Pesticide exposure as a risk factor for myelodysplastic syndromes: a meta-analysis based on 1,942 cases and 5,359 controls

• Published in: PloS one 2014-10, Vol.9 (10), p.e110850
• Main Authors: Jin, Jie, Yu, Mengxia, Hu, Chao, Ye, Li, Xie, Lili, Jin, Jin, Chen, Feifei, Tong, Hongyan
• Format: Article
• Language: English
• Subjects: Anemia; Bias; Cancer; Case-Control Studies; Confidence intervals; Disorders; Environmental Exposure; Epidemiology; Exposure; Fungicides; Fungicides, Industrial - toxicity; Health aspects; Health risk assessment; Health risks; Hematology; Herbicides; Herbicides - toxicity; Humans; Identification methods; Insecticides; Insecticides - toxicity; Leukemia; Lymphoma; Medical ethics; Medicine; Medicine and Health Sciences; Meta-analysis; Myelodysplastic syndrome; Myelodysplastic syndromes; Myelodysplastic Syndromes - chemically induced; Myelodysplastic Syndromes - epidemiology; Occupational Exposure; Pesticides; Pesticides - toxicity; Prostate cancer; Refractory anemia; Risk Factors; Sideroblasts; Statistical analysis; Stem cells; Studies; Subgroups; Systematic review
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0110850

Pesticide exposure has been linked to increased risk of cancer at several sites, but its association with risk of myelodysplastic syndromes (MDS) is still unclear. A meta-analysis of studies published through April, 2014 was performed to investigate the association of pesticide exposure with the risk of MDS. Studies were identified by searching the Web of Science, Cochrane Library and PubMed databases. Summary odds ratios (ORs) with corresponding 95% confidence intervals (CIs) were calculated using random- or fixed-effect models. This meta-analysis included 11 case-control studies, all of which demonstrated a correlation between pesticide exposure and a statistically significant increased risk of MDS (OR=1.95, 95% CI 1.23-3.09). In subgroup analyses, patients with pesticide exposure had increased risk of developing MDS if they were living in the Europe or Asia and had refractory anemia (RA) or RA with ringed sideroblasts (RARS). Moreover, in the analysis by specific pesticides, increased risk was associated with exposure to insecticides (OR=1.71, 95% CI 1.22-2.40) but not exposure to herbicides or fungicides. This meta-analysis supports the hypothesis that exposure to pesticides increases the risk of developing MDS. Further prospective cohort studies are warranted to verify the association and guide clinical practice in MDS prevention.