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Original article
Incidence of solid tumours among pesticide applicators exposed to the organophosphate insecticide diazinon in the Agricultural Health Study: an updated analysis
  1. Rena R Jones1,
  2. Francesco Barone-Adesi2,
  3. Stella Koutros1,
  4. Catherine C Lerro1,
  5. Aaron Blair1,
  6. Jay Lubin1,
  7. Sonya L Heltshe3,
  8. Jane A Hoppin4,
  9. Michael C R Alavanja1,
  10. Laura E Beane Freeman1
  1. 1Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA
  2. 2Population Health Research Institute, St. George's, University of London, London, UK
  3. 3Department of Pediatrics, University of Washington, Seattle, Washington, USA
  4. 4Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA
  1. Correspondence to Dr Rena R Jones, Occupational and Environmental Epidemiology Branch, National Cancer Institute, 9609 Medical Center Drive, Room 6E116, Rockville, MD 20850, USA; rena.jones{at}


Objective Diazinon, a common organophosphate insecticide with genotoxic properties, was previously associated with lung cancer in the Agricultural Health Study (AHS) cohort, but few other epidemiological studies have examined diazinon-associated cancer risk. We used updated diazinon exposure and cancer incidence information to evaluate solid tumour risk in the AHS.

Methods Male pesticide applicators in Iowa and North Carolina reported lifetime diazinon use at enrolment (1993–1997) and follow-up (1998–2005); cancer incidence was assessed through 2010(North Carolina)/2011(Iowa). Among applicators with usage information sufficient to evaluate exposure-response patterns, we used Poisson regression to estimate adjusted rate ratios (RRs) and 95% CI for cancer sites with ≥10 exposed cases for both lifetime (LT) exposure days and intensity-weighted (IW) lifetime exposure days (accounting for factors impacting exposure).

Results We observed elevated lung cancer risks (N=283) among applicators with the greatest number of LT (RR=1.60; 95% CI 1.11 to 2.31; Ptrend=0.02) and IW days of diazinon use (RR=1.41; 95% CI 0.98 to 2.04; Ptrend=0.08). Kidney cancer (N=94) risks were non-significantly elevated (RRLT days=1.77; 95% CI 0.90 to 3.51; Ptrend=0.09; RRIW days 1.37; 95% CI 0.64 to 2.92; Ptrend=0.50), as were risks for aggressive prostate cancer (N=656).

Conclusions Our updated evaluation of diazinon provides additional evidence of an association with lung cancer risk. Newly identified links to kidney cancer and associations with aggressive prostate cancer require further evaluation.

  • diazinon
  • insecticides
  • organophosphate
  • neoplasms

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