Document 3QkXZvnnZ7yN666Jqzw0JrzYJ

Cancer in Humans and Potential Occupational and Environmental Exposure to Pesticides Selected Epidemiological Studies and Case Reports E d ito r's n ote: T h e fo llo w in g abstracts are a compendium of data resources for additional infor mation .on the topic of minority workers. MORTALITY STUDIES Alavanja, M CR, Rush, G A, Stew art P, at al. Proportionate m ortality study of w orkers in the gra in in d u stry. Jou rn al of the N a tio n a l C a n ce r In stitu te 1987; 78(2):247-252. A proportionate mortality study of 1,114 members (all white males) of the American Federation of Grain Millers union who died between 1968*83, compared to the U.S. popu lation. Statistically significant increased risk was found for pancreatic cancer (PMR* 191. PCMR of 171 was not significant), and ocher lymphoma (PMR 272 PCMR 249). Nonsignificant elevated ratios were found for stomach cancer (PMR 141, PCMR 121), bladder cancer (PMR. 178, PCMR 155), lym phosarcoma (PMR 216, PCMR 191k Hodgkin's disease (PMR 174. PCMR 153), and leukemia (PMR 170. PCMR 139). Potential pesticide exposures included methyl bromide, ethylene dibromide. carbon tetrachloride, phosphine, and malathion, among others. Alavanja, M C R , M alker, H, H ayes, RB. Occupational cancer risk associated w ith the storage and bulk handling of agri cultural foodstuff, Journal of Toxicology a n d E n viro n m e n ta l H ealth 1987; 22(31:247-254. A study of cancer incidence in 2,649 Swed ish grain milters (all white males) between 1961-79, compared to the Swedish general pop ulation. Statistically significant increased risk was found for /nvrcancer (SIR 238). Nonsignificant increased ratios were found forcancer of the stomach (SIR 103). colon (SIR 'Siv Figure ai ike end o farticlefo r abbreviations. by Marion Moses, MD 116), kidney (SIR 113), bladder (SIR 125),'other lymphoma (SIR 137), and multiple myeloma (SIR 139). Barths), E. Increased risk of lung cancer in p e a tic id a -e x p o sa d m ale a g ric u ltu ra l w o rke rs. Jo u rn a l of Toxicology and Environmental Health 1981; 8:1027-1040. A proportionate mortality study of 1,658 agricultural pesticide sprayers in East Ger many, 169 of whom died between 1948-78. compared to the general population (excluding Berlin). Statistically significant increased risk was found for lung cancer (PCMR 180). Nonsignificant elevated risk was found for cancer of the pancreas (PCMR 146), bladder (PCMR 118) and other genitourinary cancer^ (PCMR 186). Potential pesticide exposures* included Zineb, Maneb. Atrazine, Simazine, Amicrole, arsenic, D D T Lindane, methyl parathion, toxaphene, DNOC. 2,4-D, 2,4,5-*K among others. Blair, A, G raum an, DJ, Lubln, JH. Lung cancer end other causes of death am ong licensed pesticide applicators. Journal of the N a tio n a l'C a n c e r institute 1983; 71(11:31-37. A mortality study o f3,827 pest control oper ators licensed in Florida during 1965-66, of whom 378 had died as of January 1, 1977. For those with 20 or more years latency, statistically significant increased risk was found for lung cancer (SMR 289), and a nonsignificant eleva tion for all cancers (SMR 177). For the entire cohort, nonsignificant ele vated risk was found for all cancers (SMR 114), lung cancer (SMR 135) and brain cancer (SMR 200). Potenrial pesticide exposures included Aldrin. Chlordane, DD*L hcpuchlor, tox aphene, lindane, chlorpyrifos, diazinon, mal athion, dichlorvos, carbaryl, propoxur, bendiocarb, 2 ,4 -0 . 2,4,5-T, Paraquat, pentachlorophenol. Captan, folpet. arsenic, methyl bromide, and paradichlorobenzcne. Burm m sUr, LE Cancer m ortality In Iow a farm ers, 1971-78. Journal of the National Cancer Institute 1981; 66{3):481-464. A mortality study of 6,402 Iowa farmers who died between 1971 and 1978. compared to 13,809 rionfarmers. Statistically significant increased risk for farmers was found for cancer of the stomach (SMR 135). colon (SMR 122), pancreas (SMR 123), shin (SMR 131). prostate (SMR 141), bladder (SMR 114), kidney (SMR 122). lip (SMR 206). Hodgkins disease (SN1R 137). leukemia (SMR 135). otherlymphoma (SMR 129) and multiple myeloma (SMR 147). Nonsignificant elevated ratios were found for: bone cancer (SMR 126). and brain cancer (SMR 111). .. . Carlson, M L, Petersen, GR. M ortality of California agricultural w orkers. Journal of Occupational Medicine 1978; 20(11:30-32. A mortality study in California comparing 2,936 farm laborers with 90S farm operator/ managers who died between 1959-61, using state health department a p e s indexing death to occupation. A nonsignificant elevated morality rate ratio between laborers and managers for all cancers of 1.13 was found. ', C oggon, D, Pannett, B, Winter, PD, at al. M o rta lity ' of w o rkars axp osod to 2 m a th y l-4 c h lo ro p h e n o x y a c a tic acid. Scandinavian Journal of Work, Environ ment and Health 1988; 12:448-454. A morality study o f5,754 workers (all white .males) who both manufactured and sprayed MCPA as well as other pesticides from 1947 to 1975 for the same British company. As of December 1983, there were 1.039 deaths, 297 from cancer. Sutistically significant increased risk compared to the'general rural population was found for nasalcancer (SMR 493). Nonsignificant elevated ratios were found for all cancer (SMR 107). cancer o f the tongue (SMR 112), digestive system (SMR 273). colon (SMR 102). larynx (SMR 174). lung (SMR 1I5X nonmelanoma skin (SMR 306), prosrate (SMR 132),.testes (SMR 223). brain (SMR 124), thy AA O H N Journal, March 1989, Vol. 37, No. 3 131 Moses roid (SMR 170), nonbladdcr genitourinary (SMR 227). small intestine (SMR 159). gall'-' bladder (SMR f19). leukemia (SMR 177), mul tiple myeloma (SMR 162) and soft-tissue sar coma (SMR 104). A dditional potential pesticide exposures included DNOC, copper oxychloride, a variety of organophosphorous insecticides, chlortriazinc herbicides, and 2,4,5-'!'. D elzell, W, G ru fferm sn , S. M o rta lity am ong w hite and nonw hite farm ers in N o rth C aro lin a, 1976-1978. Am erican Jo u rn a l of E p id e m io lo gy 1985; 121(31:391-402. A mortality study in North Carolina of 9.245 white and 3.508 non-white (94% black) farm ers who died between 1976-78, compared to the general population of the state. Statistically, significant increased risk was found in white farmers for nonmelanomaskin cancer (PM R 180) and in non-white farmers for melanoma skin cancer (PMR 630) and leukemia (PMR 190). Nonsignificant elevated ratios were found in white farmers for melanoma (PMR 120), pros tate cancer (PMR 110): and in non-white farm ers for brain cancer (PMR 230) and other lym phoma (PMR 120). . Fasal, E. Jackson, EW, Klsuber, M R. Leuke mia and lym phom a m ortality and farm residence. American Journal of Epidemi ology 1968; 87:267-274. A mortality study of 1,857 farmers in Califor nia who died between 1959-61, compared to nonfarmers in the state. Nonsignificant elevated ratios were seen in both males and females for leukemia (PMR 114), and in females for Hodgkin's disease (PMR 109), and multiple myeloma (PMR 102). Gallagher, RP, Threlfall, W J, Spinelli, JJ, et el. O c c u p a tio n a l m o rta lity p a tte rn s am ong B ritish C olum bia farm w orkers. Journal of Occupational Medicine 1984; 26(121:906-908. A proportionate mortality study of 2,328 British Columbia farmworkers (all males) who died between 1950-78. Nonsignificant elevated ratios were found for cancer of the stomach (PCMR 126), pan creas (PCMR 124), and prostate (PCMR 109). Gallagher, RR Threlfall, W J, Jaffries. E, at si. Cancer and aplastic anem ia In British Colum bia farmers. Journal ofthe National Cancer Institute 1384; 72(61:1311-1315. A proportionate mortality study of 28,032 fanners in British Columbia (all males) who died between 1950-78. Statistically significant increased risk was found for cancer of the stom ach lPCMR 119), pancreas (PMR 112, PCMR 105 not significant), prostate (PCMR 113), lip (PCMR 191), leukemia (PCMR 122), nasal can cer (PMR 186, PCMR 178 not significant), and aplastic anemia (PMR 186, PCMR 178 not sig nificant). A nonsignificant increased ratio was found for multiple myeloma (PCMR 103). M abuchi, K, Ulienfeld, A M , Snell, LM. C an cer and occupational exposure to arsenic: A study of pesticide w orkers. Preventive Medicine 1980; 9:51-77. A mortality study of3,141 hourly and salaried men and women who worked four months or more between 1946-74 at a pesticide manufac turing plant in Baltimore, Maryland. As of August. 1977, there were 240 deaths, 56 from cancer. In males, compared to the U.S. general population, statistically significant increased risk was found for all cancers (SMR 168), and /tfffgcancer (SMR 265)., . Nonsignificant increased ratios were found for oral cancer (SMR 201). cancer of the esoph agus (SMR 451), stomach (SMR 172), skin (SMR 162) and lymphopoietic cancer (SMR 209). The number of female cancer deaths was too small for significance testing: however, an elevated ratio was found for rectal cancer (2 observed v$. 0.4 expected). Potential pesticide exposures included lead and calcium arsenate, sodium, zinc and magnesium arsenite, copper acctoarscnite (Paris green), DDT Aldrin. toxaphcnc, chlordeconc, various organophosphates. various carbamates, 2,4-D, monuronTC.'A. and orher organic herbicides. Riihim aki, V, Asp, S, Hem barg, S. M o r tality of 2,4- diehtorophenoxy aeeticacid and 2,4,5-trich loroph anoxyacetic acid herbicide ap p licato rs in Finland. First report of an ongoing prospective study. Scandinavian Journal of Work, Environment and Health 1982; 8:37-42. A mortality study of 1,926 Finnish pesticide sprayers who worked for two weeks or more between 1955-71 as applicators of 2,4-D and 2.4,5-T. As of 1980, 144 had died, 26 from cancer. Nonsignificant elevated ratios were found for qancer of the esophagus/stomach (SMR 108, based on 4 cases), lung cancer (SMR 108, 12 cases), prostate cancer (SMR 182, 2 cases) and multiple myeloma (SMR 500, 1case). Saftlas, A R Blair, A, Cantor, KP. at al. Cancar and other causes of death am ong W isconsin farm ers. American Journal of Industrial Medicine 1987; 11:119-129. A proportionate mortality study of 35.972 Wisconsin farmers (all white males) who died from 1968-76. compared to the general U.S. general population and to nonfarmers in Wisconsin (excluding Milwaukee). Statis tically significant increased risk was found for cancer of the stomach (PMR 124, PCMR 113), /ofu/szrfPM R 110, PCMR 98), psuuft/r(PMR 122, PCMR 114). i?r(PMR 375, PCMR 343). lymphosarcoma (PMR 125, PCMR 110 not sig nificant), Hodgkin's disease (PMR 155, PCMR 126 not significant), other lymphoma, two thirds of which were multiple myeloma (PMR 123, PCMR 110 not significant), lymphopoieticcancer (PMR 123, PCMR 110), and leukemia (PMR 120, PCMR 109 not significant). Elevated ratios not statistically significant were found for cancer of the rectum (PMR 113), bone (PMR 105), skin (PMR 115), testes (PMR '103), kidney (PMR 106), and brain (PMR 110). Shindell, S, Ulrich, S. M ortality of w orkers em ployed in the m anufacture Chlordane: An update. Journal of Occupational Medicine 1986; 28(7):4987-501. A mortality study of 800 persons who worked three months or more from 1946-85, at the only plant that.^manufactures chlordanc in the LLS. (Vclsicol plant in Illinois). 181 deaths were traced, 37 from^cancer. No statistically significant increased'risks were found. Of the 37 cancers, 12 were lung (SMR 86). '4 colon! rectal, 3 stomach, 2 pancreas, 2 renal, 9 of different types (not specified) and 5 of unknown type. Infante, PR Freeman, C, Cancer m ortality am ong w orkers exp osed to chlordane (letter). Journal of Occupational Mddicine 1987; 29(11):908-909. ~ A critique of the Shindell mortality.study of chlordane workers. Sh in d e ll, S. Cancer m ortality am ong w orkers exposed to C hlord ane (letter). Journal.of Occupational Medicine 1987; 29(11):909-911. A reply to the critique by Infante and Free man. Stubbs, HA, Herns, J, Spear, RC. A propor tionate m ortality a n a lysis of C alifornia agricufturarw orkers, 1978-1979, American Journal of industrial M edicine 1984; 6:305-320. A proportionate mortality study in California of 7,504 farmworkers and 7,404 farm owners/ managers who died between 1978-79, com pared to the state's general population. Statis tically significant increased risk was found in white (includes Hispanics) farmworkers for cancer of thc stomach (PCMR 134), and in non whites fat brain cancer (PCMR 155). Nonsignificant elevated ratios were found in white farmworkers for oral cancer (PCMR 111), cancer of the esophagus (PCMR 121), liver and gallbladder (PCMR 145), larynx (PCMR 129), lung (PCMR 108). bone (PCMR 159), prostate (PCMR 101), other lymphoma (PCMR 107); and in non-whites for cancer of the esophagus (PCMR 115), stomach (PCMR 101), rectum (PCMR 190). liverand galibladder(PCMR 151) 132 AA O H N Journal, March 1989, Voi. 37, No. 3  r Cancer and other lymphoma (PCMR 114). Statistically significant increased risk in white farm owner/managers was found for can cer of the prostate (PCMR 122) and otker lym phoma (PCMR 150) and in non-whites for can cer of the stomach (PCMR 202), and rectum (PCMR 224). Nonsignificant elevated rarios were found in white farmer managers for cancer of the stom ach (PCMR 109), rectum (PCMR 109), liver (PCMR 137), larynx (PCMR 111), skin (PCMR 130), kidney (PCMR 102) and lymphopoetic (PCMR 105), and in non-whites for cancer of rhe esophagus (PCMR 127), colon (PCMR 107) , liver (PCMR 150), other lymphoma (PCMR 127) and lymphopoetic cancer (PCMR 108) . W ang, HH, M acM ah on, B. M ortality of pesticide applicators. Journal of Occupa tions) Modicine 1979; 21(11)741-744. A mortality study using the personnel rec ords of three nationwide pest control com panies based in Atlanta, Memphis, and Tucson with members in 40 states, of 16,126 members (all males) em ployed for three months between 1967-76, and who died in this time period. 311 deaths ascertained, of which 47 were from cancer. Nonsignificant elevated .ratios were found for cancer of the lung (SMR 115), skin (SMR 173), and bladder (SMR 277). Potential pesticide exposures included chlordane, heptachlor, as well as a variety* of fumigants, botanicals, carbamates, organophosphates, and other chlorinated Hydrocarbons. W iklund, K. Trends in cancer risks am ong Sw edish agricultural w orkers. Journal of the N otional C a n ce r Institute 1986; 77(3):657-664. A prospective study of the time related trends from 1961 to 1979 in the incidence of cancer in 254,417 Swedish males aged 20 to 69 employed in agriculture in 1960, compared to 1,725,845 controls. Statistically significant increased risk in agricultural workers was found for cancer of the /ip (SMR 19Z), shin (SMR 115), stomach (SMR 107), malignant melanoma (SMR 139), and multiple myeloma (SMR 120). A trend for increasing risk over three rime periods (1967-73,1974-79,1974-79) was found for cancer of die Up, liver, prostate, nasal and genitourinary cancer. W iklund, K. Tosticular cancer am ong agri cultural w orkers and licensed pesticide a p p licato rs In Sw e d e n . Scandinavian Journal of Work, Environment and Haatth 1986; 12:630-631. A prospective study of the incidence of testi cular cancer in 254,417 Swedish men employed in agriculture as determined by a 1960 census. Compared to controls a nonsignificant trend for increasing risk of testicular cancer over time was found--an SMR of 83 in 1961-66 increased to 94 in 1967-73, and to 135 in 1974-79. Eigh teen cases of testicular cancer were found in a cohort o f20,245 pest control operators licensed between 1965 and 1976, with 11.6 expected (SMR 155), which was not significant. W ong, O, Brocket, W, Davis, HV, et al. M or tality of w orkers potentially exposed to organic and inorganic brom lnated chem i cals, DBCP, T R IS, P B B and DDT. British Journal of industrial M edicine 1984; 41:15-25. A mortality study of 3.579 workers (all mates) employed between 1935 and 1976 in throe chemical manufacturing plants, two in Michigan, one in Arkansas. Of 541 who had died as of December, 1976, 112 were from can cer. Nonsignificant elevated ratios were found for all cancer (SMR 102), cancer of the liver (SMR 124), lung (SMR 131), prostate (SMR 164), testes (SMR 193), bladder (SMR 188), kidney (SMR 145), brain (SMR 132). leukemia (SMR 187), and lymphoetic cancer (SMR 111). The mortality from testicular cancer was sig nificantly higher (SMR 1799, based on two cases) in workers whose common exposure was to methyl brom ide. Potential chemical exposures included DBCP, methyl bromide, ethyl bromide, bromochlorobenzcne, chlorobromomethanc. sodium and potassium bro mide. PCBs, PBBs, Tris. and DDT. CASE-CONTROL STUDIES Austin, H, Delzetl, E, Grufferman, S, et at. Case-control stu dy of hepatocellular car c in o m a , o c c u p a tio n a n d c h e m ic a l exposures. Journal of Occupational Medi cine 1988; 29:665-669. A case-control study of 86 persons aged 18 to 84 at one of five medical centers (Alabama. Duke, Miami, Pennsylvania, and Harvard) with primary liver cancer, 60 men and 26 women; compared to 146 controls with other cancers (except those related to smoking). Nonsignificant elevated risk was found for: pesticide exposure (RR 2.1). employment in agriculture (RR 1.1), employment in livestock agriculture (RR 1.5), and occupation as farmer or farmworker (RR 1.4). No consistent trend between years of farming and risk for liver cancer was found. Blair, A, T hom as, TL. Leukem ia am ong N a b ra sk a farm ers: A death certificate study. Ammrican Journal ofEpidemiology 1979; 110131:264-273. A case-control study in Nebraska of 1,084 white mates who died of leukemia from 1957-74, compared to 2,168 deaths from other cancers. Statistically significant increased risk for leukemia was found in farmers (OR 1.25). with the risk being higher for those born after 1900 (OR 1.64). and even higher for those from high insecticide use counties (OR 1.95). Blair, A, W hite, DW. Leukem ia cell types and agricultural practices In Nebraska. Journal of Occupational Medicine 1985; 40(41:211-214. A further analysis of the above study of Nebraska farmers in which it was found that farmers from high pesticide and fertilizer-use counties tended to be at higher risk of acute lymphatic, acute myeloid, chronic myeloid, and acute unspecifiedleukemia than farmers from low use counties. Blair, A. Everett, G, Cantor, K, et al. Leukem la a n d fa rm p ra c tic e s (a b stra c t). American Journal of Epidem iology 1985; 122:535. A population-based case-control study in Iowa and Minnesota of 578 cases of histo logically confirmed leukemia in white males aged 30 or older who died between 1980-1983, compared with 1,245 who died of other causes. More cases than controls reported use of dichlorvos on animals (OR 1.8). Pesticides used more frequently by cases than controls included Ethoprop (OR 1.9), nicorine (OR 1.6), Methoxvchlor (OR 1,5), and D D T (OR 1.4). Brown, LM , Pattern, LM . Testicular cancer and farm ing (letter). Lancet 1984; 1:1356. A case-control study, using death certificates only, from three Washington. D.C. medical centers, of 271 ///fu/tfrcancer cases, aged 18to 42 and diagnosed between 1976-1981. Com pared to 259 controls with other cancers, a small increase in risk that was statistically sig nificant (OR 1.4) was found for current farmers who grew up in the south. Burm eistsr, LR Van Uer, S B Isacson, R Leu kem ia an d farm p ra c tic e s in Iow a . American Journal of Epidem iology 1982; 115(51:720-728. A case-control study in Iowa of 1,675 white males over age 30 who died of leukemia between 1964-78, compared to 3,350 controls'. Farmers had a statistically significant elevated risk (oxleukemia (OR 1.24), even higher in those who died between 1971-78 (OR 1.39). Signifi cant excess mortality was also seen in high herbicide use counties for chose bom after 1900 (OR 1.60). Bum taister, LB Everett, GD, Van Liar, S R at al. S a la d ad canear m ortality and farm p ra d ic a s In Iow a. Am erican Journal of Epidem iology 1983; 118(11:72-77. A case-control study in Iowa of 8,290 white males who died of cancer from 1964-78, (4,827 AA O H N Journal, March 1989, Vo 1.37, No. 3 133 Moses prostate, 1,812 stomach, 1,101 nonHodgkin's lymphoma, 550 multiple myeloma). Farmers were found to have statistically significant excess mortality from multiple myeloma (OR 1.5), nonHodgkin's lymphoma (OR 1.3), stomach cancer (OR 1.3) and prostate cancer (OR 1.2). Cantor. K, Everett, G, Blair. A. et al. Farm in g a n d n o n H o d g k in 's ly m p h o m a (abstract). American Journal of Epidemi ology 1985; 122(3):535. A case-control study of 622 Iowa and Min nesota white males, aged 30 or more who died of nonH odgkin's lymphom a betw een I980-1983, compared to 1,245 men who died of other causes. A suggestion of excess mortality for farmers from smallcelllymphocytic lymphoma (RR 1.35) was found, especially in those reporting use of high volume pesticides 20 or more years prior. Increased risk was associated with exposure to nicotine (OR 2.0), lindane (OR 1.9), 2,4,5-T (OR 1.9), glyphosate (Roundup),(OR 1.9), atrazine (OR 1.6). and Cyanazine (OR 1.6). Evidence of elevated risk of all types of nonHodgkin's lymphoma was found for uses of D D T (OR 1.5). chloramben (OR 2.2) and Carbofuran (OR 1.6). Cantor, KP, Blair, A. Farm ing and m ortality from m ultiple m yelom a: A ease-control study w ith the use of death certificates. Journal of the National Cancer Institute 1984; 72(2>:251-255. A case-control study of4tl deaths from mul tiple myeloma in Wisconsin white males (except Milwaukee), aged 30 or more who died from 1968-76, compared to 725 controls with smoking-related causes of death excluded. Statistically significant excess mortality was found in the farmers for multiple myeloma (OR 1.4), which was greater in those 65 and older (OR 1.5), and for those who died between 1968-70 (OR 1.9). Significant association with pesticide use was found-for high insecticide use counties for those bom after 1905 (OR 2.8). Everett, G, Blair, A , C antor, K, et al. Environ m e ntal chem ical e xp o su re s as rlak fa c to rs fo r le u ke m ia and n o n H o d g k in 's ly m p h o m a (a b s tra c t). American Journal of Epidem iology 1985; 122(3):535-536. A population-based case-control study in Iowa and Minnesota based on interviews of 1200 white males (or their proxies) diagnosed with leukemia and nonHodgkin's lymphoma between 1980-1983. Statistically significant increased risk of leukemia was associated with exposure to insecticides (OR 1.5) and her bicides (OR 1.66). Significant increased risk for nonHodgkin's lymphoma was associated with exposure to methyl bromide (OR 2,82), insec ticides (OR 1.9), herbicides (OR 2.06), and pentachlorophcnol (OR 1.86). Hoar, SK , Blair, A. Holm es, Ffi at al. A gri cultural herbicide u se and risk of lym phom a and soft-tissue sarcom a. Journal of the Am erican M edical Association 1986; 256(9) :1141-1147. A population-based case-control study of 442 white male Kansas residents aged 21 or older diagnosed with soft-tissue sarcoma, Hodgkin's disease, and nonHodgkin's lym phoma from 1976 through 1982, compared to 948 controls from the general population of the state. Nonsignificant increased risk of non Hodgkin's lymphoma was associated with her bicide use (OR 1.6). Statistically significant increased risk was found for those exposed to herbicides more than 20 days a year (OR 6.0), and frequent users who mixed or applied the herbicides themselves (OR 8.0). The excess mortality was associated with use of phcnoxyherbicidcs, spe cifically 2,4-D (OR 2.2). Neither soft-tissue sarcoma nor Hodgkin's disease were found ro be related to herbicide exposure. Colton, T. Herbicide exposure and cancer. Journal of the American MedicalAssocia tion 1986; 256:1176-1178, Editorial comments on the study described above. M cDow ell, M , Balarajan, R. Testicular can cer and em ploym ent in agriculture (let ter). Lancet 1984; 1:510-511. Preliminary data from a case-control study in progress, using death certificates, of 2.434 males over age 15 who died from testicular cancer in England and Wales from 1971 to 1980. Agricultural workers were found to be at increased risk of testicularcancer (OR 1.42), the risk being significant in farmers and farm man agers (OR 1,85), but not in farmworkers (OR 0.9). M ilh am , S . Jr. Leukem ia and m ultiple m yelom a In farm ers. American Journal of Epidam tolagy 1971; 91(1):307-310. A case-control study based on a previous occupational mortality study, confined to leukemia/tymphoma group of cancers of 4,444 farmers compared to an equal number of con trols using occupation as stated on death cer tificates in sure files in Oregon and Wash ington. Statistically significant increased risk in farmers for multiple myeloma and leukemia was found (based on chi-square analyses of fre quencies). M ilts, PK, Newell, GR, Johnson, DE. Testi cular cancer associated w ith em ploym ent In a gricu ltu re end o il end natural g a s extraction. Lancet 1984; 1:207-209. A case-control study of 347 patients with histologically confirmed germ-cell testicular cancer diagnosed at M.D, Anderson Hospital in Houston, Texas, between I977-1980. Statis tically significant increased risk for testicular cancer was found to be associated with agri cultural employment (OR 4.18), and was even higher for those whose present occupation was in fanning (OR 6,27). M ills, PK, Newell, GR. Testicular cancer risk in agricultural occupations (letter). Journal of Occupational Medicine 1984; 26(11):798-799. A brief discussion of testicular cancer as found in other studies and the author's findings as described above. M orris, PD, Koepsell, TD, Dating, JR, et al. Toxic substance exposure and m ultiple m yelom a: A case-control study. Joum el of the National Cancor Institute 1986; 76(61:987-994. A case-control study from SEER (Sur veillance Epidemiology and End Results) can cer registry data in selected counties in the states of Washington and Utah, and in metro politan Detroit and Atlanta, of 698 cases of multiple myeloma newly diagnosed between 1977-1981, compared to 1.683 controls from the general population of the four study areas. Of the 20exposure categories studied, the highest risk was for subjects who reported past exposure to pesticides (OR 2.6), which was statistically significant. In those cases where exposure was scif-rcporrcd the risk was even higher (OR 2.9). M usicco, M , Filippini, G, Bordo, B M , at al. G liom as and occupational oxposure to c a rc in o g e n s: C a sa -c o n tro l stu d y. Am erican Joum el of Epidem iology 1982; 116(5):782-790. A case-control study in Milan, Italy, of 42 cases of primary brain cancer, compared to 42 patients with other neurological disease ar the same institute. Farmers were found to be at increased risk for glioma (OR 5.0). Nandakum ar, A, Arm strong, 8K, doKlork. NH. M ultiple m yelom a In W estern A u s tralia: A case-control study In relation to occupation, fathor'a occupation, so c io econom ic status, and country o f birth. International Journal o f Cancer 1986; 37:223-226. A case-control study in Western Australia of 249 deaths from multiple myeloma between 1975-1984, compared to 996 control who died from other causes. Statistically nonsignificant increased risk for multiple myeloma was found in farmers (OR 1.36). No relationship was found with farming as the father^ occupation (OR 0.88). Psares, NE, Sm ith, AH , How ard, JK, s t al. 134 A A O H N Journal, March 1989, Voi. 37, No. 3 i Cancer N o n H o d gk in 's lym phom a and exposure to phenoxyherbicides, chlorophenols, fencing work, and meat w o rks em ploy* merit: A case-control study. British Journa/ of Industrial Medicine 1986; 43:75-83. A case-control study in New Zealand of 83 cases of adult males with nonHodgkin's lym phoma. diagnosed between 1977-1981, com pared to 168 controls with ocher cancers and 228 general population controls. Nonsignificant increased risk for nonHodgkins lymphoma was found for fanners exposed to chlorophenols (OR 1.4), for fencing work (OR 2.0k and meat works employment (OR 1.8), with greatest risk for employment in both activities (OR 5.7). Pearce, NE, Sm ith, AH, Fisher, DO. M a lig nant lym phom a and m ultiple m yelom a United w ith agricultural occupations in a N ew Zealand cancer registry-based study: American Journal of Epidem iology 1985; 121(2):225-237. A case-control study in New Zealand of 734 white males aged 20 or older who died from lymphoma and multiple myeloma between 1977-1981, compared to 2,986 deaths from other cancers. A nonsignificant increased risk of lymphoma and multiple myeloma was associatcd'with agricultural occupation (OR 1.25). Statistically significant increased risk for lym phoma and multipit myeloma was found for orchard farming (OR 5.51); for nonHodg/tins lympAoma in farmers diagnosed before age 65 (OR 1.76) and for multipit myeloma as well (OR 2. 22). Schum acher, M C. Farm ing occupations and m ortality from n o n H o d g kin 's lym p hom a In U tah: A case-co n tro l study. Journal of Occupational Medicine 1985; 27(81:580-584. A case-control study in Utah of 228 white males who died from nonHodgkin's lymphoma between 1967-1982. compared with 295 deaths from colon cancer. Statistically significant increased risk of nonHodgkin's lymphoma was found for fanners diagnosed between 1952-65 (OR 6.6) and between 1966-71 (OR 3.1). Ele vated risk ratios were also found for rural versus urban residence for 1952-1966 (OR 3.3), 1966-71 (OR 3.4), 1972-77 (OR 2.4), but none were significant. Stem hagen, A, Slade, J, Altm an, R, ft al. Occupational risk factors and liver cancer. Am erican Journal of Epidem iology 1983; t17(4):443-454. A case-control study in New Jersey of 265 cases of primary liver cancer, diagnosed between 1975 and 1979. compared to 265 cases selected from hospital records and 265 cases selected from state death certificate records. Statistically significant increased risk of livtr cancer was found associated with agriculture (RR 2.08), agricultural production or services (RR 2.08), and for occupation of farm laborer (RR 1.89).Nonsignificant elevated ratios were found for horticulture (RR 1.83), and in farm owner/managers (RR 1.23). VTnels, P, Torracini, B, Cfccone, G, at al. Phenoxy herbicides and soft-tissue sar com as In fem ale rice w eedera: A popula tio n -b a se d c a se -re fe re n t study. Scandinavian Journal of Work, Environ ment and Health 1986; 13:9-17. A case-control study in three rice-growing provinces of northern Italy of 68 cases (31 females) of soft-tissut sarcoma diagnosed between, 1961-1983, compared to 158 popula tion-based controls (73 females). Fifteen (40.5%) of the male cases had worked in agri culture compared ro 26 (30.5%) of the controls. Fourteen (45%) of the.fem ale cases had worked in agriculture compared to 21 (28.5%) of the controls. O f the living women, exposure to phenoxy herbicides increased risk (OR 2.7), but not in living men (OR 0.91). W oods, JS, Polissar, L, Savorson, RK, at al. S o ft-tissu e sarco m a and n o n H o d g kin 's lym phom a in relation to phenoxyherbidde and chlorinated phenol exposure in w estern W a sh in gto n . Jou rnal of the N a tio n a l C a n ce r In stitu te 1987; 78(5):899-919. A case-control study in 13 counties of west ern Washington state of 128 cases of soft-tissue sarcoma, and 576 cases of nonHodgkin's lym phoma, in males aged 20 and older who were diagnosed between 1981-1984, compared to 694 controls without cancer. Statistically sig nificant increased risk for nonHodgkin's hm pkoma was found for farmers (OR 1.33), for estry herbicide applicators (OR 4.80), and for those with 15 or more years of occupational exposure to phenoxvherbicides 15 years prior to their diagnosis of cancer (OR 1.71). Pesticide exposures associated with increased risk of nonHodgkin's lymphoma were D D T (OR 1.82), and lead arsenate (OR 1.60); the elevated ratio associated with exposure to chtordane (OR 1.61) was not statistically significant. No increased risk for soft-tissue sarcoma was found. CHILDHOOD CANCER Gold, E. Gordfs, L, Tonascta, J, at al. Risk fa c to rs fo r b ra in tu m o rs In child ren. Am erican Journal of Epidem iology 1979; 109(31:309*319. A case-control study of 84 children with pri mary brain cancer in Baltimore, Maryland, diagnosed between 1965-1975, compared to 76 children without cancer, and 112 children with other types of cancer, Compared to the normal controls children with brain cancer were more likely to have been exposed to insecticides in the home (OR 2.3). There was no difference when compared to cancer controls. Hem m inki, K, Saloniem i, I, Salonen, T, et al. Childhood cancer and parental occupa tion in Finland. Journet of Epidemiology end Community Health 1981; 35:11-15. A case-control study using birth records, of the occupations of parents of all children less than age 15 diagnosed with cancer in Finland from 1959-1975. S tatistically significant increased risk of cancer in children was associ ated with the mother being a farm wife (OR 2.2, 1969-75), or food worker, mainly bakers (OR 4.0, 1959-68); and for fathers* occupation in agriculture, gardening, and forestry (OR 1.42). Infante, PE Epstein, S S , New ton, W A, Jr. Blood dyscrasias and childhood tum ors and exposure to chtordane and hep* techlor. Scandinavian Journal of Work, Environment and Health 1978; 4:137*150. Reports of five cases of neuroblastoma diag nosed in Ohio at the same pediatric hospital in 1975. All of the children had had prenatal and/ or extensive environmental exposure to chiordane. Also reported was a case of aplastic ane mia in a 15-year-old boy with exposure to chlordane and lsotox and a 9-year-old girl with leukemia with chlordane exposure only. Infante. PE New ton, W A. Prenatal chlordano exposure and neuroblastom a (lettor).' New England Journal of Medicine 1975; 240:308. The first report of the neuroblastoma cases described above. Kern C o u n ty H ealth D epartm ent: Epi dem iologic stu dy of cancer In children in M cFarland, California, 1985*1986: Phase t. Sta tistica l C onsiderations, Current Environm ent. B a k e rsfie ld , C a lifo rn ia 93305, Novem ber 1986. The first report of the findings of an inves tigation of an increased number of childhood cancer cases in the agricultural community of McFarland, California, with a population of approximately 6,400. From 1975 to 1985 when three cases of cancer in children less than 15 would have been expected, ten were observed. For the period of 1982 to 1985 when one case would have been expected, eight were observed. The number and types of tumors observed and year of occurrence are: two leukemias (1978, 1978). two Wilms* tumor (1982, 1984), one astrocytoma (1982), one nonHodgkin's lymphoma (1983), one osteogenic sarcoma (1984), one fibrosarcoma (1985), and one rhab- A A O H N Journal, March 1989, Voi. 37, No. 3 135 Moses V f \ domyosarcorru (1985). An excess of fetal and infant deaths (miscarriages and stillbirths) also occurred in the time period from 1981 to 1983. No current environmental cause was found. Low ongart. RA, Pater, JM , Cicioni, C, at al. C h ild h o o d le u ke m ia a n d p a re n ts' occu p ation al and hom e e xp osu re s. Journal of the National Cancer Institute 1987; 79(11:39-46. - Acase-control srudy of 123 children aged ten or less with leukemia diagnosed between 1980-1984, compared to 123 controls. Statis tically significant increased risk ofacutelympho cytic leukemia was found for children' when either parent used household pesticides once a week or more (OR 3.8) or garden pesticides or herbicides once a month or more (OR 6.5): if the mother used household (OR 3.2) or garden (OR 9.0) pesticides; and if the father used household (OR 4.0) pesticides. Use of garden pesticides by the father (OR 5.0) increased the risk, but was not significant. Pratt, CB, Rivera, <3,Shanks, E, at al. Color ectal carcinom a in adolescents. Im plica tio n s re gard in g etiology. Cancer 1977; 40:2464-2472. A case report of nine children with colorectal cancer (very rare in children), diagnosed at the same hospital between 1974-1975. Eight of the children were from rural areas of Mississippi, Arkansas, or Tennessee and had had exposure to insecticides. Reeves, JD. H ousehold insecticide-associ ated blood dyscrasics in children (letter). Am erican Journal of Pediatric Hem ctology/Oncoiogy 1982; 4:438-439. A report of 15children aged 2 to 17years who were reported to the blood dyscrasia clinic at Travis Air Force Base Medical Center in Cal ifornia. The most common exposure was inha lation of household aerosol sprays containing DDVP-Bavgon. The most prolonged exposure was in a child with / uveni/e chronic myelogenous leukemia whose mattress had been sprayed twice weekly for most of his life. Eleven chil dren had aplastic anemia, and three acute lym phoblastic leukemia. Alvanjs, M CR, Blair, A, Merkel, S, at al. M o rta lity am on g agricultural extension gents. Am erican Journal of Induatrial Medicine 1988; 14:167-176. A proportionate-mortality and case-control study of 1,495 white male agricultural exten- . ston agents in the Cooperative Extension Ser vice of che U.S. Department of Agriculture who died betw een January 1, 1970 and December 31, 1979, compared to the USDA mortality file exclusive of the agricultural extension workers. Statistically significant excess mortality in the'proportionate-mortality study was found for colon cancer (PMR 1.46), prostate cancer (PMR 1.50), kidney cancer (PMR 2.00), brain cancer (PMR 2.08), lymphatic and hematopoietic cancer (PMR 2.16). Hodgkin's disease (PMR 2.72), nonHodgkin's lymphoma (PMR 2.32), multiple myeloma (PMR 1.97), and leukemia (PMR 1.80). In the case-control study, statistically signifi cant increased risk was found only far leukemia (OR 1.92), which also showed a significant increase in risk with increased number of years as an extension agent, A nonsignificant increased risk was found for nonHodgkins lym phoma (OR 1.21) and multiple myeloma (OR 1.05),. both of which also showed a nonsignifi cant increase in risk with increased number of years as an extension agent. CASE REPORTS El Zayadl, A, Kahlis, A, El Sam m y, N, at al. Hepatic angio sarcom a am ong Egyptian farm ers exp osed to pesticides. Hapatogastroenterology 1986; 33:148-150. Case report of 14 patients diagnosed with angiosarcoma o fthe liver at the same hospiul in Egypt from 1980 to 1984. Ten of the 14 had a history of II to 20 years (mean = 14) of chronic recurrent exposure to agricultural pesticides as sprayers of a variety of organophosphates, organochlorines. and arsenates. Marfcovrtz, A, Crosby, W H. Chem ical car c in o g e n e s is : A s o li fu m ig a n t, 1,3d lchloroprope ne a s p o ssib le causa of hem atologic m alignancies. Archives of Internai M edicina 1984; 144:1409-1411. A case report of two firemen involved in the clean-up of a tank-truck spill of 1,3dichtoropropene, both of whom developed F IG U R E : Abbreviations PMR PCMR SMR SIR RR OR Proportionate Mortality Ratio Proportionate Cancer Mortality Ratio Standard Mortality Ratio Standard Incidence Ratio Risk Ratio Odds Ratio malignant lymphoma six years later. A case of acute myclomonocytic leukemia in a farmer sprayer is also discussed. Prabhakar, JM . P o ssib le relationship of Insecticide exposure to em bryonal cell cancer (letter). Journal of the American Medical Association 1978; 240:288. A report from Illinois of two cases oftesticular cancer in 1976 in 30-year-old men diagnosed within one year of each other. Both had worked at the same canning plant where they had occupational exposure to pesticides. Weininger. RB, Davis, G, H aw ks, CD. Her bicides and cancer (letter). Journal of the Am erican M edical A sso ciatio n 1967; 257:2292. A report of92 cases ofnonHodgkin'slymphoma diagnosed from 1975-1985 in upstate New York. The incidence of 15.3/100,000 (not ageadjusted), compared to SEER data (Sur veillance Epidemiology and End Results) of 10.1/100,000 for the U.S. This elevated ratio of 1.51 was stated to support the Hoar srudy (vide supra), but no data reported regarding whether or not herbicide exposure was a risk factor in the cases. 136 A A O H N Journal, M arch 1989, Voi. 37, No. 3