Pesticides and atopic and nonatopic asthma among farm women in the Agricultural Health Study.
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.
Hoppin
Jane A
JA
NIEHS Epidemiology Branch, MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709-2233, USA. hoppin1@niehs.nih.gov
Umbach
David M
DM
London
Stephanie J
SJ
Henneberger
Paul K
PK
Kullman
Greg J
GJ
Alavanja
Michael C R
MC
Sandler
Dale P
DP
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
D010575:Pesticides