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Occupational exposure to pesticides and bile tract carcinoma in men: results from a European multicenter case–control study

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Abstract

Objectives

To estimate the associations between occupational exposure to pesticides and extrahepatic biliary tract carcinoma in men, a population-based case–control study was carried out.

Methods

Cases (n = 104), aged 35–70, diagnosed in 1995–1997, were sampled by active reporting systems from hospitals. Controls (n = 1,401) were a random sample of the general male population. Information on occupation and confounding factors was obtained by questionnaires. Exposures were quantified with respect to time, application methods, and use of personal protective equipment. Intensity was evaluated by using a published algorithm which weighted the exposure assigned according to the use of personal protective equipment and mode of application. Logistic regression analyses were conducted adjusted for gallstones, age, and country.

Results

Being ever exposed to pesticides resulted in an odds ratio (OR) of 1.0 [95%-confidence interval (CI) 0.6–1.6]. A modestly elevated risk was found for backpack mounted sprayers OR = 1.4 [95% CI 0.7–2.6] and vine farmers OR = 2.5 [95% CI 0.9–7.2]. Using time periods and exposure frequency as intensity measure, no elevated risks were found. The only exception was year of maximum exposure which yielded an OR of 1.6 [95% CI 0.7–3.5]. However, no clear trend was observed in this analysis.

Conclusions

This study does not rule out that pesticide exposure represents an occupational risk factor for extrahepatic biliary tract carcinoma, but no indication of a strong association was observed. Some modes of exposure were weakly, albeit not significantly associated with carcinoma risk. The observed estimates of effects may be influenced by a lack of precise exposure assessment. Different chemical compositions of pesticides were utilized during a long time span of pesticide exposure, and it should be considered that the exposure is assessed with substantial uncertainty that could non-differential and bias results toward the null.

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Acknowledgments

We acknowledge collaboration from participating patients, control persons, hospitals, and data providers such as the French Cancer Registry Associated (Résion FRANCIM). The study “Occupational risk factors for rare cancers of unknown etiology” was financially supported by the European Commission, DGXII, grants no BMH1 CT 931630 and ERB CIPD CT 940285, and national funding agencies. Denmark: The Stategic Environment Programme. France: Ligue Nationale contre le Cancer, Fédération Nationale des Centres de Lutte contra le Cancer, Fondation de France, contract # 955368, Institut National de la Santé et de la Recherche Médicale (INSERM) contract “Réseau en Santé Pulique” (Network for Public Health) # 4R006A, French Ministry of Environment, contract # 237.01.94.40 182. Germany: Federal Ministry for Education, Science, Research and Technology (BMBF), grant no. 01-HP-684/8. Italy: MURST, Italian Association for Cancer Research, Compagnia SanPaolo/FIRMS. Portugal: Junta Nacional de Investidacäo Cientifica e Tecnológica, Praxis XXI, no2/2.1/SAU/1178/95. Spain: Fondo de Investigación de la Sanitarie, Ministerio de Sanidad y Consumo, Unidad de Investigación Clinico-Epidemiológica, Hospital Dr. Peset. Generalitet Valenciana; Departmento de Sanidad y Consumo, Gobierno Vasco; Fondo de Investigación de la Sanitaria (FIS), Ministerio de Sanidad y Consumo, Ayuda a la Investigación del Departamento de Salud del Gobierno de Navarra. Sweden: Swedish Council for Work Life Research, Research Foundation of the Department of Oncology in Umeå, Swedish Society of Medicine, Lund University Hospital Research Foundation, Gunnar, Arvid and Elisabeth Nilsson Cancer Foundation, Örebro County Council Research Committee, Örebro Medical Center Research Foundation, John and Augusta Persson Foundation for Scientific Medical research, Berta Kamprad Foundation for Cancer Research.

Author information

Authors and Affiliations

  1. Bremen Institute for Prevention Research and Social Medicine, University of Bremen, Linzer Str. 10, 28359, Bremen, Germany

    N. Schmeisser & W. Ahrens

  2. Department of Epidemiology, Institute of Public Health, University of Aarhus, Aarhus, Denmark

    L. Kaerlev

  3. Center for National Clinical Databases South, Department of Research and HTA, Odense University Hospital, Odense, Denmark

    L. Kaerlev & J. Olsen

  4. Registre du cancer de la Somme; CHU Nord. Bat. de Santé Publique, Amiens, France

    N. Bourdon-Raverdy & O. Ganry

  5. Unit of Public Health and Environmental Care, Department of Preventive Medicine, University of Valencia, Valencia, Spain

    A. Llopis-González & M. Morales-Suárez-Varela

  6. Research group CIBER CB06/02/0045, CIBER Actions, Epidemiology and Public Health, Valencia, Spain

    A. Llopis-González & M. Morales-Suárez-Varela

  7. INSERM (National Institute of Health and Medical Research) U754, IFR69, Villejuif, France

    P. Guénel

  8. Department of Oncology, Orebro University Hospital, Orebro, Sweden

    L. Hardell

  9. Unit of Cancer Epidemiology, University of Turin, Turin, Italy

    F. Merletti & P. Zambon

  10. Clinical Epidemiologic Research Unit, Dr Peset University Hospital, Valencia, Spain

    M. Morales-Suárez-Varela

  11. Department of Epidemiology, School of Public Health, UCLA, Los Angeles, CA, USA

    H. Olsson

  12. Department of Oncology, Lund University Hospital, Lund, Sweden

    H. Olsson

  13. Institute of Pathology, Aalborg Hospital, University of Aarhus, Aarhus, Denmark

    M. Vyberg

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  1. N. Schmeisser
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  2. L. Kaerlev
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  3. N. Bourdon-Raverdy
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  4. O. Ganry
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  5. A. Llopis-González
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  6. P. Guénel
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  7. L. Hardell
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  9. P. Zambon
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  10. M. Morales-Suárez-Varela
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  11. J. Olsen
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  12. H. Olsson
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  13. M. Vyberg
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  14. W. Ahrens
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Corresponding author

Correspondence to W. Ahrens.

Appendix

Appendix

The European Study Group on Occupational Causes of Rare Cancers: DENMARK: Herman Autrup, Henrik Kolstad, Linda Kaerlev, Elsebeth Lynge, Jorn Olsen, Lisbeth Norum Pedersen, Svend Sabroe, Preben Johansen, Stein Poulsen, Peter Stubbe Teglbjaerg, Mogens Vyberg. FRANCE: Pascal Guénel, Joëlle Févotte and the members of the FRANCIM association: Patrick Arveux, Antoine Buemi, Paule-Marie Carli, Gilles Chaplain, Jean-Pierre Daurès, Jean Faivre, Pascale Grosclaude, Anne-Valérie Guizard, Michel Henry-Amar, Guy Launoy, Francois Ménégoz, Nicole Raverdy, Paul Schaffer. GERMANY: Wolfgang Ahrens, Cornelia Baumgardt-Elms, Sibylle Gotthardt, Ingeborg Jahn, Karl-Heinz Jöckel, Hiltrud Merzenich, Andreas Stang, Christa Stegmaier, Antje Timmer, Hartwig Ziegler. ITALY: Terri Ballard, Franco Bertoni, Giuseppe Gorini, Sandra Gostinicchi, Giovanna Masala, Enzo Merler, Franco Merletti, Lorenzo Simonato, Paola Zambon. LATVIA: Irena Rogovska, Galina Sharkova, Aivars Stengrevics. LITHUANIA: Jolita Gibaviciene, Laimonas Jazukevicius, Juozas Kurtinaitis, Poma Pociute. PORTUGAL: Noemia Alfonso, Altamiro Costa-Pereira, Sonia Doria, Carlos Lopes, José Manuel Lopes, Ana Miranda, Cristina Santos. SPAIN: M Adela Sanz Aguado, Juan J Aurrekoetxea, Concepción Brun, Alicia Córdoba, Miguel Angel Martínez González, Francisco Guillén Grima, Rosa Guarch, Agustin Llopis González, Blanca Marín, Amparo Marquina, María M Morales Suárez-Varela, Inés Aguinaga Ontoso, JM Martínez Peñuela, Ana Puras, Francisco Vega, Maria Aurora Villanueva Guardia. SWEDEN: Mikael Eriksson, Lennart Hardell, Irene Larsson, Hakan Olson, Monica Sandström, Gun Wingren. SWITZERLAND: Jean-Michel Lutz. UNITED KINGDOM: Janine Bell, Ian Cree, Tony Fletcher, Alex JE Foss.

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Schmeisser, N., Kaerlev, L., Bourdon-Raverdy, N. et al. Occupational exposure to pesticides and bile tract carcinoma in men: results from a European multicenter case–control study. Cancer Causes Control 21, 1493–1502 (2010). https://doi.org/10.1007/s10552-010-9578-6

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  • DOI: https://doi.org/10.1007/s10552-010-9578-6

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