title: Incidence of solid tumours among pesticide applicators exposed to the organophosphate insecticide diazinon in the Agricultural Health Study: an updated analysis.
abstract: OBJECTIVE
  Diazinon, a common organophosphate insecticide with genotoxic properties, was previously associated with lung cancer in the Agricultural Health Study (AHS) cohort, but few other epidemiological studies have examined diazinon-associated cancer risk. We used updated diazinon exposure and cancer incidence information to evaluate solid tumour risk in the AHS.
  
  
  METHODS
  Male pesticide applicators in Iowa and North Carolina reported lifetime diazinon use at enrolment (1993-1997) and follow-up (1998-2005); cancer incidence was assessed through 2010(North Carolina)/2011(Iowa). Among applicators with usage information sufficient to evaluate exposure-response patterns, we used Poisson regression to estimate adjusted rate ratios (RRs) and 95% CI for cancer sites with ≥10 exposed cases for both lifetime (LT) exposure days and intensity-weighted (IW) lifetime exposure days (accounting for factors impacting exposure).
  
  
  RESULTS
  We observed elevated lung cancer risks (N=283) among applicators with the greatest number of LT (RR=1.60; 95% CI 1.11 to 2.31; P(trend)=0.02) and IW days of diazinon use (RR=1.41; 95% CI 0.98 to 2.04; P(trend)=0.08). Kidney cancer (N=94) risks were non-significantly elevated (RR(LT) days=1.77; 95% CI 0.90 to 3.51; P(trend)=0.09; RR(IW) days 1.37; 95% CI 0.64 to 2.92; P(trend)=0.50), as were risks for aggressive prostate cancer (N=656).
  
  
  CONCLUSIONS
  Our updated evaluation of diazinon provides additional evidence of an association with lung cancer risk. Newly identified links to kidney cancer and associations with aggressive prostate cancer require further evaluation.
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Rena R
authors.initials: RR
authors.lastname: Jones
authors.affiliation: Population Health Research Institute, St. George's, University of London, London, UK.
authors.forename: Francesco
authors.initials: F
authors.lastname: Barone-Adesi
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Stella
authors.initials: S
authors.lastname: Koutros
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Catherine C
authors.initials: CC
authors.lastname: Lerro
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Jay
authors.initials: J
authors.lastname: Lubin
authors.affiliation: Department of Pediatrics, University of Washington, Seattle, Washington, USA.
authors.forename: Sonya L
authors.initials: SL
authors.lastname: Heltshe
authors.affiliation: Department of Biological Sciences, North Carolina State University, Raleigh, North Carolina, USA.
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Michael C R
authors.initials: MC
authors.lastname: Alavanja
authors.affiliation: Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA.
authors.forename: Laura E
authors.initials: LE
authors.lastname: Beane Freeman
mesh_terms: D000328:Adult; D000382:Agricultural Workers' Diseases / Q000453:epidemiology / Q000209:etiology*; D000383:Agriculture; D003976:Diazinon / Q000009:adverse effects*; D006801:Humans; D015994:Incidence; D007484:Iowa / Q000453:epidemiology; D007680:Kidney Neoplasms / Q000453:epidemiology / Q000209:etiology; D008175:Lung Neoplasms / Q000453:epidemiology / Q000209:etiology*; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D009943:Organophosphorus Compounds / Q000009:adverse effects; D010575:Pesticides / Q000009:adverse effects*; D011446:Prospective Studies; D011471:Prostatic Neoplasms / Q000453:epidemiology / Q000209:etiology*
chemical_list: D009943:Organophosphorus Compounds; D010575:Pesticides; D003976:Diazinon
keywords: diazinon; insecticides; neoplasms; organophosphate