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Cancer risks and immunological effects in agriculture
Linköping University, Department of Molecular and Clinical Medicine, Occupational and Environmental Medicine. Linköping University, Faculty of Health Sciences.
2003 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

In general, farmers and agricultural workers are characterized by relatively low mortality rates when considering all causes of death and deaths due to all types of cancer. However, several studies have shown that this occupational category tend to be at increased risks of developing the following forms of malignancies: leukaemia, lymphomas, multiple myeloma, and cancers of the skin, lip, prostate, stomach, brain, and connective tissue. Although the reported excesses have not been consistent in different studies, they nevertheless suggest that agricultural exposures, especially pesticides, contribute to cancer aetiology through different mechanisms of action. It has been hypothesised that immunotoxic effects may play a role, since most of the malignancies found to be increased in workers employed in agriculture are also elevated in patients suffering from innnunodeficiencies. The present studies were conducted to ascertain whether agricultural activities and exposures influence the risk of developing cancer, and to evaluate the innnunological effects of phenoxy herbicides as possibly important for the aetiology of lymphomas.

Different types of cancer were considered in relation to farming in two case-control studies, focused one on men and the other on women. A decreased risk of postmenopausal breast cancer (odds ratio [OR] 0.4) and an excess of skin melanoma (OR 2.7) and bladder cancer (OR 2.7) were observed in the women. The main finding in the men was an excess of prostate cancer (OR 1.5). Further analyses showed that this malignancy was associated with exposure to chlorinated compounds (OR 2.5), and, more specifically, to DDT (OR 2.1) and dicofol and tetradifon (OR 2.8).

Mortality in selected groups of farmers and their relatives was investigated in two cohort studies. Farmers and their wives showed reduced mortality from all causes and all cancers although there was a tendency towards increased risk of leukaemia, particularly among wives of pesticide users (standardised mortality ratio [SMR] 2.4). Adult sons and daughters of green-house owners exhibited increased mortality from all types of cancer (SMR 1.9).

A study was also performed to compare pre- and post-exposure values of selected immunological parameters in a group of ten farmers exposed to phenoxy herbicides. The most notable fmdings were reduced levels of the following: circulating natural killer (NK) cells (-38%), NK cytotoxic activity (-53%), and lymphocyte response to mitogenic stimulation (-50%).

Place, publisher, year, edition, pages
Linköping: Linköpings universitet , 2003. , 49 p.
Series
Linköping University Medical Dissertations, ISSN 0345-0082 ; 779
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:liu:diva-26668Local ID: 11234ISBN: 91-7373-538-8 (print)OAI: oai:DiVA.org:liu-26668DiVA: diva2:247217
Public defence
2003-04-08, Aulan, Hälsans hus, Universitetssjukhuset, Linköping, 13:00 (Swedish)
Opponent
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-10-15Bibliographically approved
List of papers
1. Cancer risk among female agricultural workers: a multi-center case-control study
Open this publication in new window or tab >>Cancer risk among female agricultural workers: a multi-center case-control study
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1999 (English)In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 36, no 1, 135-141 p.Article in journal (Refereed) Published
Abstract [en]

Background

Cancer risk among women engaged in farming has been poorly investigated. This group of female workers is of particular interest, however, since they may experience exposure to several potential agricultural hazards.

Methods

A hospital-based case-control study was conducted in five Italian rural areas to examine the association between cancer and farming among women. The areas selected were located in three different regions (i.e., Piedmont, Tuscany, and Emilia-Romagna). The following cancer sites were selected for the study: stomach, colon, rectum, lung, skin melanoma, skin non-melanoma, breast, cervix and corpus uteri, ovary, bladder, kidney. Cases of non-Hodgkin's lymphoma were also included. Altogether, 1,044 newly diagnosed cases aged 20–75 years were ascertained from hospital records from March 1990 to September 1992, and for 945 of them detailed information was collected by a standard questionnaire. The analyses of data were performed comparing each case series to a reference group drawn from among the other sites. Unconditional logistic regression models were used in the statistical analyses.

Results

Statistically significant increased risks in association with farming were estimated for skin melanoma (OR 2.7, 95% CI 1.2–5.8) and bladder cancer (OR 2.7, 95% CI 1.2–6.1). Lung cancer was also found increased but not at a statistically significant level (OR 1.7, 95% CI 0.7–4.4). An OR lower than unity was observed for postmenopausal breast cancer (OR 0.4, 95% CI 0.3–0.7).

Conclusions

The present study suggests that women in farming might experience increased risk of cancers, not usually found in excess among male farmers, as well as a protective effect for postmenopausal breast cancer. The role of different patterns of exposure or gender specific responses should be considered in further studies.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25776 (URN)10.1002/(SICI)1097-0274(199907)36:1<135::AID-AJIM19>3.0.CO;2-H (DOI)10211 (Local ID)10211 (Archive number)10211 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
2. Cancer risk among male farmers: a multi-site case-control study
Open this publication in new window or tab >>Cancer risk among male farmers: a multi-site case-control study
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2001 (English)In: International Journal of Occupational Medicine and Environmental Health, ISSN 1232-1087, Vol. 14, no 4, 339-348 p.Article in journal (Refereed) Published
Abstract [en]

Farmers may experience exposure to several hazardous substances, and cancer risk in this occupational group is considered an important public health issue.

In order to examine the association between cancer and farming among male agricultural workers, a hospital-based case-control study was conducted in five Italian rural areas. The cancer sites selected for the study were: lip, oral cavity and oropharynx, oesophagus, stomach, colon, rectum, lung, skin melanoma, skin non-melanoma, prostate, bladder, kidney, and non-Hodgkin's lymphoma. In all, 1525 newly diagnosed cases, aged 20-75 years, were ascertained in hospital records, covering the period between March 1990 and September 1992, and for 1279 of them, a detailed exposure information was collected by a standard questionnaire. Data analyses were performed comparing each cancer site to a control group, including a subset of the other cancer sites in the study. Unconditional logistic regression models were used in the statistical analyses.

Increased risks of cancer associated with agricultural work were found for stomach (OR = 1.4, 95%CI:0.9-2.0), rectum (OR = 1.5, 95%CI:0.8-2.7), larynx (OR = 1.4, 95%CI:0.8-2.5), and prostate (OR = 1.4, 95%CI:1.0-2.1). The excess of prostate cancer was specifically related to application of pesticides (OR = 1.7, 95%CI:1.2-2.6).

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-25779 (URN)11885917 (PubMedID)10214 (Local ID)10214 (Archive number)10214 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2012-10-15Bibliographically approved
3. Prostate cancer and exposure to pesticides in agricultural settings
Open this publication in new window or tab >>Prostate cancer and exposure to pesticides in agricultural settings
2003 (English)In: International Journal of Cancer, ISSN 0020-7136, E-ISSN 1097-0215, Vol. 104, no 4, 458-461 p.Article in journal (Refereed) Published
Abstract [en]

Our study evaluates the association between prostate cancer and exposure to pesticides in agricultural settings in Italy. The data were derived from a hospital-based multi-site case-control study carried out in 5 rural areas between 1990–92. In our study, 124 new cases of prostate cancer were ascertained and interviewed, along with 659 cancer controls. A team of agronomists assessed past exposure to pesticides by using a checklist of 100 chemical families and 217 compounds applied from 1950–85 in the areas considered. The association between prostate cancer and different occupational risk factors was measured by maximum likelihood estimation of the odds ratio, controlling for potential confounders. “Ever been employed in agriculture” was associated with a 40% increased risk (OR = 1.4, 95% CI = 0.9–2.0). Prostate cancer was also related positively to food and tobacco (OR= 2.1, 95% CI = 1.1–4.1), and chemical products (OR = 2.2, 95% CI = 0.7–7.2) industries. The analyses carried out to estimate the association between different types of pesticides and prostate cancer showed increased risks among farmers exposed to organochlorine insecticides and acaricides (OR = 2.5, 95% CI = 1.4–4.2), more specifically to the often contemporary used compounds DDT (OR = 2.1, 95% CI = 1.2–3.8), and dicofol (OR = 2.8, 95% CI = 1.5–5.0), whose effects could not be well separated.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-26372 (URN)10.1002/ijc.10955 (DOI)10906 (Local ID)10906 (Archive number)10906 (OAI)
Available from: 2009-10-08 Created: 2009-10-08 Last updated: 2017-12-13Bibliographically approved
4. Cancer among greenhouse owners and their relatives: results of a pilot study
Open this publication in new window or tab >>Cancer among greenhouse owners and their relatives: results of a pilot study
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1998 (English)In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 33, no 1, 88-89 p.Article in journal (Refereed) Published
Abstract [en]

No abstract is available for this article.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84604 (URN)10.1002/(SICI)1097-0274(199801)33:1<88::AID-AJIM10>3.0.CO;2-1 (DOI)
Available from: 2012-10-15 Created: 2012-10-15 Last updated: 2017-12-07Bibliographically approved
5. Mortality among male licensed pesticide users and their wives
Open this publication in new window or tab >>Mortality among male licensed pesticide users and their wives
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1999 (English)In: American Journal of Industrial Medicine, ISSN 0271-3586, E-ISSN 1097-0274, Vol. 36, no 1, 142-146 p.Article in journal (Refereed) Published
Abstract [en]

Background

We evaluated the mortality pattern of male licensed pesticide users and their wives in central Italy.

Methods

The cohort consisted of 2978 male farmers licensed for buying and handling toxic pesticides during the period 1971–1973 and 2586 farmers' wives. The Standardized Mortality Ratio (SMRs) and their 95% Confidence Intervals (95% CI) were computed on the basis of regional death rates.

Results

We found a lower than expected overall and cancer mortality. Non-Hodgkin's lymphoma was increased among women (SMR = 2.29, 0.62–5.86) but not in male farmers (SMR = 0.90, 0.24–2.30), while both sexes were characterized by an increased risk of leukemia (men: SMR = 1.44, 0.69–2.64; women: SMR = 2.41, 1.04–4.76), mainly due to myeloid leukemia (men: SMR = 2.43, 0.98–5.00; women: SMR = 3.14, 1.02–7.33).

Conclusions

Men and women tend to share the same mortality profile. The statistically significant increase of leukemia with a threefold increased risk of the myeloid subtype only among women suggests that different pattern of exposure or biological differences between genders should be considered in evaluating health risks in agricultural settings.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84606 (URN)10.1002/(SICI)1097-0274(199907)36:1<142::AID-AJIM20>3.0.CO;2-E (DOI)
Available from: 2012-10-15 Created: 2012-10-15 Last updated: 2017-12-07Bibliographically approved
6. Immunological changes among farmers exposed to phenoxy herbicides: preliminary observations
Open this publication in new window or tab >>Immunological changes among farmers exposed to phenoxy herbicides: preliminary observations
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1999 (English)In: Occupational and Environmental Medicine, ISSN 1351-0711, E-ISSN 1470-7926, Vol. 53, no 9, 583-589 p.Article in journal (Refereed) Published
Abstract [en]

OBJECTIVES: To evaluate short term immunological changes after agricultural exposure to commercial formulations of chlorophenoxy herbicides.

METHODS: Blood samples were collected from 10 farmers within seven days before exposure, one to 12 days after exposure, and again 50 to 70 days after exposure. Whole blood was used to count lymphocyte subsets with monoclonal antibodies. Peripheral blood mononuclear (PBM) cells were used to measure natural killer (NK) cell activity and lymphocyte response to mitogenic stimulations. Values before exposure were used as reference.

RESULTS: In comparison with concentrations before exposure, a significant reduction was found one to 12 days after exposure in the following variables (P < 0.05): circulating helper (CD4) and suppressor T cells (CD8), CD8 dim, cytotoxic T lymphocytes (CTL), natural killer cells (NK), and CD8 cells expressing the surface antigens HLA-DR (CD8-DR), and lymphoproliferative response to mitogen stimulations. All immunological values found 50-70 days after exposure were comparable with concentrations before exposure, but mitogenic proliferative responses of lymphocytes were still significantly decreased.

CONCLUSIONS: According to our data agricultural exposure to commercial 2,4-dichlorophenoxyacetic acid (2,4-D) and 4-chloro-2-methylphenoxyacetic acid (MCPA) formulations may exert short term immunosuppressive effects. Further studies should clarify whether the immunological changes found may have health implications and can specifically contribute to cancer aetiology.

National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:liu:diva-84607 (URN)10.1136/oem.53.9.583 (DOI)
Available from: 2012-10-15 Created: 2012-10-15 Last updated: 2017-12-07Bibliographically approved

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