title: Pesticide exposure and risk of monoclonal gammopathy of undetermined significance in the Agricultural Health Study.
abstract: Pesticides are associated with excess risk of multiple myeloma, albeit inconclusively. We included 678 men (30-94 years) from a well-characterized prospective cohort of restricted-use pesticide applicators to assess the risk of monoclonal gammopathy of undetermined significance (MGUS). Serum samples from all subjects were analyzed by electrophoresis performed on agarose gel; samples with a discrete or localized band were subjected to immunofixation. Age-adjusted prevalence estimates of MGUS were compared with MGUS prevalence in 9469 men from Minnesota. Associations between pesticide exposures and MGUS prevalence were assessed by logistic regression models adjusted for age and education level. Among study participants older than 50 years (n = 555), 38 were found to have MGUS, yielding a prevalence of 6.8% (95% CI, 5.0%-9.3%). Compared with men from Minnesota, the age-adjusted prevalence of MGUS was 1.9-fold (95% CI, 1.3- to 2.7-fold) higher among male pesticide applicators. Among applicators, a 5.6-fold (95% CI, 1.9- to 16.6-fold), 3.9-fold (95% CI, 1.5- to 10.0-fold), and 2.4-fold (95% CI, 1.1- to 5.3-fold) increased risk of MGUS prevalence was observed among users of the chlorinated insecticide dieldrin, the fumigant mixture carbon-tetrachloride/carbon disulfide, and the fungicide chlorothalonil, respectively. In summary, the prevalence of MGUS among pesticide applicators was twice that in a population-based sample of men from Minnesota, adding support to the hypothesis that specific pesticides are causatively linked to myelomagenesis.
authors.affiliation: Division of Cancer Epidemiology and Genetics, Medical Oncology Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD 20892, USA. landgreo@mail.nih.gov
authors.forename: Ola
authors.initials: O
authors.lastname: Landgren
authors.forename: Robert A
authors.initials: RA
authors.lastname: Kyle
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: Laura E
authors.initials: LE
authors.lastname: Beane Freeman
authors.forename: James R
authors.initials: JR
authors.lastname: Cerhan
authors.forename: Jerry A
authors.initials: JA
authors.lastname: Katzmann
authors.forename: S Vincent
authors.initials: SV
authors.lastname: Rajkumar
authors.forename: Michael C
authors.initials: MC
authors.lastname: Alavanja
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000139:chemically induced / Q000453:epidemiology*; D001797:Blood Protein Electrophoresis; D002246:Carbon Disulfide / Q000009:adverse effects; D002251:Carbon Tetrachloride / Q000009:adverse effects; D015331:Cohort Studies; D004026:Dieldrin / Q000009:adverse effects; D004587:Electrophoresis, Agar Gel; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009570:Nitriles / Q000009:adverse effects; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure; D010265:Paraproteinemias / Q000139:chemically induced / Q000453:epidemiology*; D010575:Pesticides / Q000009:adverse effects*; D015995:Prevalence; D011446:Prospective Studies; D012494:Sampling Studies
chemical_list: D009570:Nitriles; D010575:Pesticides; D002251:Carbon Tetrachloride; D004026:Dieldrin; C005806:tetrachloroisophthalonitrile; D002246:Carbon Disulfide