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

PLoS One. 2014 Oct 21;9(10):e110850. doi: 10.1371/journal.pone.0110850. eCollection 2014.

Abstract

Objective: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Case-Control Studies
  • Environmental Exposure*
  • Fungicides, Industrial / toxicity
  • Herbicides / toxicity
  • Humans
  • Insecticides / toxicity
  • Myelodysplastic Syndromes / chemically induced
  • Myelodysplastic Syndromes / epidemiology*
  • Occupational Exposure*
  • Pesticides / toxicity*
  • Risk Factors

Substances

  • Fungicides, Industrial
  • Herbicides
  • Insecticides
  • Pesticides

Grants and funding

This study was supported by grants from the Key Innovation Team Foundation of Zhejiang Province (2011R50015), major program fund of the Science Technology Department of Zhejiang Province (2013c03043-2), Zhejiang Province Fund for Distinguished Young Scholars (LR12H08001), National Public Health Grand Research Foundation (201202017) and the National Natural Science Foundation of China (No.30870914, No.81270582). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.