Health Effects Of Exposures In Agriculture

农业接触对健康的影响

• 批准号: 8336562
• 负责人: Dale P Sandler
• 金额: $ 146.57万
• 依托单位: NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES
• 依托单位国家: 美国
• 资助国家: 美国
• 起止时间: 至
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/8336562
• 关键词: 21 year old; Acute; Adult; Age related macular degeneration; Agriculture; Allergic; Annual Reports; Asthma; Autoimmune Diseases; Biological; Birth; Cardiovascular Diseases; Cause of Death; Cells; Cessation of life; Child; Chronic Bronchitis; Classification; Cohort Studies; Collaborations; Computer Assisted; DNA; Data; Data Analyses; Data Set; Diabetes Mellitus; Dietary Assessment; Disease; Dose; Endocrine System Diseases; Endotoxins; Enrollment; Event; Exposure to; Family; Farming environment; Fertility; Fibroid Tumor; Follow-Up Studies; Food; Frequencies; Funding; Future; General Population; Genes; Growth; Health; Health Status; Height; Home environment; Hormones; Human; Incidence; Individual; Injury; Insecticides; Interview; Iowa; Kidney Diseases; Licensing; Lung; Lung diseases; Lupus; Macular degeneration; Mails; Malignant Neoplasms; Malignant neoplasm of pancreas; Measures; Medical History; Medical Records; Mental Depression; Morbidity - disease rate; Myocardial Infarction; National Cancer Institute; National Institute for Occupational Safety and Health; National Institute of Environmental Health Sciences; Nervous System Physiology; Neurodegenerative Disorders; Neurological outcome; Non-Malignant; North Carolina; Organophosphates; Outcome; Paper; Parkinson Disease; Participant; Patient Self-Report; Pattern; Peripheral Nervous System; Pesticides; Pilot Projects; Population; Pre-Eclampsia; Prospective Studies; Puberty; Questionnaires; Reporting; Reproductive Health; Rheumatoid Arthritis; Rhinitis; Risk; Saliva; Sampling; Sjogren' s Syndrome; Solvents; Source; Spouses; Staging; Stroke; Suicide; Symptoms; Telephone; Telephone Interviews; Testing; Thyroid Diseases; United States Environmental Protection Agency; Universities; Update; Urine; Woman; Work; base; cancer risk; cohort; endometriosis; farmer; follow-up; gene environment interaction; genetic analysis; hazard; hearing impairment; high risk; interest; member; men; mortality; neoplasm registry; nervous system disorder; neurobehavioral; pesticide exposure; population based; reproductive; respiratory; response; suicidal risk

The Agricultural Health Study (AHS) is a long-term prospective study of potential health effects associated with exposure to pesticides and other agricultural exposures. The study is a collaboration of the National Cancer Institute, the National Institute of Environmental Health Sciences, and the US Environmental Protection Agency, with additional collaboration by the National Institute for Occupational Safety and Health. We are examining cancer incidence and other health endpoints in a prospective study of licensed pesticide applicators, spouses and children from North Carolina (NC) and Iowa (IA). Over a 3-year period (1993-7), we enrolled more than 57,000 licensed applicators, representing 82% of eligible private pesticide applicators (largely farmers) in IA and NC and 43% of commercial applicators from Iowa. About 40% of the private applicators also completed a more detailed take-home questionnaire covering farming practices and health. Nearly 32,000 spouses of farmer applicators enrolled and 2/3 of these also provided data on reproductive health, including information on all children under age 21. Since enrollment, 70% of participants completed the five-year followup phone interview (1999-2003) and the study achieved a similar response rate in our most recent followup phone interview (2005-2010). We are currently planning the next followup interview for FY13-14, to identify new cases of non-malignant outcomes and to update other factors that influence medical history. Annually, cancer incidence among the applicators, spouses, and children is determined through linkage with the population-based cancer registries in IA and NC. Follow-up computer-assisted telephone interviews are used to update exposure information, identify cases of non-malignant disease, and to collect information on changes in health status since enrollment in the study. We completed the second round of followup interviewing with cohort members in 2010. Buccal-cell samples have been collected from participants in order to extract DNA for future analyses of gene and environment interactions. In addition, a dietary assessment (food frequency questionnaire) was self-completed and returned by mail. In-depth assessment of agricultural exposures has been done for a small sample of farmers and their families in order to validate the questionnaires and facilitate exposure classification. Both environmental and biological samples were collected. Non-cancer outcomes of particular interest in this follow-up period include neurological diseases and symptoms (Parkinson's Disease, hearing loss, depression, neurobehavioral function, and suicide), respiratory and allergic outcomes (asthma, rhinitis, and chronic bronchitis), heart attacks (incidence and mortality), diabetes (both gestational and in adults), autoimmune diseases (rheumatoid arthritis, lupus, and Sjogren's syndrome), age-related macular degeneration, and birth outcomes (fertility, birthweight, pre-eclampsia) and reproductive outcomes (fibroids and endometriosis) in addition to cancer. We are currently involved in a number of substudies to collect more detailed information on potential health consequences of pesticides. In a collaboration with Frederic Gerr at the University of IA, we studied neurobehavioral function using a number of standardized tests for 701 farmers in the cohort. In this sample, high pesticide exposure events were associated with adverse CNS function and we saw no strong evidence of an association with organophosphate insecticide use and adverse CNS fuunction. Current analyses are focusing on peripheral nervous system function, depression, solvent exposure and other pesticides. The Growth and Puberty (GAP) Study is an intramurally-funded pilot study to assess the feasibility of measuring early puberty markers (hormone levels in urine and saliva, height velocity, Tanner staging) among farm children in the AHS. This study has enrolled approximately 60 children; sample and data analysis are ongoing. The Genes and Age Related Macular Degeneration (GENARM) Study is obtaining medical records, opthamalogical photographs, and saliva as a source of DNA for individuals who reported incident macular degeneration at one of the followup interviews. Field work is completed and data analysis is ongoing. Two more (Parkinson's disease and lung health) are described in separate annual reports. Recent results from the Agricultural Health Study include: 1) use of specific pesticides was associated with thyroid disease, particularly hypothryoid, in women; 2) pesticides were associated with myocardial infarction incidence in women, but not men; 3) farmers continue to have lower mortality risk, although after adjusting for this overall reduced risk, farmers and their spouses are at high risk of death of certain cancers; and 4) suicide risk for farmers is lower than that for the general population and there was no evidence of pesticide use contributing to suicide risk. The AHS cohort also participated in a number of large pooling studies that resulted in some important papers on BMI and mortality and BMI and pancreatic cancer. The Agricultural Health Study is one of the founding members of the Agricultural cohort consortium (AGRICOH) and we hope to use this collaboration to enhance our ability to assess rare exposures and outcomes, as well as gene-environment interactions. We continue to analyze data on farm exposures and non-cancer morbidity. Ongoing work focuses on patterns of pesticide use, endotoxin exposures, allergic and respiratory outcomes, reproductive outcomes, endocrine disorders, and neurological outcomes. Use of specific pesticides was associated with thyroid disease among farm women; we have just started the analysis of thyroid disease in men. Recent work also focuses on mortality in the cohort, specifically injury, stroke and kidney disease mortality. We are currently exploring agricultural factors associated with deaths from these causes. The most recent round of interviewing was completed in 2010 with the dataset available in 2011. With the newly collected data, we plan to conduct analysis of incident diseases such as asthma to expand on our earlier cross-sectional results. We have initiated a health followup study to validate self reports of diseases that may be inaccurate based on self-report; we are currently contacting individuals who reported autoimmune diseases (Rheumatoid arthritis, lupus, and Sjogren's syndrome) to confirm self-report, obtain medical records, and,for confirmed cases, collect a buccal cell for genetic analysis in the future.

农业健康研究（AHS）是对与农药和其他农业暴露有关的潜在健康影响的长期前瞻性研究。该研究是国家癌症研究所，美国国家环境健康科学研究所和美国环境保护署的合作，以及美国国家职业安全与健康研究所的额外合作。在一项对北卡罗来纳州（NC）和爱荷华州（IA）的许可农药施用者，配偶和子女的前瞻性研究中，我们正在研究癌症的发病率和其他健康终点。在3年的时间（1993 - 7年）中，我们招收了57,000多名许可的申请者，占IA和NC的合格私人农药施用者（主要是农民）的82％，以及来自爱荷华州的商业申请者的43％。约有40％的私人申请者还完成了一份更详细的带户调查表，涵盖了农业实践和健康。招收的近32,000名农民申请者的配偶也提供了有关生殖健康的数据，包括有关21岁以下儿童的信息。自入学时，有70％的参与者完成了为期五年的随访电话采访（1999-2003），这项研究在我们最近的最新随访电话采访中获得了相似的响应率（2005-2010）。 我们目前正在计划对13-14财年的下一次后续采访，以确定新的非政体结果案例，并更新影响病史的其他因素。 每年，施加者，配偶和儿童之间的癌症发病率是通过与IA和NC中的基于人群的癌症注册表的联系来确定的。后续计算机辅助的电话访谈用于更新暴露信息，识别非恶性疾病的病例，并收集自研究入学以来健康状况变化的信息。 我们在2010年完成了与队列成员的第二轮后续访谈。从参与者那里收集了颊细胞样本，以提取DNA，以便将来对基因和环境相互作用进行分析。此外，饮食评估（食品频率问卷）是自我完成的，并通过邮件返回。为了验证问卷并促进暴露分类，已经对农业及其家人进行了深入评估。收集环境和生物样品。 在此随访期间特别感兴趣的非癌症结局包括神经疾病和症状（帕金森氏病，听力丧失，抑郁，神经行为功能和自杀功能和自杀），呼吸道和过敏性（哮喘，炎症，ron炎和慢性支气管炎），心脏病发作（糖尿病），糖尿病（发病率）（吉尼斯（Gestros））（gestationals and gestational and gestational and gestational and gestational and gestations; （类风湿关节炎，狼疮和Sjogren综合征），与年龄相关的黄斑变性以及出生结局（生育能力，出生体重，前宾夕化）和生殖结果（肌瘤和子宫内膜异常），此外还包括癌症。 目前，我们参与了许多物质，以收集有关农药潜在健康后果的更多详细信息。 在与IA大学的Frederic Gerr合作的过程中，我们使用了许多在同胞中的701名农民的标准化测试来研究神经行为功能。 在该样品中，高农药暴露事件与中枢神经系统功能不良有关，我们没有看到有机磷酸盐杀虫剂使用和不良中枢神经系统渠道的有力证据。 当前的分析重点是外周神经系统功能，抑郁症，溶剂暴露和其他农药。 生长和青春期（GAP）研究是一项由壁内资助的试点研究，旨在评估AHS中农场儿童中测量早期青春期标志物（尿液和唾液中的激素水平，高度速度，Tanner分期）的可行性。 这项研究已招募了大约60名儿童。样本和数据分析正在进行中。 基因和年龄与年龄相关的黄斑变性（Genarm）研究正在获得医疗记录，科目照片和唾液作为在其中一次后续访谈中报告了事件黄斑变性的个体的DNA来源。 现场工作已经完成，并且正在进行数据分析。 在单独的年度报告中描述了另外两个（帕金森氏病和肺部健康）。 农业健康研究的最新结果包括：1）使用特定农药与女性甲状腺疾病，尤其是雌性疾病有关； 2）农药与女性的心肌梗塞发生率有关，而不是男性； 3）农民继续存在较低的死亡风险，尽管调整了总体降低的风险后，农民及其配偶处于某些癌症死亡的高风险； 4）农民的自杀风险低于普通人群的风险，没有证据表明使用农药会导致自杀风险。 AHS队列还参加了许多大型合并研究，这些研究导致了一些有关BMI和死亡率以及BMI和胰腺癌的重要论文。 农业健康研究是农业队列联盟（Agricoh）的创始成员之一，我们希望使用这种合作来增强我们评估罕见暴露和结果以及基因环境相互作用的能力。 我们继续分析有关农场暴露和非癌症发病率的数据。正在进行的工作着重于农药使用的模式，内毒素暴露，过敏和呼吸系统结果，生殖结果，内分泌疾病和神经学结果。在农场妇女中使用特定的农药与甲状腺疾病有关；我们刚刚开始对男性甲状腺疾病进行分析。最近的工作还集中在队列中的死亡率，特别是损伤，中风和肾脏疾病死亡率。我们目前正在探索与这些原因死亡有关的农业因素。 最近的一轮访谈于2010年完成了2011年的数据集。随着新收集的数据，我们计划对哮喘等事件疾病进行分析，以扩大我们较早的横截面结果。 我们已经开始了一项健康后续研究，以验证可能基于自我报告的疾病的自我报告；我们目前正在与报告自身免疫性疾病（类风湿关节炎，狼疮和Sjogren综合征）的个人联系以确认自我报告，获得病历，并为确认的病例收集颊细胞，以便将来收集遗传分析。