Background

Self-reported residential use of pesticides has consistently been associated with increased risk of childhood leukemia. However, these studies were limited in their ability to identify specific insecticide active ingredients that were associated with risk.

Objective

We used household carpet dust measurements of 20 insecticides (two carbamate, 10 organophosphate, two organochlorine, and six pyrethroid) as indicators of exposure and evaluated associations with the risk of childhood acute lymphoblastic leukemia (ALL).

Methods

We conducted a population-based case-control study of 252 ALL cases diagnosed from 1999 to 2007 and 306 birth certificate controls from 35 counties in Central and Northern California. Carpet dust was collected at a second interview (2001–2007) for cases who had not moved since diagnosis (comparable reference date for controls) using a specialized vacuum cleaner in the room where the child spent most of their time or from the household vacuum. Insecticides were categorized as detected (yes/no), or as tertiles or quartiles of their distributions among controls. We calculated odds ratios (OR) and 95% confidence intervals (CI) using unconditional logistic regression adjusting for demographic characteristics, interview year, and season of dust collection.

Results

Permethrin, chlorpyrifos, diazinon, and carbaryl were the most frequently detected insecticide active ingredients. When we compared the highest quartile to the lowest or to non-detections, there was no association with ALL for permethrin (OR Q4 vs. Q1 = 0.81; 95% CI 0.50–1.31), carbaryl (OR Q4 vs. non-detects = 0.61, 95% CI 0.34–1.08) or chlorpyrifos (OR Q4 vs. Q1 = 0.60; 95% CI 0.36–1.00). The highest quartile of diazinon concentration was inversely associated with risk in the single pesticide model but without a monotonic exposure-response (p-trend = 0.14). After adjusting for other common insecticides, the OR was not significant (OR Q4 vs. Q1 = 0.58; 95% CI 0.33–1.05). None of the other insecticides were associated with risk.

Conclusion

Our results should be interpreted within the limitations of the case-control study design including the use of a single post-diagnosis dust sample and restriction to residentially stable participants, which may have resulted in selection bias. Although difficult to implement, additional studies with assessment of exposure to insecticide active and non-active ingredients are necessary to elucidate the role of these common exposures in childhood leukemia risk.

中文翻译：

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住宅暴露于室内灰尘中的氨基甲酸酯、有机磷和拟除虫菊酯杀虫剂以及患儿童急性淋巴细胞白血病的风险

背景

自我报告的住宅使用杀虫剂一直与儿童白血病风险增加有关。然而，这些研究在识别与风险相关的特定杀虫剂活性成分方面的能力有限。

客观的

我们使用 20 种杀虫剂（两种氨基甲酸酯、10 种有机磷酸酯、两种有机氯和六种拟除虫菊酯）的家用地毯灰尘测量值作为暴露指标，并评估了与儿童急性淋巴细胞白血病 (ALL) 风险的关联。

方法

我们对 1999 年至 2007 年诊断的 252 例 ALL 病例和来自加利福尼亚中部和北部 35 个县的 306 例出生证明对照进行了基于人群的病例对照研究。在第二次访谈（2001-2007 年）中，针对自诊断后未移动过的病例（对照的可比参考日期），使用专门的真空吸尘器在孩子大部分时间呆的房间或使用家用真空吸尘器收集地毯灰尘。杀虫剂被分类为检测到（是/否），或分类为它们在对照中的分布的三分位数或四分位数。我们使用无条件逻辑回归调整人口特征、访谈年份和集尘季节来计算比值比 (OR) 和 95% 置信区间 (CI)。

结果

氯菊酯、毒死蜱、二嗪磷和西维因是最常检测到的杀虫剂活性成分。当我们将最高四分位数与最低四分位数或未检测到的值进行比较时，氯菊酯（OR Q4 与 Q1 = 0.81；95% CI 0.50–1.31）、西维因（OR Q4 与未检测 = 0.61，95% CI 0.34–1.08）或毒死蜱（OR Q4 与 Q1 = 0.60；95% CI 0.36–1.00）。二嗪磷浓度的最高四分位数与单一农药模型中的风险呈负相关，但没有单调的暴露-反应（p 趋势 = 0.14）。调整其他常见杀虫剂后，OR 不显着（OR Q4 与 Q1 = 0.58；95% CI 0.33–1.05）。其他杀虫剂均与风险无关。

结论

我们的结果应该在病例对照研究设计的限制范围内进行解释，包括使用单一的诊断后灰尘样本和限制居住稳定的参与者，这可能导致选择偏差。尽管难以实施，但有必要开展更多研究来评估接触杀虫剂活性成分和非活性成分，以阐明这些常见接触在儿童白血病风险中的作用。