Abstract

Background:

Some pesticides are immunotoxic and have been associated with an increased risk of immune-mediated diseases. The risk of shingles, the clinical reactivation of varicella-zoster virus, increases with aging and immunosuppression; little is known about its associations with pesticides.

Objective:

We examined the use of agricultural pesticides in relation to incident shingles in a prospective cohort of licensed pesticide applicators.

Methods:

The study sample included 12,820 (97% male) farmers (enrolled in 1993–1997 in North Carolina and Iowa), who were followed for a median of 12 y (interquartile range: 11–13). Shingles was self-reported at enrollment and at follow-up. We evaluated ever-use of 48 agricultural pesticides reported at study enrollment in relation to shingles risk and considered exposure–response for intensity-weighted lifetime days (IWLDs) of use. Hazard ratios (HRs) and 95% confidence intervals (CIs) were calculated using Cox proportional hazard models, adjusting for state, and allowing estimates to vary by median attained age (60 y).

Results:

Incident shingles was reported by 590 participants. Associations were positive ($\text{HRs}>1.2$) for ever- vs. never-use of eight insecticides, three fumigants, two fungicides, and five herbicides, and exposure–response trends were seen across increasing quartiles (Q3 and $\mathrm{Q}4>\mathrm{Q}1$) or tertiles (T3 and $\mathrm{T}2>\mathrm{T}1$) of IWLDs for four insecticides [permethrin (crops), coumaphos, malathion, and lindane], two fumigants (carbon tetrachloride/carbon disulfide and methyl bromide), and three herbicides [alachlor, trifluralin ($<60\text{\hspace{0.17em}years of age}$) and 2,4-dichlorophenoxyacetic acid]. Shingles was not associated with total years or days per year mixed or applied any pesticides, but in older participants, shingles was associated with a history of a high pesticide exposure event [$\text{HR}=1.89$ (95% CI: 1.45, 2.45)].

Conclusions:

Several specific pesticides were associated with increased risk of shingles in farmers, especially at higher levels of cumulative use. These novel findings, if replicated in other populations, could have broader implications for the potential effects of pesticides on vaccine efficacy and susceptibility to other infections. https://doi.org/10.1289/EHP7797

中文翻译：

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许可农药施用者的预期队列中的农业农药和带状疱疹风险

摘要

背景：

一些杀虫剂具有免疫毒性，并与免疫介导疾病的风险增加有关。带状疱疹的风险，即水痘-带状疱疹病毒的临床再激活，随着年龄的增长和免疫抑制而增加；关于它与杀虫剂的关系知之甚少。

客观的：

我们在一组有执照的杀虫剂施用者的前瞻性队列中检查了与事件带状疱疹相关的农业杀虫剂的使用。

方法：

研究样本包括 12,820 名（97% 男性）农民（于 1993-1997 年在北卡罗来纳州和爱荷华州登记），他们被跟踪的中位数为 12 年（四分位距：11-13）。带状疱疹是在入组和随访时自我报告的。我们评估了研究登记时报告的 48 种农药的使用情况与带状疱疹风险的关系，并考虑了使用强度加权寿命天数 (IWLD) 的暴露反应。使用 Cox 比例风险模型计算风险比 (HRs) 和 95% 置信区间 (CIs)，调整状态，并允许估计值因中位年龄（60 岁）而异。

结果：

590 名参与者报告了带状疱疹事件。关联是积极的（$\text{人力资源}>1.2$) 与从不使用八种杀虫剂、三种熏蒸剂、两种杀真菌剂和五种除草剂的比较，并且在增加的四分位数（Q3 和$\mathrm{问}4>\mathrm{问}1$) 或三分位数 (T3 和$\mathrm{吨}2>\mathrm{吨}1$) 的 IWLD 用于四种杀虫剂 [氯菊酯 (作物)、香豆磷、马拉硫磷和林丹]、两种熏蒸剂 (四氯化碳/二硫化碳和溴甲烷) 和三种除草剂 [甲草胺、氟乐灵 ($<60\text{\hspace{0.17em}岁}$) 和 2,4-二氯苯氧乙酸]。带状疱疹与每年混合或施用任何农药的总年数或天数无关，但在老年参与者中，带状疱疹与高农药暴露事件的历史相关[$\text{人力资源}=1.89$(95% CI: 1.45, 2.45)]。

结论：

几种特定的杀虫剂与农民患带状疱疹的风险增加有关，尤其是在累积使用量较高的情况下。如果在其他人群中复制这些新发现，可能会对杀虫剂对疫苗效力和其他感染易感性的潜在影响产生更广泛的影响。https://doi.org/10.1289/EHP7797