Objectives Farming and exposure to pesticides have been linked to non-Hodgkin lymphoma (NHL), and multiple myeloma (MM) in previous studies. We evaluated use of insecticides, fungicides and fumigants and risk of NHL, including MM and other NHL sub-types in the Agricultural Health Study, a US-based prospective cohort study.
Method A total of 527 cases occurred among 55 875 pesticide applicators from enrollment (1993–1997) through 2011 in Iowa and 2010 in North Carolina. Information on pesticide use, other agricultural exposures and other factors was obtained from questionnaires at enrollment and follow-up approximately five years later (1999–2005). Information from these questionnaires was used to create lifetime-days and intensity-weighted lifetime-days of pesticide use. Poisson regression and polytomous logit models were used to calculate relative risks (RR) and 95% confidence intervals (CI) to evaluate associations between 26 pesticides and NHL and five NHL-subtypes including multiple myeloma, while adjusting for potential confounding factors.
Results Statistically significant positive exposure-response trends occurred between overall NHL risk and lindane (p-trend = 0.004) and DDT (p-trend = 0.02). In addition, ever use of terbufos was associated with NHL overall (RR=1.2; CI=1.0–1.5), but with no exposure-response trend. In sub-type analyses, terbufos and DDT were associated with small cell lymphoma/chronic lymphocytic leukaemia/marginal cell lymphoma. In addition, lindane and diazinon were associated with follicular lymphoma and permethrin with MM although tests of homogeneity did not show significant differences in exposure-response among NHL-subtypes for any chemical.
Conclusions These findings are among the first to suggest links between DDT, lindane, permethrin, diazinon and terbufos and specific NHL subtypes.
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