title: Pesticides and atopic and nonatopic asthma among farm women in the Agricultural Health Study.
abstract: BACKGROUND
  Risk factors for asthma among farm women are understudied.
  
  
  OBJECTIVE
  We evaluated pesticide and other occupational exposures as risk factors for adult-onset asthma.
  
  
  METHODS
  Studying 25,814 farm women in the Agricultural Health Study, we used self-reported history of doctor-diagnosed asthma with or without eczema and/or hay fever to create two case groups: patients with atopic asthma and those with nonatopic asthma. We assessed disease-exposure associations with polytomous logistic regression.
  
  
  RESULTS
  At enrollment (1993-1997), 702 women (2.7%) reported a doctor's diagnosis of asthma after age 19 years (282 atopic, 420 nonatopic). Growing up on a farm (61% of all farm women) was protective for atopic asthma (odds ratio [OR], 0.55; 95% confidence interval [CI], 0.43-0.70) and, to a lesser extent, for nonatopic asthma (OR, 0.83; 95%CI, 0.68-1.02; P value for difference = 0.008). Pesticide use was almost exclusively associated with atopic asthma. Any use of pesticides on the farm was associated only with atopic asthma (OR, 1.46; 95% CI, 1.14-1.87). This association with pesticides was strongest among women who had grown up on a farm. Women who grew up on farms and did not apply pesticides had the lowest overall risk of atopic asthma (OR, 0.41; 95% CI, 0.27-0.62) compared with women who neither grew up on farms nor applied pesticides. A total of 7 of 16 insecticides, 2 of 11 herbicides, and 1 of 4 fungicides were significantly associated with atopic asthma; only permethrin use on crops was associated with nonatopic asthma.
  
  
  CONCLUSIONS
  These findings suggest that pesticides may contribute to atopic asthma, but not nonatopic asthma, among farm women.
authors.affiliation: NIEHS Epidemiology Branch, MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709-2233, USA. hoppin1@niehs.nih.gov
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: David M
authors.initials: DM
authors.lastname: Umbach
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: London
authors.forename: Paul K
authors.initials: PK
authors.lastname: Henneberger
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Kullman
authors.forename: Michael C R
authors.initials: MC
authors.lastname: Alavanja
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000453:epidemiology* / Q000517:prevention & control; D001249:Asthma / Q000453:epidemiology* / Q000517:prevention & control; D015984:Causality; D015331:Cohort Studies; D003430:Cross-Sectional Studies; D003876:Dermatitis, Atopic / Q000453:epidemiology / Q000517:prevention & control; D005260:Female; D006801:Humans; D007484:Iowa; D008875:Middle Aged; D009657:North Carolina; D016273:Occupational Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000009:adverse effects*; D012044:Regression Analysis; D012130:Respiratory Hypersensitivity / Q000453:epidemiology* / Q000517:prevention & control; D006255:Rhinitis, Allergic, Seasonal / Q000453:epidemiology / Q000517:prevention & control; D012307:Risk Factors
chemical_list: D010575:Pesticides