BACKGROUND Agricultural work and occupational pesticide use have been associated with increased risk of renal cell carcinoma (RCC), the most common form of kidney cancer. However, few prospective studies have investigated links to specific pesticides. OBJECTIVE We evaluated the lifetime use of individual pesticides and the incidence of RCC. METHODS We evaluated the associations between intensity-weighted lifetime days (IWDs) of 38 pesticides and incident RCC in the Agricultural Health Study, a prospective cohort of licensed pesticide applicators in Iowa and North Carolina. Among 55,873 applicators, 308 cases were diagnosed between enrollment (1993-1997) and the end of follow-up (2014-2015). We estimated incidence rate ratios (RRs) and 95% confidence intervals (CIs) using Poisson regression, controlling for potential confounding factors, with lagged and unlagged pesticide exposures. RESULTS There was a statistically significant increased risk of RCC among the highest users of 2,4,5-T compared with never users [unlagged RRIWD Tertile 3=2.92 (95% CI: 1.65, 5.17; ptrend=0.001)], with similar risk estimates for lagged exposure [20-y lag RRIWD Tertile 3=3.37 (95% CI: 1.83, 6.22; ptrend=0.001)]. In 20-y lagged analyses, we also found exposure-response associations with chlorpyrifos [RRIWD Quartile 4=1.68 (95% CI: 1.05, 2.70; ptrend=0.01)], chlordane [RRIWD Tertile 3=2.06 (95% CI: 1.10, 3.87; ptrend=0.02)], atrazine [RRIWD Quartile 4=1.43 (95% CI: 1.00, 2.03; ptrend=0.02)], cyanazine [RRIWD Quartile 4=1.61 (95% CI: 1.03, 2.50; ptrend=0.02)], and paraquat [RRIWD>Median=1.95 (95% CI: 1.03, 3.70; ptrend=0.04)]. CONCLUSIONS This is, to our knowledge, the first prospective study to evaluate RCC risk in relation to various pesticides. We found evidence of associations with RCC for four herbicides (2,4,5-T, atrazine, cyanazine, and paraquat) and two insecticides (chlorpyrifos and chlordane). Our findings provide insights into specific chemicals that may influence RCC risk among pesticide applicators. Confirmation of these findings and investigations of the biologic plausibility and potential mechanisms underlying the observed associations are warranted. https://doi.org/10.1289/EHP6334.

中文翻译：

---

农业健康研究中职业性农药的使用和肾细胞癌的风险。

背景技术农业工作和职业农药的使用已经与肾细胞癌（RCC）的风险增加有关，RCC是肾癌的最常见形式。但是，很少有前瞻性研究调查与特定农药的联系。目的我们评估了单个农药的使用寿命以及RCC的发生率。方法在农业健康研究中，我们评估了38种农药的强度加权生命天数（IWD）与RCC事件之间的关联性，该研究是爱荷华州和北卡罗来纳州许可的农药施药者的前瞻性队列。在55873名申请者中，有308例被诊断为入组（1993年至1997年）至随访结束（2014年至2015年）。我们使用Poisson回归估计了发生率比（RRs）和95％置信区间（CIs），并控制了潜在的混杂因素，滞后和未滞后的农药暴露。结果在最高使用量的2,4,5-T人群中，与从未使用过的人群相比，RCC的风险有统计学上的显着增加[未滞后的RRIWD Tertile 3 = 2.92（95％CI：1.65，5.17; ptrend = 0.001）]，相似滞后风险的风险估计[20年滞后RRIWD Tertile 3 = 3.37（95％CI：1.83，6.22； ptrend = 0.001）]。在20 y滞后分析中，我们还发现了与毒死rif [RRIWD四分位数4 = 1.68（95％CI：1.05，2.70; ptrend = 0.01）]，氯丹[RRIWD Tertile 3 = 2.06（95％CI：1.10）的暴露-反应关联。 ，3.87； ptrend = 0.02）]，at去津[RRIWD四分位数4 = 1.43（95％CI：1.00，2.03; ptrend = 0.02）]，氰嗪[RRIWD四分位数4 = 1.61（95％CI：1.03，2.50; ptrend = 0.02） ）]和百草枯[RRIWD>中位数= 1.95（95％CI：1.03，3.70; ptrend = 0.04）]。结论据我们所知，第一项评估与各种农药相关的RCC风险的前瞻性研究。我们发现了与四种有机除草剂（2,4,5-T，阿特拉津，氰嗪和百草枯）和两种杀虫剂（毒死rif和氯丹）的RCC关联的证据。我们的发现提供了对可能影响农药施用者RCC风险的特定化学物质的见解。这些发现的确认以及对生物学合理性和所观察到的关联的潜在机制的研究是必要的。https://doi.org/10.1289/EHP6334。这些发现的确认以及对生物学合理性和所观察到的关联的潜在机制的研究是必要的。https://doi.org/10.1289/EHP6334。这些发现的确认以及对生物学合理性和所观察到的关联的潜在机制的研究是必要的。https://doi.org/10.1289/EHP6334。