title: Is pesticide exposure a cause of obstructive airways disease?
abstract: A systematic review was performed to identify any associations between pesticide exposure and the occurrence (both prevalence and incidence) of airways disease (asthma and chronic obstructive pulmonary disease) and wheezing symptoms. PubMed, MEDLINE, Embase, Scopus, CINAHL, Google Scholar and the Cochrane Database of Systematic Reviews were searched between September 2010 and October 2010 for papers with the inclusion criteria of English language, published after 1990, peer-reviewed and nondietary exposure. From a total of 4390 papers identified, 42 were included after initial assessment of content. After evaluating the included studies for quality, those considered to be at high risk of bias were excluded, leaving a total of 23 relevant papers. Results suggest that exposure to pesticides may be associated with prevalent asthma, but methodological issues, such as cross-sectional/case-control design, measurements of exposure and limited adjustment for confounders, limit the strength of the evidence base in this area. The association between pesticide exposure and asthma appears to be more evident and consistent in children than in adults. Exposure to pesticides may be associated with COPD; however, the strength of evidence for an association with COPD is weaker than for asthma. As the exposure metrics within each health end-point varied across studies, no meta-analyses were carried out.
authors.affiliation: Institute of Occupational Medicine, Edinburgh, UK. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK. Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK. Dept of Environmental and Occupational Medicine, University of Aberdeen King's College, Aberdeen, UK.
authors.forename: Emma
authors.initials: E
authors.lastname: Doust
authors.affiliation: Institute of Occupational Medicine, Edinburgh, UK. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK. Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK. Dept of Environmental and Occupational Medicine, University of Aberdeen King's College, Aberdeen, UK.
authors.forename: Jon G
authors.initials: JG
authors.lastname: Ayres
authors.affiliation: Institute of Occupational Medicine, Edinburgh, UK. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK. Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK. Dept of Environmental and Occupational Medicine, University of Aberdeen King's College, Aberdeen, UK.
authors.forename: Graham
authors.initials: G
authors.lastname: Devereux
authors.affiliation: Institute of Occupational Medicine, Edinburgh, UK. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK. Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK. Dept of Environmental and Occupational Medicine, University of Aberdeen King's College, Aberdeen, UK.
authors.forename: Finlay
authors.initials: F
authors.lastname: Dick
authors.affiliation: Institute of Occupational Medicine, Edinburgh, UK. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK. Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK. Dept of Environmental and Occupational Medicine, University of Aberdeen King's College, Aberdeen, UK. joanne.crawford@iom-world.org.
authors.forename: Joanne O
authors.initials: JO
authors.lastname: Crawford
authors.affiliation: Institute of Occupational Medicine, Edinburgh, UK. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK. Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK. Dept of Environmental and Occupational Medicine, University of Aberdeen King's College, Aberdeen, UK.
authors.forename: Hilary
authors.initials: H
authors.lastname: Cowie
authors.affiliation: Institute of Occupational Medicine, Edinburgh, UK. Institute of Occupational and Environmental Medicine, University of Birmingham, Birmingham, UK. Child Health, Royal Aberdeen Children's Hospital, Aberdeen, UK. Dept of Environmental and Occupational Medicine, University of Aberdeen King's College, Aberdeen, UK.
authors.forename: Ken
authors.initials: K
authors.lastname: Dixon
mesh_terms: D001249:Asthma / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D006801:Humans; D015994:Incidence; D008168:Lung / Q000187:drug effects* / Q000503:physiopathology; D016273:Occupational Exposure / Q000009:adverse effects; D010575:Pesticides / Q000009:adverse effects*; D015995:Prevalence; D029424:Pulmonary Disease, Chronic Obstructive / Q000139:chemically induced* / Q000175:diagnosis / Q000453:epidemiology / Q000503:physiopathology; D012135:Respiratory Sounds / Q000209:etiology / Q000503:physiopathology; D018570:Risk Assessment; D012307:Risk Factors
chemical_list: D010575:Pesticides