© 2004 by Oxford University Press
© 2004 Oxford University Press
ARTICLE |
Cancer Incidence Among Pesticide Applicators Exposed to Chlorpyrifos in the Agricultural Health Study
Affiliations of authors: Occupational and Environmental Epidemiology Branch (WJL, AB, JAR, MD, MCRA), and Biostatistics Branch (JHL), Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, MD; Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC (JAH, DPS); Department of Preventive Medicine, College of Medicine, Korea University, Seoul, Korea (WJL).
Correspondence to: Michael C. R. Alavanja, DrPH, 6120 Executive Blvd., EPS 8000, Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20852 (e-mail: alavanjm{at}mail.nih.gov)
Background: Chlorpyrifos is one of the most widely used insecticides in the United States. We evaluated the incidence of cancer among pesticide applicators exposed to chlorpyrifos in the Agricultural Health Study, a prospective cohort study of licensed pesticide applicators in Iowa and North Carolina. Methods: A total of 54 383 pesticide applicators were included in this analysis. Detailed information on pesticide exposure and lifestyle factors was obtained from self-administered questionnaires completed at the time of enrollment (December 1993–December 1997). Poisson regression analysis was used to evaluate the association between chlorpyrifos exposure and cancer incidence after adjustment for potential confounders. All statistical tests were two-sided. Results: A total of 2070 incident malignant neoplasms were diagnosed through 2001. The rate ratio for all cancers combined among chlorpyrifos-exposed applicators compared with nonexposed applicators was 0.97 (95% confidence interval = 0.87 to 1.08). For most cancers analyzed, there was no evidence of an exposure–response relationship. However, the incidence of lung cancer was statistically significantly associated with both chlorpyrifos lifetime exposure-days (Ptrend = .002) and chlorpyrifos intensity-weighted exposure-days (Ptrend = .036). After adjustment for other pesticide exposures and demographic factors, individuals in the highest quartile of chlorpyrifos lifetime exposure-days (>56 days) had a relative risk of lung cancer 2.18 (95% confidence interval = 1.31 to 3.64) times that of those with no chlorpyrifos exposure. Conclusion: Our findings suggest an association between chlorpyrifos use and incidence of lung cancer that deserves further evaluation.
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