Pesticide exposures and the risk of multiple myeloma in men: An analysis of the North American Pooled Project.
Multiple myeloma (MM) has been consistently linked with agricultural activities, including farming and pesticide exposures. Three case-control studies in the United States and Canada were pooled to create the North American Pooled Project (NAPP) to investigate associations between pesticide use and haematological cancer risk. This analysis used data from 547 MM cases and 2700 controls. Pesticide use was evaluated as follows: ever/never use; duration of use (years); and cumulative lifetime-days (LD) (days/year handled × years of use). Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using logistic regression adjusted for age, province/state of residence, use of proxy respondents and selected medical conditions. Increased MM risk was observed for ever use of carbaryl (OR = 2.02, 95% CI = 1.28-3.21), captan (OR = 1.98, 95% CI = 1.04-3.77) and DDT (OR = 1.44, 95% CI = 1.05-1.97). Using the Canadian subset of NAPP data, we observed a more than threefold increase in MM risk (OR = 3.18, 95% CI = 1.40-7.23) for ≤10 cumulative LD of carbaryl use. The association was attenuated but remained significant for >10 LD of carbaryl use (OR = 2.44; 95% CI = 1.05-5.64; ptrend  = 0.01). For captan, ≤17.5 LD of exposure was also associated with a more than threefold increase in risk (OR = 3.52, 95% CI = 1.32-9.34), but this association was attenuated in the highest exposure category of >17.5 LD (OR = 2.29, 95% CI = 0.81-6.43; ptrend  = 0.01). An increasing trend (ptrend  = 0.04) was observed for LD of DDT use (LD > 22; OR = 1.92, 95% CI = 0.95-3.88). In this large North American study of MM and pesticide use, we observed significant increases in MM risk for use of carbaryl, captan and DDT.
Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada.|Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.
Roseanna
R
Presutti
Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada.|Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.|Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|Department of Occupational and Environmental Health, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
Shelley A
0000-0003-2306-7921
SA
Harris
Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada.|Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.|Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada.
Linda
L
Kachuri
British Columbia Cancer Agency Research Centre and University of British Columbia, Vancouver, BC, Canada.
John J
JJ
Spinelli
Occupational Cancer Research Centre, Cancer Care Ontario, Toronto, ON, Canada.|Prevention and Cancer Control, Cancer Care Ontario, Toronto, ON, Canada.
Manisha
M
Pahwa
Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD.
Aaron
A
Blair
Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD.
Shelia Hoar
SH
Zahm
Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD.
Kenneth P
KP
Cantor
Department of Pathology, City of Hope Medical Center, Duarte, CA.
Dennis D
DD
Weisenburger
Canadian Centre for Health and Safety in Agriculture.|Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.
Punam
P
Pahwa
Department of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.|Lunenfeld-Tanenbaum Research Institute, Toronto, ON, Canada.|Public Health Ontario, Toronto, ON, Canada.
John R
JR
McLaughlin
Department of Community Health and Epidemiology, University of Saskatchewan, Saskatoon, SK, Canada.
James A
JA
Dosman
Division of Cancer Epidemiology and Genetics, U.S. National Cancer Institute, Bethesda, MD.
Laura Beane
LB
Freeman
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000139:chemically induced / Q000453:epidemiology; D002170:Canada / Q000453:epidemiology; D016022:Case-Control Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009101:Multiple Myeloma / Q000139:chemically induced* / Q000453:epidemiology*; D009784:Occupational Diseases / Q000139:chemically induced / Q000453:epidemiology; D016273:Occupational Exposure / Q000706:statistics & numerical data; D010575:Pesticides / Q000506:poisoning*; D012306:Risk; D014481:United States / Q000453:epidemiology
D010575:Pesticides
carbamates; insecticides; multiple myeloma; pesticides; pooled case-control study