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Environ Health Perspect. 2017 Jul 19;125(7):077013. doi: 10.1289/EHP793.

Pesticide Use and Age-Related Macular Degeneration in the Agricultural Health Study.

Author information

1
Epidemiology Branch, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services (DHHS) , Research Triangle Park, North Carolina, USA.
2
Department of Ophthalmology, Duke University Medical School , Durham, North Carolina, USA.
3
Biostatistics and Computational Biology Branch, NIEHS, NIH, DHHS , Research Triangle Park, North Carolina, USA.
4
Westat , Durham, North Carolina, USA.
5
Social & Scientific Systems, Inc. , Durham, North Carolina, USA.
6
Occupational and Environmental Epidemiology Branch, National Cancer Institute, NIH, DHHS , Rockville, Maryland, USA.
7
Department of Medicine, Duke University Medical School , Durham, North Carolina, USA.

Abstract

BACKGROUND:

Age-related macular degeneration (AMD) is a leading cause of blindness in developed countries. Few studies have investigated its relationship to environmental neurotoxicants. In previous cross-sectional studies, we found an association between pesticide use and self-reported retinal degeneration.

OBJECTIVE:

We evaluated the association of pesticide use with physician-confirmed incident AMD.

METHODS:

The Agricultural Health Study (AHS) is a prospective cohort of pesticide applicators and their spouses enrolled from 1993-1997 in Iowa and North Carolina. Cohort members reported lifetime use of 50 specific pesticides at enrollment. Self-reports of incident AMD during follow-up through 2007 were confirmed by reports from participants' physicians and by independent evaluation of retinal photographs provided by the physicians. Confirmed cases (n=161) were compared with AHS cohort members without AMD (n=39,108). We estimated odds ratios (ORs) and 95% confidence intervals (CIs) by logistic regression with adjustment for age, gender, and smoking.

RESULTS:

AMD was associated with ever use of organochlorine [OR=2.7 (95% CI: 1.8, 4.0)] and organophosphate [OR=2.0 (95% CI: 1.3, 3.0)] insecticides and phenoxyacetate herbicides [OR=1.9 (95% CI: 1.2, 2.8)]. Specific pesticides consistently associated with AMD included chlordane, dichlorodiphenyltrichloroethane (DDT), malathion, and captan; others with notable but slightly less consistent associations were heptachlor, diazinon, phorate, 2,4,5-trichlorophenoxyacetic acid (2,4,5-T), and 2,4-dichlorophenoxyacetic acid (2,4-D). Results were similar for men and women. Some specific pesticides were associated with both early- and late-stage AMD, but others were associated with only one stage.

CONCLUSIONS:

Exposures to specific pesticides may be modifiable risk factors for AMD. https://doi.org/10.1289/EHP793.

PMID:
28886597
PMCID:
PMC5744702
DOI:
10.1289/EHP793
[Indexed for MEDLINE]
Free PMC Article

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