Occupational factors associated with hematological neoplasms in a fruit production pole: a case-control study

Abstract Objectives: to identify the occupational risk factors for hematological neoplasms, specifically leukemia, lymphomas, and multiple myeloma. Methods: this is a case-control study. Cases were individuals with hematological neoplasms and controls were individuals with other diagnoses; frequency-matched by sex and age. Individual interviews were conducted by trained researchers using a structured questionnaire. We collected information on participants’ occupational history and chemicals use and exposure, in general, and pesticides, in particular. Odds ratios (OR) were used as association measurements, estimated by multivariate non-conditional logistic regression models for exploratory analysis. Results: 61 cases and 146 controls were included. We found that agricultural work (OR: 2.18; 95% confidence interval (95%CI): 1.10;4.30), occupational exposure to pesticides (OR: 2.37; 95%CI: 1.18;4.77), and total occupational exposure to pesticides throughout their working life (in hours) - both short (OR: 3.52; 95%CI: 1.25;9.87) and long (OR: 3.95; 95%CI: 1.54;10.14) - constituted risk factors for hematological neoplasms, when compared to those unexposed. We adjusted these measures for alcohol consumption and smoking, physical activity, income, education, and history of occupational exposure to chemicals. Conclusion: occupational exposure to pesticides is associated with hematological neoplasms regardless of lifestyle and socioeconomic status.

摘要
研究目的：明确血液系统肿瘤（hematological neoplasms），具体包括白血病、淋巴瘤及多发性骨髓瘤的职业危险因素。
研究方法：本研究为病例对照研究。病例组为血液系统肿瘤患者，对照组为其他疾病患者，按性别与年龄进行频率匹配。由经过培训的研究人员采用结构化问卷开展个人访谈，收集受试者的职业史、一般化学品使用与暴露情况，尤其针对农药相关信息进行采集。本研究以比值比（Odds Ratios, OR）作为关联强度指标，通过多因素非条件logistic回归模型开展探索性分析。
研究结果：本研究共纳入61例病例与146例对照。结果显示，与未暴露人群相比，农业劳作（OR=2.18；95%置信区间（95% Confidence Interval, 95%CI）：1.10~4.30）、职业性农药暴露（OR=2.37；95%CI：1.18~4.77），以及整个职业生涯中累计职业性农药暴露时长（以小时计）——包括短期暴露（OR=3.52；95%CI：1.25~9.87）与长期暴露（OR=3.95；95%CI：1.54~10.14）——均为血液系统肿瘤的危险因素。本研究对上述指标进行了校正，校正变量包括饮酒与吸烟史、体力活动水平、收入、受教育程度，以及职业性化学品暴露史。
研究结论：无论生活方式与社会经济状况如何，职业性农药暴露均与血液系统肿瘤存在关联。