Montgomery MP, Postel E, Umbach DM, Richards M, Watson M, Blair A, Chen H, Sandler DP, Schmidt S, Kamel F. Pesticide Use and Age-Related Macular Degeneration in the Agricultural Health Study.
ENVIRONMENTAL HEALTH PERSPECTIVES 2017;
125:077013. [PMID:
28886597 PMCID:
PMC5744702 DOI:
10.1289/ehp793]
[Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/12/2016] [Revised: 03/17/2017] [Accepted: 03/18/2017] [Indexed: 05/28/2023]
Abstract
BACKGROUND
Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. Few studies have investigated its relationship to environmental neurotoxicants. In previous cross-sectional studies, we found an association between pesticide use and self-reported retinal degeneration.
OBJECTIVE
We evaluated the association of pesticide use with physician-confirmed incident AMD.
METHODS
The Agricultural Health Study (AHS) is a prospective cohort of pesticide applicators and their spouses enrolled from 1993-1997 in Iowa and North Carolina. Cohort members reported lifetime use of 50 specific pesticides at enrollment. Self-reports of incident AMD during follow-up through 2007 were confirmed by reports from participants' physicians and by independent evaluation of retinal photographs provided by the physicians. Confirmed cases (n=161) were compared with AHS cohort members without AMD (n=39,108). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) by logistic regression with adjustment for age, gender, and smoking.
RESULTS
AMD was associated with ever use of organochlorine [OR=2.7 (95% CI: 1.8, 4.0)] and organophosphate [OR=2.0 (95% CI: 1.3, 3.0)] insecticides and phenoxyacetate herbicides [OR=1.9 (95% CI: 1.2, 2.8)]. Specific pesticides consistently associated with AMD included chlordane, dichlorodiphenyltrichloroethane (DDT), malathion, and captan; others with notable but slightly less consistent associations were heptachlor, diazinon, phorate, 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), and 2,4-dichlorophenoxyacetic acid (2,4-D). Results were similar for men and women. Some specific pesticides were associated with both early- and late-stage AMD, but others were associated with only one stage.
CONCLUSIONS
Exposures to specific pesticides may be modifiable risk factors for AMD. https://doi.org/10.1289/EHP793.
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