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Occupational exposure to pesticides and other biocides and risk of thyroid cancer
  1. Fanhua Zeng1,2,
  2. Catherine Lerro2,
  3. Jérôme Lavoué3,
  4. Huang Huang4,
  5. Jack Siemiatycki3,
  6. Nan Zhao2,
  7. Shuangge Ma5,
  8. Nicole C Deziel2,
  9. Melissa C Friesen6,
  10. Robert Udelsman7,
  11. Yawei Zhang2,4
  1. 1 Chongqing Safety Engineering Institute, Chongqing University of Science and Technology, Chongqing, China
  2. 2 Department of Environmental Health Sciences, Yale School of Public Health, New Haven, Connecticut, USA
  3. 3 Department of Environmental and Occupational Health, University of Montreal, Montreal, Canada
  4. 4 Department of Surgery, Section of Surgical Outcomes and Epidemiology, Yale School of Medicine, New Haven, Connecticut, USA
  5. 5 Department of Biostatistics, Yale School of Public Health, New Haven, Connecticut, USA
  6. 6 Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
  7. 7 Department of Surgery and Yale Cancer Center, Yale School of Medicine, Yale New Haven Hospital, New Haven, Connecticut, USA
  1. Correspondence to Dr Yawei Zhang, Section of Surgical Outcomes and Epidemiology, Department of Surgery, Yale School of Medicine, Yale School of Public Health, Yale Cancer Center, 60 College Street, LEPH 440, New Haven, CT 06520, USA; yawei.zhang{at}


Objectives To assess the associations between occupational exposure to biocides and pesticides and risk of thyroid cancer.

Methods Using data from a population-based case–control study involving 462 incident thyroid cancer cases and 498 controls in Connecticut collected in 2010–2011, we examined the association with occupational exposure to biocides and pesticides through a job-exposure matrix. We used unconditional logistic regression models to estimate OR and 95% CI, adjusting for potential confounders.

Results Individuals who were occupationally ever exposed to biocides had an increased risk of thyroid cancer (OR=1.65, 95% CI 1.16 to 2.35), and the highest risk was observed for the high cumulative probability of exposure (OR=2.18, 95% CI 1.28 to 3.73). The observed associations were similar when we restricted to papillary thyroid cancer and well-differentiated thyroid cancer. Stronger associations were observed for thyroid microcarcinomas (tumour size ≤1 cm). No significant association was observed for occupational exposure to pesticides.

Conclusions Our study provides the first evidence linking occupational exposure to biocides and risk of thyroid cancer. The results warrant further investigation.

  • thyroid cancer
  • occupational exposure
  • job-exposure matrix

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  • Contributor RU and YZ designed the research; JL and JS designed the CANJEM; FZ and HH performed statistical analysis; MF, JL and JS contributed to the JEM study results interpretation; FZ, CL and YZ wrote the first draft; HH, NZ, MS, ND and YZ revised the manuscript and submitted the study. All authors contributed to the final draft and approved the manuscript.

  • Funding This research was supported by the American Cancer Society grants RSGM-10-038-01-CCE and MRSG-15-147-01-CNE, the National Institutes of Health (NIH) grant R01ES020361, and the Ministry of Science and Technology of the People’s Republic of China grant 2016YFC1302500. CL and MCF were supported by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics, NCI, NIH. The creation of CANJEM was funded jointly by the Cancer Research Society of Canada, the Quebec Ministry of Economy, Science and Innovation and the Fonds de Recherche du Québec – Santé. Dr S holds the Guzzo-Cancer Research Society Chair in Environment and Cancer.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.