Background

Little is known about modifiable risk factors for thyroid disease. Several pesticides have been implicated in thyroid disruption, but clinical implications are not clear.

Objective

We assessed associations between pesticide use and other farm exposures and incident hypothyroidism and hyperthyroidism in female spouses of farmers in the Agricultural Health Study (AHS).

Methods

We used Cox proportional hazards models to estimate hazard ratios (HR) and 95% confidence intervals for risk of thyroid disease in 24,092 spouses who completed at least one follow-up questionnaire.

Results

We identified 1627 hypothyroid and 531 hyperthyroid cases over 20 years of follow-up. The fungicides benomyl, maneb/mancozeb, and metalaxyl, the herbicide pendimethalin, and among those over 60 years of age the insecticides parathion and permethrin (applied to crops) were associated with elevated hypothyroidism risk, with HR ranging from 1.56–2.44. Conversely, the insecticide phorate, and the herbicides imazethapyr and metolachlor were associated with decreased risk (HR ranging 0.63–0.73), as were long-term farm residence and other farm-related activities (HR ranging 0.69–0.84). For hyperthyroidism, the insecticide diazinon, the fungicides maneb/mancozeb, and the herbicide metolachlor were associated with increased risk (HR ranging 1.35–2.01) and the herbicide trifluralin with decreased risk (HR: 0.57).

Conclusions

Several individual pesticides were associated with increased risk of hypothyroidism and hyperthyroidism, although some pesticides were associated with decreased risk. Some of the findings, specifically associations with fungicides, are consistent with results from an earlier analysis of prevalent diseases in AHS spouses.

中文翻译：

---

私人杀虫剂施药者女性配偶的甲状腺疾病

背景

关于甲状腺疾病的可改变的危险因素知之甚少。几种杀虫剂与甲状腺功能紊乱有关，但临床意义尚不清楚。

客观的

在《农业健康研究》（AHS）中，我们评估了农药使用与其他农场暴露与农民女性配偶的甲状腺功能减退和甲状腺功能亢进之间的关联。

方法

我们使用Cox比例风险模型估算了至少完成一项随访调查问卷的24,092名配偶的甲状腺疾病风险的风险比（HR）和95％置信区间。

结果

在20年的随访中，我们确定了1627例甲状腺功能低下和531例甲状腺功能亢进。杀菌剂苯菌灵，薄荷脑/代森锰锌和甲霜灵，除草剂二甲戊乐灵，以及60岁以上的杀虫剂对硫磷和氯菊酯（适用于农作物）与甲状腺功能减退症的风险增高相关，HR范围为1.56-2.44。相反，杀虫剂磷酸根，除草剂咪唑乙草胺和甲草胺与降低的危险性相关（HR范围为0.63-0.73），与长期农场居住和其他与农场有关的活动（HR范围为0.69-0.84）也相关。对于甲亢，杀虫剂二嗪农，杀菌剂maneb / mancozeb和除草剂甲草胺与增加的风险相关（HR范围为1.35-2.01），而除草剂三氟拉林具有降低的风险（HR：0.57）。

结论

几种单独的农药与甲状腺功能减退和甲状腺功能亢进的风险增加有关，尽管有些农药与降低的风险有关。一些发现，特别是与杀真菌剂的发现，与对AHS配偶中普遍疾病的早期分析结果一致。