Table 3.
Associations between occupational herbicide use and risk of NHL and NHL subtypes (odds ratios [OR] & 95% confidence intervals [CI]) a
| All NHL | CLL | DLBCL | FL | OBCL | MM | TCL | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Exposure | Controls | Cases | OR (95% CI) | Cases | OR (95% CI) | Cases | OR (95% CI) | Cases | OR (95% CI) | Cases | OR (95% CI) | Cases | OR (95% CI) | Cases | OR (95% CI) | Adjustments for other pesticides | |
| Herbicides, any b 10 studies: BCMM, ENGELA, Epilymph, Italian, LANHL, LAMMCC, Mayo, NCISEER, NSW, Yale |
Never | 9030 | 8585 | 1 (Referent) | 1473 | 1 (Referent) | 2031 | 1 (Referent) | 1451 | 1 (Referent) | 1482 | 1 (Referent) | 1299 | 1 (Referent) | 422 | 1 (Referent) | OP insecticides, OC insecticides, Any other pesticide |
| Ever | 596 | 644 | 1.10 (0.94–1.29) | 165 | 0.99 (0.74–1.31) | 129 | 1.07 (0.82–1.39) | 136 | 1.13 (0.85–1.52) | 99 | 1.08 (0.80–1.44) | 56 | 1.18 (0.81–1.71) | 34 | 1.40 (0.87–2.27) | ||
| Duration | |||||||||||||||||
| ≤12 years | 302 | 323 | 1.11 (0.92–1.33) | 78 | 1.03 (0.74–1.42) | 63 | 1.02 (0.75–1.40) | 78 | 1.25 (0.91–1.72) | 44 | 0.97 (0.67–1.39) | 30 | 1.13 (0.72–1.79) | 17 | 1.31 (0.74–2.31) | ||
| >12 to 25.5 | 157 | 182 | 1.23 (0.95–1.58) | 58 | 1.14 (0.77–1.69) | 35 | 1.24 (0.81–1.90) | 28 | 0.93 (0.57–1.50) | 34 | 1.41 (0.91–2.20) | 9 | 1.00 (0.44–2.24) | 13 | 2.21 (1.11–4.41) | ||
| >25.5 | 132 | 129 | 0.94 (0.71–1.25) | 28 | 0.66 (0.40–1.07) | 29 | 1.05 (0.66–1.67) | 27 | 0.99 (0.60–1.65) | 18 | 0.87 (0.50–1.52) | 17 | 1.44 (0.75–2.80) | 3 | 0.62 (0.18–2.10) | ||
| p-trend=0.94 c | p-trend=0.19 | p-trend=0.61 | p-trend=0.70 | p-trend=0.85 | p-trend=0.31 | p-trend=0.80 | |||||||||||
| Phenoxy herbicides 10 studies: BCMM, ENGELA, Epilymph, Italian, LANHL, LAMMCC, Mayo, NCISEER, NSW, Yale |
Never | 9256 | 8834 | 1524 | 2089 | 1509 | 1518 | 1327 | 433 | OP insecticides, OC insecticides, Glyphosate, Any other pesticide | |||||||
| Ever | 370 | 395 | 1.12 (0.90–1.38) | 114 | 1.05 (0.73–1.50) | 71 | 1.04 (0.73–1.49) | 78 | 0.75 (0.52–1.11) | 63 | 1.28 (0.87–1.88) | 28 | 1.43 (0.85–2.40) | 23 | 1.85 (0.98–3.48) | ||
| Duration | |||||||||||||||||
| ≤8 years | 188 | 195 | 1.11 (0.86–1.42) | 60 | 1.12 (0.74–1.69) | 31 | 0.93 (0.59–1.47) | 42 | 0.80 (0.51–1.24) | 27 | 1.10 (0.68–1.79) | 13 | 1.25 (0.62–2.51) | 11 | 1.61 (0.75–3.46) | ||
| >8 to 25.5 | 105 | 120 | 1.22 (0.89–1.67) | 35 | 1.07 (0.65–1.75) | 22 | 1.19 (0.70–2.04) | 19 | 0.68 (0.38–1.22) | 25 | 1.81 (1.06–3.08) | 5 | 1.46 (0.52–4.15) | 9 | 2.53 (1.08–5.93) | ||
| >25.5 | 70 | 72 | 1.01 (0.69–1.46) | 18 | 0.84 (0.46–1.53) | 16 | 1.20 (0.65–2.23) | 14 | 0.71 (0.36–1.38) | 10 | 1.01 (0.49–2.09) | 10 | 1.78 (0.74–4.27) | 2 | 0.89 (0.20–4.01) | ||
| p-trend=0.71 | p-trend=0.57 | p-trend=0.42 | p-trend=0.25 | p-trend=0.38 | p-trend=0.15 | p-trend=0.49 | |||||||||||
| 2,4-D 7 studies: BCMM, Epilymph, Italian, LANHL, Mayo, NCISEER, NSW |
Never | 7908 | 7477 | 1371 | 1814 | 1335 | 1391 | 836 | 379 | OP insecticides, OC insecticides, Other phenoxy herbicides, Glyphosate, Any other pesticide | |||||||
| Ever | 287 | 300 | 1.10 (0.85–1.43) | 103 | 1.14 (0.76–1.70) | 51 | 1.10 (0.70–1.74) | 66 | 0.89 (0.57–1.38) | 50 | 1.44 (0.89–2.32) | 9 | 1.19 (0.43–3.29) | 12 | 0.62 (0.26–1.44) | ||
| Duration | |||||||||||||||||
| ≤8 years | 150 | 150 | 1.06 (0.79–1.44) | 58 | 1.20 (0.77–1.88) | 21 | 0.93 (0.53–1.64) | 35 | 0.88 (0.53–1.46) | 22 | 1.19 (0.67–2.11) | 3 | 0.55 (0.13–2.34) | 7 | 0.73 (0.28–1.90) | ||
| >8 to 25.5 | 88 | 95 | 1.14 (0.79–1.64) | 30 | 1.02 (0.59–1.75) | 18 | 1.32 (0.70–2.46) | 16 | 0.72 (0.37–1.37) | 21 | 1.96 (1.05–3.67) | 6 d | 2.54 (0.68–9.53) | 5 d | 0.51 (0.17–1.55) | ||
| >25.5 | 45 | 51 | 1.14 (0.71–1.83) | 15 | 1.18 (0.58–2.41) | 11 | 1.47 (0.67–3.21) | 13 | 1.19 (0.56–2.52) | 6 | 1.06 (0.40–2.81) | ||||||
| p-trend=0.49 | p-trend=0.91 | p-trend=0.21 | p-trend=0.92 | p-trend=0.32 | p-trend=0.18 | p-trend=0.27 | |||||||||||
| Other phenoxy herbicides 7 studies: BCMM, Epilymph, Italian, LANHL, Mayo, NCISEER, NSW |
Never | 8385 | 7971 | 1460 | 1850 | 1388 | 1423 | 1114 | 383 | OP insecticides, OC insecticides, 2,4-D, Glyphosate, Any other pesticide | |||||||
| Ever | 88 | 81 | 0.85 (0.61–1.19) | 14 | 0.67 (0.36–1.25) | 15 | 0.85 (0.47–1.56) | 13 | 0.80 (0.42–1.52) | 18 | 0.83 (0.46–1.50) | 6 | 0.65 (0.21–1.97) | 8 | 2.71 (1.16–6.33) | ||
| Duration | |||||||||||||||||
| ≤6.5 years | 50 | 33 | 0.63 (0.40–1.00) | 7 | 0.54 (0.23–1.26) | 6 | 0.63 (0.26–1.53) | 5 | 0.48 (0.18–1.25) | 6 | 0.59 (0.24–1.46) | - | 4 | 2.60 (0.85–7.95) | |||
| >6.5 | 37 | 46 | 1.13 (0.71–1.79) | 7 | 0.92 (0.39–2.17) | 8 | 1.05 (0.46–2.38) | 8 | 1.41 (0.61–3.26) | 11 | 1.01 (0.47–2.17) | 4 | 2.94 (0.94–9.23) | ||||
| p-trend=0.77 | p-trend=0.69 | p-trend=0.98 | p-trend=0.56 | p-trend=0.96 | p-trend=0.05 | ||||||||||||
| Glyphosate 8 studies: BCMM, ENGELA, Epilymph, Italian, Mayo, NCISEER, NSW, Yale |
Never | 8636 | 8241 | 1532 | 1968 | 1457 | 1435 | 1066 | 437 | OP insecticides, OC insecticides, Phenoxy herbicides, Any other pesticide | |||||||
| Ever | 340 | 345 | 1.03 (0.83–1.29) | 106 | 0.91 (0.63–1.30) | 60 | 0.96 (0.66–1.42) | 91 | 1.42 (0.98–2.05) | 46 | 0.97 (0.63–1.49) | 14 | 0.74 (0.38–1.46) | 18 | 0.99 (0.50–1.99) | ||
| Duration | |||||||||||||||||
| ≤8 years | 207 | 219 | 1.11 (0.87–1.43) | 71 | 1.04 (0.70–1.53) | 38 | 1.04 (0.67–1.59) | 66 | 1.66 (1.12–2.45) | 21 | 0.77 (0.45–1.31) | 7 | 0.66 (0.27–1.63) | 11 | 1.00 (0.46–2.18) | ||
| >8 to 15.5 | 69 | 68 | 0.96 (0.65–1.42) | 23 | 0.88 (0.49–1.57) | 12 | 0.92 (0.47–1.84) | 12 | 0.89 (0.44–1.79) | 13 | 1.30 (0.66–2.59) | 2 | 0.80 (0.17–3.66) | 5 | 1.29 (0.44–3.75) | ||
| >15.5 | 56 | 55 | 0.90 (0.59–1.37) | 12 | 0.57 (0.28–1.16) | 9 | 0.78 (0.36–1.69) | 12 | 1.06 (0.52–2.17) | 11 | 1.34 (0.64–2.80) | 5 | 0.85 (0.28–2.60) | 2 | 0.65 (0.14–3.01) | ||
| p-trend=0.54 | p-trend=0.12 | p-trend=0.51 | p-trend=0.64 | p-trend=0.27 | p-trend=0.68 | p-trend=0.83 | |||||||||||
| Triazine herbicides 6 studies: BCMM, ENGELA, Epilymph, Italian, Mayo, NCISEER |
Never | 8050 | 7591 | 1491 | 1802 | 1370 | 1366 | 895 | 399 | OP insecticides, OC insecticides, Phenoxy herbicides, Glyphosate, Any other pesticide | |||||||
| Ever | 220 | 222 | 0.91 (0.70–1.18) | 81 | 1.05 (0.71–1.55) | 38 | 0.88 (0.55–1.39) | 42 | 0.75 (0.48–1.17) | 35 | 0.94 (0.58–1.54) | 6 | 0.75 (0.28–2.01) | 12 | 0.91 (0.40–2.04) | ||
| Duration | |||||||||||||||||
| ≤10 years | 114 | 108 | 0.86 (0.62–1.20) | 40 | 0.99 (0.61–1.59) | 17 | 0.78 (0.43–1.42) | 19 | 0.61 (0.34–1.08) | 18 | 0.98 (0.54–1.80) | 3 | 1.22 (0.32–4.63) | 7 | 1.03 (0.40–2.69) | ||
| >10 | 105 | 113 | 0.95 (0.69–1.32) | 41 | 1.11 (0.70–1.78) | 20 | 0.95 (0.54–1.67) | 23 | 0.93 (0.53–1.61) | 17 | 0.93 (0.50–1.72) | 3 | 0.53 (0.14–2.00) | 5 | 0.79 (0.27–2.27) | ||
| p-trend=0.86 | p-trend=0.65 | p-trend=0.93 | p-trend=0.96 | p-trend=0.81 | p-trend=0.36 | p-trend=0.64 | |||||||||||
| Atrazine 3 studies: Italian, Mayo, NCISEER |
Never | 5183 | 5235 | 930 | 1195 | 1076 | 967 | 250 | OP insecticides, OC insecticides, Phenoxy herbicides, Glyphosate, Any other pesticide | ||||||||
| Ever | 178 | 174 | 0.85 (0.63–1.14) | 67 | 0.93 (0.61–1.43) | 26 | 0.68 (0.40–1.17) | 36 | 0.68 (0.42–1.10) | 27 | 0.90 (0.52–1.56) | - | 9 | 0.85 (0.33–2.15) | |||
| Duration | |||||||||||||||||
| ≤8 years | 96 | 86 | 0.77 (0.53–1.11) | 36 | 0.88 (0.53–1.46) | 10 | 0.51 (0.24–1.07) | 17 | 0.56 (0.30–1.03) | 12 | 0.78 (0.38–1.59) | - | 6 | 1.02 (0.35–2.94) | |||
| >8 | 80 | 87 | 0.95 (0.66–1.37) | 31 | 1.00 (0.59–1.70) | 15 | 0.84 (0.44–1.61) | 19 | 0.85 (0.46–1.55) | 15 | 1.07 (0.55–2.09) | 3 | 0.64 (0.17–2.42) | ||||
| p-trend=0.88 | p-trend=0.96 | p-trend=0.70 | p-trend=0.71 | p-trend=0.79 | p-trend=0.51 | ||||||||||||
| Amide herbicides 4 studies: ENGELA, Italian, Mayo, NCISEER |
Never | 5266 | 5269 | 1034 | 1306 | 1132 | 1035 | 270 | OP insecticides, OC insecticides, Phenoxy herbicides, Glyphosate, Any other pesticide | ||||||||
| Ever | 171 | 153 | 0.74 (0.55–1.00) | 61 | 0.85 (0.55–1.31) | 22 | 0.58 (0.33–1.00) | 30 | 0.59 (0.36–0.99) | 19 | 0.61 (0.34–1.10) | - | 10 | 1.14 (0.46–2.82) | |||
| Duration | |||||||||||||||||
| ≤8 years | 92 | 94 | 0.86 (0.60–1.24) | 43 | 1.11 (0.68–1.82) | 12 | 0.65 (0.33–1.31) | 16 | 0.57 (0.31–1.07) | 9 | 0.55 (0.25–1.20) | - | - | - | |||
| >8 | 77 | 56 | 0.59 (0.40–0.89) | 17 | 0.54 (0.29–1.00) | 9 | 0.47 (0.22–1.01) | 14 | 0.65 (0.34–1.27) | 9 | 0.62 (0.28–1.34) | ||||||
| p-trend=0.01 | p-trend=0.05 | p-trend=0.05 | p-trend=0.20 | p-trend=0.20 | |||||||||||||
| Alachlor 3 studies: Italian, Mayo, NCISEER |
Never | 4181 | 4207 | 893 | 976 | 838 | 848 | 227 | OP insecticides, OC insecticides, Phenoxy herbicides, Glyphosate, Any other pesticide | ||||||||
| Ever | 126 | 123 | 0.84 (0.60–1.18) | 53 | 0.96 (0.60–1.51) | 16 | 0.58 (0.30–1.09) | 25 | 0.63 (0.36–1.10) | 15 | 0.79 (0.40–1.55) | - | 8 | 1.47 (0.53–4.12) | |||
| Duration | |||||||||||||||||
| ≤8 years | 79 | 84 | 0.92 (0.62–1.35) | 39 | 1.11 (0.67–1.86) | 10 | 0.62 (0.29–1.33) | 16 | 0.64 (0.33–1.21) | 7 | 0.58 (0.24–1.40) | - | - | - | |||
| >8 | 44 | 36 | 0.70 (0.43–1.16) | 13 | 0.69 (0.34–1.39) | 5 | 0.46 (0.17–1.24) | 9 | 0.67 (0.30–1.48) | 7 | 1.07 (0.44–2.63) | ||||||
| p-trend=0.19 | p-trend=0.48 | p-trend=0.07 | p-trend=0.16 | p-trend=0.71 | |||||||||||||
| Trifluralin 6 studies: BCMM, Italian, Mayo, NCISEER, NSW, Yale |
Never | 5919 | 6052 | 1016 | 1388 | 1229 | 1053 | 742 | 295 | OP insecticides, | |||||||
| Ever | 148 | 130 | 0.75 (0.55–1.00) | 47 | 0.85 (0.55–1.32) | 21 | 0.70 (0.41–1.21) | 19 | 0.41 (0.24–0.72) | 21 | 0.81 (0.46–1.41) | 5 | 1.07 (0.38–3.05) | 8 | 0.96 (0.39–2.37) | ||
| Duration | |||||||||||||||||
| ≤8 years | 87 | 76 | 0.77 (0.53–1.11) | 34 | 0.99 (0.60–1.63) | 8 | 0.49 (0.22–1.08) | 11 | 0.40 (0.20–0.79) | 12 | 0.89 (0.44–1.80) | 2 | 1.17 (0.25–5.54) | 5 | 1.05 (0.36–3.07) | ||
| >8 | 60 | 50 | 0.67 (0.44–1.02) | 13 | 0.63 (0.32–1.25) | 11 | 0.81 (0.40–1.64) | 7 | 0.39 (0.17–0.91) | 8 | 0.65 (0.29–1.45) | 3 | 0.96 (0.26–3.61) | 3 | 0.83 (0.23–3.01) | ||
| p-trend=0.05 | p-trend=0.19 | p-trend=0.49 | p-trend=0.02 | p-trend=0.29 | p-trend=0.97 | p-trend=0.78 | |||||||||||
| Dicamba 4 studies: Italian, Mayo, NCISEER, NSW |
Never | 5602 | 5657 | 948 | 1337 | 1126 | 1076 | 254 | OP insecticides, OC insecticides, Phenoxy herbicides, Glyphosate, Any other pesticide | ||||||||
| Ever | 131 | 120 | 0.79 (0.57–1.10) | 49 | 0.87 (0.55–1.38) | 16 | 0.60 (0.32–1.14) | 25 | 0.64 (0.37–1.10) | 18 | 0.92 (0.49–1.74) | - | 6 | 0.78 (0.27–2.22) | |||
| Duration | |||||||||||||||||
| ≤8 years | 75 | 71 | 0.79 (0.53–1.18) | 35 | 1.04 (0.61–1.76) | 7 | 0.46 (0.19–1.08) | 13 | 0.55 (0.28–1.08) | 10 | 0.90 (0.41–1.96) | - | 3 | 0.62 (0.16–2.35) | |||
| >8 | 54 | 46 | 0.77 (0.49–1.21) | 13 | 0.61 (0.30–1.22) | 8 | 0.76 (0.33–1.74) | 11 | 0.76 (0.36–1.59) | 8 | 1.00 (0.43–2.33) | 3 | 1.08 0.28–4.15) | ||||
| p-trend=0.25 | p-trend=0.16 | p-trend=0.48 | p-trend=0.45 | p-trend=1.00 | p-trend=0.92 | ||||||||||||
| Pendimethalin 3 studies: Italian, Mayo, NCISEER |
Never | 4250 | 4272 | 921 | 982 | 855 | 857 | 230 | OP insecticides, OC insecticides, Phenoxy herbicides, Glyphosate, Any other pesticide | ||||||||
| Ever | 57 | 58 | 0.94 (0.61–1.44) | 25 | 1.11 (0.63–1.94) | 10 | 1.03 (0.48–2.21) | 8 | 0.48 (0.21–1.07) | 6 | 0.67 (0.27–1.70) | - | 5 | 1.92 (0.61–6.04) | |||
| Duration | |||||||||||||||||
| ≤4 years | 33 | 23 | 0.63 (0.35–1.14) | 11 | 0.82 (0.38–1.76) | 3 | 0.52 (0.15–1.81) | 4 | 0.40 (0.14–1.21) | - | - | - | |||||
| >4 | 24 | 31 | 1.16 (0.64–2.07) | 14 | 1.44 (0.69–3.01) | 5 | 1.19 (0.42–3.35) | 4 | 0.57 (0.19–1.73) | ||||||||
| p-trend=0.97 | p-trend=0.47 | p-trend=0.96 | p-trend=0.14 | ||||||||||||||
| Paraquat 5 studies: BCMM, Italian, Mayo, NCISEER, NSW |
Never | 5335 | 5378 | 993 | 1216 | 1104 | 987 | 565 | 257 | OP insecticides, OC insecticides, Phenoxy herbicides, Glyphosate, Any other pesticide | |||||||
| Ever | 26 | 31 | 1.17 (0.67–2.04) | 4 | 0.58 (0.19–1.74) | 5 | 1.09 (0.40–2.98) | 8 | 1.44 (0.61–3.41) | 7 | 1.48 (0.60–3.64) | 3 | 2.03 (0.34–12.3) | 2 | 1.68 (0.36–7.81) | ||
| Duration | |||||||||||||||||
| ≤4.5 years | 15 | 13 | 1.01 (0.47–2.19) | 2 | 0.50 (0.11–2.23) | - | 4 | 1.32 (0.42–4.18) | 3 | 1.60 (0.43–5.97) | - | - | |||||
| >4.5 | 11 | 17 | 1.26 (0.57–2.78) | 2 | 0.72 (0.15–3.55) | 4 | 1.61 (0.46–5.66) | 4 | 1.42 (0.43–4.70) | ||||||||
| p-trend=0.58 | p-trend=0.53 | p-trend=0.42 | p-trend=0.52 | ||||||||||||||
a
Odds ratios (OR) and 95% confidence intervals (CI) from logistic regression models, with adjustment for study center, age, gender, socioeconomic status (SES), race/Hispanic ethnicity, farming work history, and a set of covariates for use of other pesticides
b
Three-category duration variable results are shown if there were at least 50 exposed NHL cases in the highest category; otherwise, two-category duration results are shown
c
p-value for a continuous variable with values set as the median of each duration category
d
Categories collapsed if included 0 or 1 cases