Exposure to pesticides and risk of Hodgkin lymphoma in an international consortium of agricultural cohorts (AGRICOH)

Joanne Kim, Maria E Leon, Leah H Schinasi, Isabelle Baldi, Pierre Lebailly, Laura E Beane Freeman, Karl-Christian Nordby, Gilles Ferro, Alain Monnereau, Maartje Brouwer, Kristina Kjaerheim, Jonathan N Hofmann, Kurt Straif, Hans Kromhout, Joachim Schüz, Kayo Togawa

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Purpose: Some pesticides may increase the risk of certain lymphoid malignancies, but few studies have examined Hodgkin lymphoma (HL). In this exploratory study, we examined associations between agricultural use of 22 individual active ingredients and 13 chemical groups and HL incidence. Methods: We used data from three agricultural cohorts participating in the AGRICOH consortium: the French Agriculture and Cancer Cohort (2005–2009), Cancer in the Norwegian Agricultural Population (1993–2011), and the US Agricultural Health Study (1993–2011). Lifetime pesticide use was estimated from crop-exposure matrices or self-report. Cohort-specific covariate-adjusted overall and age-specific (< 40 or ≥ 40 years) hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated using Cox regression and combined using random effects meta-analysis. Results: Among 316 270 farmers (75% male) accumulating 3 574 815 person-years at risk, 91 incident cases of HL occurred. We did not observe statistically significant associations for any of the active ingredients or chemical groups studied. The highest risks of HL overall were observed for the pyrethroids deltamethrin (meta-HR = 1.86, 95% CI 0.76–4.52) and esfenvalerate (1.86, 0.78–4.43), and inverse associations of similar magnitude were observed for parathion and glyphosate. Risk of HL at ≥ 40 years of age was highest for ever-use of dicamba (2.04, 0.93–4.50) and lowest for glyphosate (0.46, 0.20–1.07). Conclusion: We report the largest prospective investigation of these associations. Nonetheless, low statistical power, a mixture of histological subtypes and a lack of information on tumour EBV status complicate the interpretability of the results. Most HL cases occurred at older ages, thus we could not explore associations with adolescent or young adult HL. Furthermore, estimates may be attenuated due to non-differential exposure misclassification. Future work should aim to extend follow-up and refine both exposure and outcome classification.

Original languageEnglish
Pages (from-to)995-1003
Number of pages9
JournalCancer Causes and Control
Volume34
Issue number11
Early online date7 Jul 2023
DOIs
Publication statusPublished - Nov 2023

Bibliographical note

Funding Information:
This work was supported by a grant from the Office National de l’Eau et des Milieux Aquatiques (ONEMA), Plan d’action national ECOPHYTO 2018, Axe 3, Volet 4, France. This work was also supported in part by the Intramural Research Program of the National Institutes of Health (NIH), National Cancer Institute, Division of Cancer Epidemiology and Genetics (Z01CP010119). JK is supported by a postdoctoral award by the Fonds de recherche du Québec—Santé.

Funding Information:
The authors have no relevant financial or non-financial interests to disclose. In the interest of full disclosure, Hans Kromhout participated in the international IMPRESS study [ www.impress-project.org ] which began in 2017 and concluded in 2020, and Pierre Lebailly’s research unit received funding from the French trade union grouping companies specializing in plant protection (UIPP), and this support ended in 2014.

Publisher Copyright:
© 2023, The Author(s).

Keywords

  • Agricultural exposures
  • Cohort study
  • Hodgkin lymphoma
  • Occupational cancer
  • Pesticides

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