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Int J Epidemiol. 2019 Mar 18. pii: dyz017. doi: 10.1093/ije/dyz017. [Epub ahead of print]

Pesticide use and risk of non-Hodgkin lymphoid malignancies in agricultural cohorts from France, Norway and the USA: a pooled analysis from the AGRICOH consortium.

Author information

Section of Environment and Radiation, International Agency for Research on Cancer (IARC), Lyon, France.
Department of Environmental and Occupational Health, Drexel University, Philadelphia, PA, USA.
ANTICIPE, U1086 INSERM, Université de Caen Normandie, and Centre de Lutte Contre le Cancer François Baclesse, Caen, France.
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute (NCI), Bethesda, MD, USA.
Department of Occupational Medicine and Epidemiology, National Institute of Occupational Health (STAMI), Oslo, Norway.
Hematological Malignancies Registry of Gironde, Bergonie Institute, Comprehensive Cancer Centre, Bordeaux, France.
University of Bordeaux, INSERM U1219 Center - EPICENE Team, CHU de Bordeaux, Bordeaux, France.
Institute for Risk Assessment Sciences (IRAS), Utrecht University, Utrecht, The Netherlands.
CHU de Bordeaux, Service de Médecine du Travail et Pathologie Professionnelle, Bordeaux, France.
Department of Research, Cancer Registry of Norway, Oslo, Norway.
Section of Evidence Synthesis and Classification, International Agency for Research on Cancer (IARC), Lyon, France.



Pesticides are commonly used in agriculture, and previous studies endorsed the need to further investigate the possible association between their use and risk of lymphoid malignancies in agricultural workers.


We investigated the relationship of ever use of 14 selected pesticide chemical groups and 33 individual active chemical ingredients with non-Hodgkin lymphoid malignancies (NHL) overall or major subtypes, in a pooled analysis of three large agricultural worker cohorts. Pesticide use was derived from self-reported history of crops cultivated combined with crop-exposure matrices (France and Norway) or self-reported lifetime use of active ingredients (USA). Cox regression models were used to estimate cohort-specific hazard ratios (HRs) and 95% confidence intervals (CIs), which were combined using random effects meta-analysis to calculate meta-HRs.


During follow-up, 2430 NHL cases were diagnosed in 316 270 farmers accruing 3 574 815 person-years under risk. Most meta-HRs suggested no association. Moderately elevated meta-HRs were seen for: NHL and ever use of terbufos (meta-HR = 1.18, 95% CI: 1.00-1.39); chronic lymphocytic leukaemia/small lymphocytic lymphoma and deltamethrin (1.48, 1.06-2.07); and diffuse large B-cell lymphoma and glyphosate (1.36, 1.00-1.85); as well as inverse associations of NHL with the broader groups of organochlorine insecticides (0.86, 0.74-0.99) and phenoxy herbicides (0.81, 0.67-0.98), but not with active ingredients within these groups, after adjusting for exposure to other pesticides.


Associations of pesticides with NHL appear to be subtype- and chemical-specific. Non-differential exposure misclassification was an important limitation, showing the need for refinement of exposure estimates and exposure-response analyses.


AGRICOH; NHL; Pesticides; cohort; farmers; meta-analysis


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