American Journal of Epidemiology 2008 167(10):1235-1246; doi:10.1093/aje/kwn028
Incident Diabetes and Pesticide Exposure among Licensed Pesticide Applicators: Agricultural Health Study, 1993–2003
1 Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, NC
2 Social & Scientific Systems, Durham, NC
3 Occupational and Environmental Epidemiology Branch, National Cancer Institute, Bethesda, MD
Correspondence to Dr. Dale P. Sandler, Epidemiology Branch, National Institute of Environmental Health Sciences, P.O. Box 12233, 111 T. W. Alexander Drive, Research Triangle Park, NC 27709 (e-mail: sandler@niehs.nih.gov ).
Received for publication October 2, 2007. Accepted for publication January 25, 2008.
Exposure to certain environmental toxicants may be associated with increased risk of developing diabetes. The authors' aim was to investigate the relation between lifetime exposure to specific agricultural pesticides and diabetes incidence among pesticide applicators. The study included 33,457 licensed applicators, predominantly non-Hispanic White males, enrolled in the Agricultural Health Study. Incident diabetes was self-reported in a 5-year follow-up interview (1999–2003), giving 1,176 diabetics and 30,611 nondiabetics for analysis. Lifetime exposure to pesticides and covariate information were reported by participants at enrollment (1993–1997). Using logistic regression, the authors considered two primary measures of pesticide exposure: ever use and cumulative lifetime days of use. They found seven specific pesticides (aldrin, chlordane, heptachlor, dichlorvos, trichlorfon, alachlor, and cyanazine) for which the odds of diabetes incidence increased with both ever use and cumulative days of use. Applicators who had used the organochlorine insecticides aldrin, chlordane, and heptachlor more than 100 lifetime days had 51%, 63%, and 94% increased odds of diabetes, respectively. The observed association of organochlorine and organophosphate insecticides with diabetes is consistent with results from previous human and animal studies. Long-term exposure from handling certain pesticides, in particular, organochlorine and organophosphate insecticides, may be associated with increased risk of diabetes.
agrochemicals; diabetes mellitus; environmental exposure; hydrocarbons, chlorinated; insecticides; pesticides; phosphoric acid esters
