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American Journal of Epidemiology Advance Access published online on September 21, 2005

American Journal of Epidemiology, doi:10.1093/aje/kwi292
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American Journal of Epidemiology Copyright © 2005 by the Johns Hopkins Bloomberg School of Public Health All rights reserved; printed in U.S.A.
Received February 4, 2005
Accepted June 1, 2005

ORIGINAL CONTRIBUTIONS

Occupational Exposure to Pesticides and Risk of Non-Hodgkin's Lymphoma

L. Fritschi 1*, G. Benke 2, A. M. Hughes 3, A. Kricker 3, J. Turner 4, C. M. Vajdic 5, A. Grulich 5, S. Milliken 4, J. Kaldor 5, and B. K. Armstrong 3

1 Viertel Centre for Research, Queensland Cancer Fund, Brisbane, Queensland, Australia
2 Department of Epidemiology and Preventive Medicine, Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourne, Victoria, Australia
3 School of Public Health, University of Sydney, Sydney, New South Wales, Australia
4 St. Vincent's Hospital, Sydney, New South Wales, Australia
5 National Centre in HIV Epidemiology and Clinical Research, University of New South Wales, Sydney, New South Wales, Australia

* To whom correspondence should be addressed.
L. Fritschi, E-mail: lfritschi{at}qldcancer.com.au


   Abstract

Pesticide exposure may be a risk factor for non-Hodgkin's lymphoma, but it is not certain which types of pesticides are involved. A population-based case-control study was undertaken in 2000-2001 using detailed methods of assessing occupational pesticide exposure. Cases with incident non-Hodgkin's lymphoma in two Australian states (n = 694) and controls (n = 694) were chosen from Australian electoral rolls. Logistic regression was used to estimate the risks of non-Hodgkin's lymphoma associated with exposure to subgroups of pesticides after adjustment for age, sex, ethnic origin, and residence. Approximately 10% of cases and controls had incurred pesticide exposure. Substantial exposure to any pesticide was associated with a trebling of the risk of non-Hodgkin's lymphoma (odds ratio = 3.09, 95% confidence interval: 1.42, 6.70). Subjects with substantial exposure to organochlorines, organophosphates, and "other pesticides" (all other pesticides excluding herbicides) and herbicides other than phenoxy herbicides had similarly increased risks, although the increase was statistically significant only for "other pesticides." None of the exposure metrics (probability, level, frequency, duration, or years of exposure) were associated with non-Hodgkin's lymphoma. Analyses of the major World Health Organization subtypes of non-Hodgkin's lymphoma suggested a stronger effect for follicular lymphoma. These increases in risk of non-Hodgkin's lymphoma with substantial occupational pesticide exposure are consistent with previous work.

Keywords: case-control studies; herbicides; lymphoma, non-Hodgkin; occupational exposure; pesticides.
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