In Utero Pesticide Exposure and Leukemia in Brazilian Children < 2 Years of Age
Jeniffer Dantas Ferreira,1 Arnaldo Cézar Couto,1 Maria S. Pombo-de-Oliveira,2 Sergio Koifman,1 and the Brazilian Collaborative Study Group of Infant Acute Leukemia
1Environment and Public Health Post-graduation Program, National School of Public Health, Oswaldo Cruz Foundation (FIOCRUZ), Rio de Janeiro, Brazil; 2Pediatric Hematology–Oncology Program, Research Center, Instituto Nacional de Câncer/Rio de Janeiro, Rio de Janeiro, Brazil
Background: An association between pesticide exposure and cancer has been suggested. Infant leukemia is a rare neoplasm and its association with maternal pesticide exposure has been poorly explored.
Objectives: We investigated the association between pesticide exposure during pregnancy and leukemia in children < 2 years of age.
Methods: A hospital-based case–control study was carried out in 13 Brazilian states during 1999–2007. Mothers of 252 cases and those of 423 controls were interviewed. Information on pesticide exposures 3 months before pregnancy, throughout pregnancy, and during breastfeeding was obtained. Unconditional logistic regression was used to estimate adjusted odds ratios (aORs) for associations between pesticide exposures and leukemia.
Results: Associations with ever use of pesticides during pregnancy were observed for acute lymphoid leukemia (ALL) (aOR = 2.10; 95% CI: 1.14, 3.86) and acute myeloid leukemia (AML) (aOR = 5.01; 95% CI: 1.97, 12.7) in children 0–11 months of age, and with ALL (aOR = 1.88; 95% CI: 1.05, 5.23) at 12–23 months of age. According to reported maternal exposure to permethrin, higher risk estimates were verified for children 0–11 months of age (aOR = 2.47; 95% CI: 1.17, 5.25 for ALL; and aOR = 7.28; 95% CI: 2.60, 20.38 for AML). Maternal pesticide exposure related to agricultural activities showed an aOR of 5.25 (95% CI: 1.83, 15.08) for ALL, and an aOR of 7.56 (95% CI: 1.83, 31.23) for AML.
Conclusions: These results support the hypothesis that pesticide exposure during pregnancy may be involved in the etiology of acute leukemia in children < 2 years of age.
Key words: childhood cancer, infant leukemia, lactation, pesticides, pregnancy.
Environ Health Perspect 121:269–275 (2013). http://dx.doi.org/10.1289/ehp.1103942 [Online 22 October 2012]
Address correspondence to S. Koifman, Environment and Public Health Post-graduation Program, National School of Public Health, Oswaldo Cruz Foundation (FIOCRUZ), Rua Leopoldo Bulhões 1480, Rio de Janeiro, RJ, 21041-210, Brazil. Telephone: 55 21 2598-2634. E-mail: email@example.com
Supplemental Material is available online (http://dx.doi.org/10.1289/ehp.1103942).
This investigation was supported by the Brazilian National Research Council (CNPq), Instituto Nacional de Câncer-Fundação Ary Frauzino, and the Swiss Bridge Foundation. J.D.F. and A.C.C. have been supported by Oswaldo Cruz Foundation, Ministry of Health of Brazil fellowships. M.S.P.O. and S.K. have been supported by CNPq research grants 309091/2007-1 and 577598/2008-2, respectively. The project was funded by INCT-Controle do Cancer; CNPq 573806/2008-0, and the State of Rio de Janeiro Research Foundation (FAPERJ) grant E026/2008.
The authors declare they have no actual or potential competing financial interests.
Received 15 May 2012; Accepted 22 October 2012; Online 22 October 2012.
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