PT  - JOURNAL ARTICLE
AU  - Johan Ohlander
AU  - Samuel Fuhrimann
AU  - Ioannis Basinas
AU  - John W Cherrie
AU  - Karen S Galea
AU  - Andrew C Povey
AU  - Martie van Tongeren
AU  - Anne-Helen Harding
AU  - Kate Jones
AU  - Roel Vermeulen
AU  - Anke Huss
AU  - Hans Kromhout
TI  - Impact of occupational pesticide exposure assessment method on risk estimates for prostate cancer, non-Hodgkin’s lymphoma and Parkinson’s disease: results of three meta-analyses
AID  - 10.1136/oemed-2021-108046
DP  - 2022 Apr 06
TA  - Occupational and Environmental Medicine
PG  - oemed-2021-108046
4099  - http://oem.bmj.com/content/early/2022/05/02/oemed-2021-108046.short
4100  - http://oem.bmj.com/content/early/2022/05/02/oemed-2021-108046.full
AB  - Assessment of occupational pesticide exposure in epidemiological studies of chronic diseases is challenging. Biomonitoring of current pesticide levels might not correlate with past exposure relevant to disease aetiology, and indirect methods often rely on workers’ imperfect recall of exposures, or job titles. We investigated how the applied exposure assessment method influenced risk estimates for some chronic diseases. In three meta-analyses the influence of exposure assessment method type on the summary risk ratio (sRR) of prostate cancer (PC) (25 articles), non-Hodgkin’s lymphoma (NHL) (29 articles) and Parkinson’s disease (PD) (32 articles) was investigated. Exposure assessment method types analysed were: group-level assessments (eg, job titles), self-reported exposures, expert-level assessments (eg, job-exposure matrices) and biomonitoring (eg, blood, urine). Additionally, sRRs were estimated by study design, publication year period and geographic location where the study was conducted. Exposure assessment method types were not associated with statistically significant different sRRs across any of the health outcomes. Heterogeneity in results varied from high in cancer studies to moderate and low in PD studies. Overall, case–control designs showed significantly higher sRR estimates than prospective cohort designs. Later NHL publications showed significantly higher sRR estimates than earlier. For PC, studies from North America showed significantly higher sRR estimates than studies from Europe. We conclude that exposure assessment method applied in studies of occupational exposure to pesticides appears not to have a significant effect on risk estimates for PC, NHL and PD. In systematic reviews of chronic health effects of occupational exposure to pesticides, epidemiological study design, publication year and geographic location, should primarily be considered.