Cancer health effects of pesticides: systematic review.
OBJECTIVE
To review literature documenting associations between pesticide use and cancer.


METHODS
We searched MEDLINE, PreMedline, CancerLit, and LILACS to find studies published between 1992 and 2003 on non-Hodgkin lymphoma, leukemia, and 8 solid-tumour cancers: brain, breast, kidney, lung, ovarian, pancreatic, prostate, and stomach cancer.


METHODS
Each title and abstract was assessed for relevance; disagreements among reviewers were resolved by consensus. Studies were assessed by a team of 2 trained reviewers and rated based on methodologic quality according to a 5-page assessment tool and a global assessment scale. Studies rated below a global score of 4 out of 7 were excluded.


RESULTS
Most studies on non-Hodgkin lymphoma and leukemia showed positive associations with pesticide exposure. Some showed dose-response relationships, and a few were able to identify specific pesticides. Children's and pregnant women's exposure to pesticides was positively associated with the cancers studied in some studies, as was parents' exposure to pesticides at work. Many studies showed positive associations between pesticide exposure and solid tumours. The most consistent associations were found for brain and prostate cancer. An association was also found between kidney cancer in children and their parents' exposure to pesticides at work. These associations were most consistent for high and prolonged exposures. Specific weaknesses and inherent limitations in epidemiologic studies were noted, particularly around ascertaining whether and how much exposure had taken place.


CONCLUSIONS
Our findings support attempts to reduce exposure to pesticides. Reductions are likely best achieved through decreasing pesticide use for cosmetic (non-commercial) purposes (where children might be exposed) and on the job.
Bassil
K L
KL
Family Medicine Centre, Queen's University, 220 Bagot St, Kingston, ON. cv4@post.queensu.ca
Vakil
C
C
Sanborn
M
M
Cole
D C
DC
Kaur
J S
JS
Kerr
K J
KJ
D000328:Adult; D001932:Brain Neoplasms / Q000139:chemically induced; D001943:Breast Neoplasms / Q000139:chemically induced; D002648:Child; D004781:Environmental Exposure / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000139:chemically induced; D007938:Leukemia / Q000139:chemically induced; D008175:Lung Neoplasms / Q000139:chemically induced; D008228:Lymphoma, Non-Hodgkin / Q000139:chemically induced; D008297:Male; D009369:Neoplasms / Q000139:chemically induced*; D010051:Ovarian Neoplasms / Q000139:chemically induced; D010190:Pancreatic Neoplasms / Q000139:chemically induced; D010573:Pesticide Residues / Q000009:adverse effects*; D011247:Pregnancy; D011471:Prostatic Neoplasms / Q000139:chemically induced; D013274:Stomach Neoplasms / Q000139:chemically induced
D010573:Pesticide Residues