study ESCALE (Etude sur les cancers de l'enfant) was carried out in France over the period 2003-2004. Population controls were frequency matched with the cases on age and sex. Maternal household use of pesticides during pregnancy and paternal use during pregnancy or childhood were reported by the mothers in a structured telephone questionnaire. Insecticides (used at home, on pets, or for garden crops), herbicides, and fungicides were distinguished. We estimated odds ratios (ORs) using unconditional regression models closely adjusting for age, sex, degree of urbanization, and type of housing (flat or house). RESULTS We included a total of 764 cases of acute leukemia (AL), 130 of Hodgkin lymphoma (HL), 166 of non-Hodgkin lymphoma (NHL), and 1,681 controls. Insecticide use during pregnancy was significantly associated with childhood AL [OR = 2.1; 95% confidence interval (CI), 1.7-2.5], both lymphoblastic and myeloblastic, NHL (OR = 1.8; 95% CI, 1.3-2.6), mainly for Burkitt lymphoma (OR = 2.7; 95% CI, 1.6-4.5), and mixed-cell HL (OR = 4.1; 95% CI, 1.4-11.8), but not nodular sclerosis HL (OR = 1.1; 95% CI, 0.6-1.9). Paternal household use of pesticides was also related to AL (OR = 1.5; 95% CI, 1.2-1.8) and NHL (OR = 1.7; 95% CI, 1.2-2.6); but for AL the relationships did not remain after adjustment for maternal pesticide use during pregnancy. CONCLUSION The study findings strengthen the hypothesis that domestic use of pesticides may play a role in the etiology of childhood hematopoietic malignancies. The consistency of the findings with those of previous studies on AL raises the question of the advisability of preventing pesticide use by pregnant women.
Collapse
Affiliation(s)
- Jérémie Rudant
- Institut national de la santé et de la recherche médicale, Villejuif, France.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
13
|
Abstract
OBJECTIVES Epidemiological studies have reported associations between childhood cancer and either parental or child exposure to pesticides. Reviews have been published in 1997, 1998 and 2006 where the evidence was found suggestive but not conclusive. The present review is an extended update of the latter one. METHODS The PubMed database was searched to identify published studies on this topic issued between 1998 and 2006. RESULTS Thirty-six new studies have been identified for this review. Some cohort studies and the majority of the case-control studies suggest an increased risk for the cancer types studied, associated with exposure to pesticides in at least one of a large variety of exposure categories. However, the evidence is conflicting with regard to cancer types as well as to causative factors across studies. The major shortcomings concern exposure assessment, where, e. g., "farming" is treated equal to "exposure to pesticides", disregarding other possible exposures, e.g., to biological or infectious agents, and hitherto unidentified lifestyle factors. Also, many exposure categories used, mainly in case-control studies, lack chemical or toxicological plausibility. In most studies exposures were categorized as "ever vs. never", with little regard of exposure intensity or duration. CONCLUSIONS The available literature does not allow firm conclusions with regard to pesticides and any type of childhood cancer. But even if the reported associations were true, exposure to pesticides could not explain the vast majority of childhood cancer cases. Investing in the acquisition and critical review of exposure information appears to be the crucial step for causal assessment in future research. However, focusing on the presence of pesticides, and not asking the question why they were used, might mask relevant associations to other causative agents.
Collapse
Affiliation(s)
- Michael Nasterlack
- Occupational Medicine and Health Protection Department, BASF AG, Ludwigshafen, Germany.
| |
Collapse
|
14
|
|