title: A review of pesticide exposure and cancer incidence in the Agricultural Health Study cohort.
abstract: OBJECTIVE
  We reviewed epidemiologic evidence related to occupational pesticide exposures and cancer incidence in the Agricultural Health Study (AHS) cohort.
  
  
  METHODS
  Studies were identified from the AHS publication list available at http://aghealth.nci.nih.gov as well as through a Medline/PubMed database search in March 2009. We also examined citation lists. Findings related to lifetime-days and/or intensity-weighted lifetime-days of pesticide use are the primary focus of this review, because these measures allow for the evaluation of potential exposure-response relationships.
  
  
  RESULTS
  We reviewed 28 studies; most of the 32 pesticides examined were not strongly associated with cancer incidence in pesticide applicators. Increased rate ratios (or odds ratios) and positive exposure-response patterns were reported for 12 pesticides currently registered in Canada and/or the United States (alachlor, aldicarb, carbaryl, chlorpyrifos, diazinon, dicamba, S-ethyl-N,N-dipropylthiocarbamate, imazethapyr, metolachlor, pendimethalin, permethrin, trifluralin). However, estimates of association for specific cancers were often imprecise because of small numbers of exposed cases, and clear monotonic exposure-response patterns were not always apparent. Exposure misclassification is also a concern in the AHS and may limit the analysis of exposure-response patterns. Epidemiologic evidence outside the AHS remains limited with respect to most of the observed associations, but animal toxicity data support the biological plausibility of relationships observed for alachlor, carbaryl, metolachlor, pendimethalin, permethrin, and trifluralin.
  
  
  CONCLUSIONS
  Continued follow-up is needed to clarify associations reported to date. In particular, further evaluation of registered pesticides is warranted.
authors.affiliation: Health Canada, Ottawa, Ontario, Canada. scott.weichenthal@hc-sc.gc.ca
authors.forename: Scott
authors.initials: S
authors.lastname: Weichenthal
authors.forename: Connie
authors.initials: C
authors.lastname: Moase
authors.forename: Peter
authors.initials: P
authors.lastname: Chan
mesh_terms: D015331:Cohort Studies; D004781:Environmental Exposure / Q000032:analysis; D004785:Environmental Pollutants / Q000633:toxicity*; D005260:Female; D006801:Humans; D015994:Incidence; D007484:Iowa / Q000453:epidemiology; D008297:Male; D009369:Neoplasms / Q000139:chemically induced / Q000453:epidemiology*; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure / Q000032:analysis*; D010575:Pesticides / Q000633:toxicity*
chemical_list: D004785:Environmental Pollutants; D010575:Pesticides
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