title: Depression and pesticide exposures among private pesticide applicators enrolled in the Agricultural Health Study.
abstract: BACKGROUND
  We evaluated the relationship between diagnosed depression and pesticide exposure using information from private pesticide applicators enrolled in the Agricultural Health Study between 1993 and 1997 in Iowa and North Carolina.
  
  
  METHODS
  There were 534 cases who self-reported a physician-diagnosed depression and 17,051 controls who reported never having been diagnosed with depression and did not feel depressed more than once a week in the past year. Lifetime pesticide exposure was categorized in three mutually exclusive groups: low (< 226 days, the reference group), intermediate (226-752 days), and high (> 752 days). Two additional measures represented acute high-intensity pesticide exposures: an unusually high pesticide exposure event (HPEE) and physician-diagnosed pesticide poisoning. Logistic regression analyses were performed relating pesticide exposure to depression.
  
  
  RESULTS
  After adjusting for state, age, education, marital status, doctor visits, alcohol use, smoking, solvent exposure, not currently having crops or animals, and ever working a job off the farm, pesticide poisoning was more strongly associated with depression [odds ratio (OR) = 2.57; 95% confidence interval (CI), 1.74-3.79] than intermediate (OR = 1.07; 95% CI, 0.87-1.31) or high (OR = 1.11; 95% CI, 0.87-1.42) cumulative exposure or an HPEE (OR = 1.65; 95% CI, 1.33-2.05). In analysis of a subgroup without a history of acute poisoning, high cumulative exposure was significantly associated with depression (OR = 1.54; 95% CI, 1.16-2.04).
  
  
  CONCLUSIONS
  These findings suggest that both acute high-intensity and cumulative pesticide exposure may contribute to depression in pesticide applicators. Our study is unique in reporting that depression is also associated with chronic pesticide exposure in the absence of a physician-diagnosed poisoning.
authors.affiliation: Colorado Injury Control Research Center, Department of Psychology, Colorado State University, Fort Collins, CO, USA. cbeseler@unmc.edu
authors.forename: Cheryl L
authors.initials: CL
authors.lastname: Beseler
authors.forename: Lorann
authors.initials: L
authors.lastname: Stallones
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: Michael C R
authors.initials: MC
authors.lastname: Alavanja
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.forename: Thomas
authors.initials: T
authors.lastname: Keefe
authors.forename: Freya
authors.initials: F
authors.lastname: Kamel
mesh_terms: D000328:Adult; D000383:Agriculture; D003863:Depression / Q000139:chemically induced*; D006801:Humans; D007484:Iowa; D008875:Middle Aged; D009657:North Carolina; D016273:Occupational Exposure; D010575:Pesticides / Q000633:toxicity*; D011795:Surveys and Questionnaires
chemical_list: D010575:Pesticides