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. 2014 Oct 22;9(10):e109332.
doi: 10.1371/journal.pone.0109332. eCollection 2014.

Non-hodgkin lymphoma risk and insecticide, fungicide and fumigant use in the agricultural health study

Michael C R Alavanja  1 , Jonathan N Hofmann  1 , Charles F Lynch  2 , Cynthia J Hines  3 , Kathryn H Barry  1 , Joseph Barker  4 , Dennis W Buckman  4 , Kent Thomas  5 , Dale P Sandler  6 , Jane A Hoppin  6 , Stella Koutros  1 , Gabriella Andreotti  1 , Jay H Lubin  1 , Aaron Blair  1 , Laura E Beane Freeman  1
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Non-hodgkin lymphoma risk and insecticide, fungicide and fumigant use in the agricultural health study

Michael C R Alavanja et al. PLoS One. .

Abstract

Farming and pesticide use have previously been linked to non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL) and multiple myeloma (MM). We evaluated agricultural use of specific insecticides, fungicides, and fumigants and risk of NHL and NHL-subtypes (including CLL and MM) in a U.S.-based prospective cohort of farmers and commercial pesticide applicators. A total of 523 cases occurred among 54,306 pesticide applicators from enrollment (1993-97) through December 31, 2011 in Iowa, and December 31, 2010 in North Carolina. Information on pesticide use, other agricultural exposures and other factors was obtained from questionnaires at enrollment and at follow-up approximately five years later (1999-2005). Information from questionnaires, monitoring, and the literature were used to create lifetime-days and intensity-weighted lifetime days of pesticide use, taking into account exposure-modifying factors. Poisson and polytomous models were used to calculate relative risks (RR) and 95% confidence intervals (CI) to evaluate associations between 26 pesticides and NHL and five NHL-subtypes, while adjusting for potential confounding factors. For total NHL, statistically significant positive exposure-response trends were seen with lindane and DDT. Terbufos was associated with total NHL in ever/never comparisons only. In subtype analyses, terbufos and DDT were associated with small cell lymphoma/chronic lymphocytic leukemia/marginal cell lymphoma, lindane and diazinon with follicular lymphoma, and permethrin with MM. However, tests of homogeneity did not show significant differences in exposure-response among NHL-subtypes for any pesticide. Because 26 pesticides were evaluated for their association with NHL and its subtypes, some chance finding could have occurred. Our results showed pesticides from different chemical and functional classes were associated with an excess risk of NHL and NHL subtypes, but not all members of any single class of pesticides were associated with an elevated risk of NHL or NHL subtypes. These findings are among the first to suggest links between DDT, lindane, permethrin, diazinon and terbufos with NHL subtypes.

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Conflict of interest statement

Competing Interests: The authors have the following interests. Joseph Barker and Dennis W. Buckman are employed by IMS, Inc. There are no patents, products in development or marketed products to declare. This does not alter the authors’ adherence to all the PLOS ONE policies on sharing data and materials, as detailed online in the guide for authors.

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