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Challenges of pesticide exposure assessment in occupational studies of chronic diseases
  1. Laura E Beane Freeman
  1. Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA
  1. Correspondence to Dr Laura E Beane Freeman, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland, USA; freemala{at}

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In this issue of Occupational and Environmental Medicine, Ohlander and colleagues review methods used to assess pesticide exposure in occupational epidemiology studies over the last 25 years .1 Their findings are striking for two reasons. The first is the very large number of studies published during this time period. Pesticides have been linked to almost every category of chronic disease, including cancer, respiratory, neurological and autoimmune diseases, as well as reproductive outcomes. The authors identified 1271 articles, averaging over 50 publications per year. Second, as the authors note, the methods used to assign pesticide exposure are relatively crude in many instances, limiting the aetiological inferences that can be made from these data.

Pesticide exposure is ubiquitous not only in occupational settings but also in the environment. Worldwide, in 2012, the last year for which data are available, almost six billion pounds of pesticide active ingredients were applied.2 These chemicals are important in agriculture and food production, public health (including vector control) and for aesthetic reasons. The use of pesticides has increased dramatically, with an estimated 11% growth per year between 1950 and 2000.3 This growth continues, particularly in low-income and middle-income countries. In the USA, it is estimated that >90% of the population has detectable concentrations of pesticide biomarkers in their urine or blood.4 It is therefore critical that we understand how they may impact human …

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  • Funding This study was funded by the National Cancer Institute.

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Provenance and peer review Commissioned; internally peer reviewed.

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