title: Pesticide exposure as a risk factor for myelodysplastic syndromes: a meta-analysis based on 1,942 cases and 5,359 controls.
abstract: OBJECTIVE
  Pesticide exposure has been linked to increased risk of cancer at several sites, but its association with risk of myelodysplastic syndromes (MDS) is still unclear. A meta-analysis of studies published through April, 2014 was performed to investigate the association of pesticide exposure with the risk of MDS.
  
  
  METHODS
  Studies were identified by searching the Web of Science, Cochrane Library and PubMed databases. Summary odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated using random- or fixed-effect models.
  
  
  RESULTS
  This meta-analysis included 11 case-control studies, all of which demonstrated a correlation between pesticide exposure and a statistically significant increased risk of MDS (OR=1.95, 95% CI 1.23-3.09). In subgroup analyses, patients with pesticide exposure had increased risk of developing MDS if they were living in the Europe or Asia and had refractory anemia (RA) or RA with ringed sideroblasts (RARS). Moreover, in the analysis by specific pesticides, increased risk was associated with exposure to insecticides (OR=1.71, 95% CI 1.22-2.40) but not exposure to herbicides or fungicides.
  
  
  CONCLUSIONS
  This meta-analysis supports the hypothesis that exposure to pesticides increases the risk of developing MDS. Further prospective cohort studies are warranted to verify the association and guide clinical practice in MDS prevention.
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Jie
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Mengxia
authors.initials: M
authors.lastname: Yu
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Chao
authors.initials: C
authors.lastname: Hu
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Li
authors.initials: L
authors.lastname: Ye
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Lili
authors.initials: L
authors.lastname: Xie
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Jin
authors.initials: J
authors.lastname: Jin
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Feifei
authors.initials: F
authors.lastname: Chen
authors.affiliation: Department of Hematology, the First Affiliated Hospital of Zhejiang University, Hangzhou, People's Republic of China; Institute of Hematology, Zhejiang University School of Medicine, Hangzhou, People's Republic of China; Myelodysplastic syndromes diagnosis and therapy center, Zhejiang University School of Medicine, Hangzhou, People's Republic of China.
authors.forename: Hongyan
authors.initials: H
authors.lastname: Tong
mesh_terms: D016022:Case-Control Studies; D004781:Environmental Exposure; D005659:Fungicides, Industrial / Q000633:toxicity; D006540:Herbicides / Q000633:toxicity; D006801:Humans; D007306:Insecticides / Q000633:toxicity; D009190:Myelodysplastic Syndromes / Q000139:chemically induced / Q000453:epidemiology*; D016273:Occupational Exposure; D010575:Pesticides / Q000633:toxicity*; D012307:Risk Factors
chemical_list: D005659:Fungicides, Industrial; D006540:Herbicides; D007306:Insecticides; D010575:Pesticides