Table 4.
Specific pesticide use in AHS applicators with ≥24 months continuous FFS Medicare coverage (1999-2016): risk of specialist-confirmed RA, stratified by smoking history (ever).
| Ever used1: | % exposed cases2 | Relative Risk (95% Confidence Intervals)3 | |
|---|---|---|---|
| Smokers / Non-smokers | Smokers | Non-smokers | |
| Insecticides | |||
| Organochlorines | |||
| Aldrin4 | 35 / 28 | 1.30 (0.82–2.08) | 0.75 (0.40–1.41) |
| Chlordane | 34 / 37 | 0.82 (0.53–1.28) | 1.07 (0.61–1.88) |
| DDT | 54 / 48 | 1.02 (0.67–1.56) | 1.06 (0.61–1.85) |
| Heptachlor | 25 / 22 | 1.20 (0.70–2.06) | 0.77 (0.39–1.53) |
| Lindane | 22 / 22 | 1.08 (0.65–1.80) | 0.94 (0.49–1.81) |
| Toxaphene | 31 / 24 | 1.36 (0.86–2.14) | 1.19 (0.64–2.24) |
| Organophosphates | |||
| Chlorpyrifos | 43 / 40 | 1.20 (0.79–1.83) | 1.05 (0.61–1.82) |
| Diazinon | 40 / 34 | 1.02 (0.66–1.58) | 0.93 (0.52–1.67) |
| Fonofos | 21 / 25 | 1.38 (0.78–2.44) | 1.27 (0.65–2.48) |
| Malathion | 78 / 85 | 1.36 (0.82–2.27) | 2.41 (1.13–5.18) |
| Parathion | 27 / 24 | 1.19 (0.74–1.92) | 1.43 (0.75–2.73) |
| Phorate | 42 / 39 | 1.80 (1.13–2.89) | 1.12 (0.62–2.03) |
| Terbufos | 36 / 38 | 1.30 (0.82–2.07) | 1.13 (0.63–2.03) |
| Carbamates | |||
| Aldicarb | 16 / * | 0.89 (0.46–1.72) | 0.77 (0.27–2.19) |
| Carbaryl | 77 / 72 | 1.53 (0.92–2.55) | 1.77 (0.95–3.31) |
| Carbofuran4 | 40 / 28 | 1.75 (1.13–2.71) | 0.89 (0.49–1.62) |
| Herbicides | |||
| Analids/analines | |||
| Alachlor4 | 64 / 42 | 1.84 (1.19–2.87) | 0.96 (0.55–1.67) |
| Metolachlor | 49 / 50 | 1.58 (1.02–2.45) | 1.37 (0.79–2.38) |
| Pendimethalin | 46 / 37 | 1.13 (0.74–1.72) | 0.84 (0.48–1.47) |
| Trifluralin | 53 / 47 | 1.50 (0.95–2.38) | 0.90 (0.51–1.62) |
| Phenoxy | |||
| 2,4-D | 39 / 30 | 1.26 (0.75–2.14) | 0.83 (0.44–1.57) |
| 2,4,5-T | 28 / 24 | 0.84 (0.53–1.36) | 0.66 (0.35–1.26) |
| Thiocarbamate | |||
| Butylate4 | 39 / 30 | 1.42 (0.87–2.30) | 0.84 (0.44–1.60) |
| EPTC | 20 / * | 1.70 (0.97–2.98) | 1.31 (0.64–2.68) |
| Triazine/Triazinone | |||
| Atrazine4 | 81 / 73 | 1.64 (0.93–2.92) | 1.04 (0.52–2.06) |
| Cyanazine | 40 / 38 | 1.54 (0.95–2.51) | 0.97 (0.52–1.79) |
| Metribuzin | 45 / 50 | 1.43 (0.90–2.26) | 1.44 (0.81–2.57) |
| Other | |||
| Chlorimuron Ethyl4 | 39 / 28 | 1.46 (0.95–2.25) | 0.82 (0.45–1.49) |
| Dicamba | 39 / 49 | 1.03 (0.61–1.73) | 1.12 (0.59–2.11) |
| Glyphosate | 81 / 78 | 1.00 (0.59–1.71) | 0.94 (0.50–1.77) |
| Imazethapyr | 30 / 41 | 1.10 (0.62–1.94) | 1.09 (0.56–2.11) |
| Paraquat | 31 / 24 | 1.11 (0.70–1.78) | 1.01 (0.52–1.95) |
| Petroleum oil/distillates | 44 / 46 | 1.13 (0.73–1.75) | 1.36 (0.78–2.36) |
| Fungicides/Fumigants | |||
| Benomyl | 21 / * | 1.52 (0.88–2.62) | 1.75 (0.82–3.75) |
| Captan | 13 / 11 | 1.29 (0.69–2.44) | 0.72 (0.26–1.99) |
| Chlorothalonil | 17 / * | 1.49 (0.76–2.94) | 0.85 (0.29–2.51) |
| Maneb | 15 / * | 0.85 (0.46–1.58) | 1.44 (0.63–3.27) |
| Metalaxyl | 38 / 23 | 1.42 (0.88–2.29) | 1.05 (0.52–2.09) |
| Methylbromide | 22 / 20 | 0.85 (0.49–1.48) | 1.47 (0.68–3.19) |
1Lifetime history ever used specific pesticides at enrollment (1993-1997) or first follow-up (1999-2003) prior to RA diagnosis.
2Among participants with ≥24 months continuous fee for service (FFS) coverage (Parts A and B coverage without Part C), including initial ≥12-month clean period with no claims for rheumatoid arthritis; specialist-confirmed cases had ≥2 claims for RA ≥30 days apart plus ≥1 claim(s) from a rheumatologist. Asterix (*) indicates percent not shown if number or percent not shown due to <11 in a cell or ability to infer the count of groups with <11 exposed cases in conjunction with other data presented.
3Relative Risk estimates calculated using log binomial regression, adjusted for categorical age (40-49, 50-59, 60-69, 70+), state (NC, IA), education (≤high school, >high school), and correlated pesticides (R2>0.35): [aldicarb (chlorothalonil and benomyl), chlorothalonil (aldicarb and benomyl), atrazine (alachlor), butylate (cyanazine and metribuzin)].
4Interaction p-values <0.20 for following pesticides by smoking (ever/never): aldrin (intp=0.18), carbofuran (intp =0.07), alachlor (intp=0.08), butylate (intp=0.19), atrazine (intp=0.14), chlorimuron ethyl (intp=0.13).