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Kori B. Flower,¹ Jane A. Hoppin,² Charles F. Lynch,³ Aaron Blair,⁴ Charles Knott,⁵ David L. Shore,⁶ and Dale P. Sandler²

¹Robert Wood Johnson Clinical Scholars Program and Division of Community Pediatrics, Department of Pediatrics, and Department of Maternal and Child Health, School of Public Health, University of North Carolina, Chapel Hill, North Carolina, USA; ²Epidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA; ³Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA; ⁴Occupational and Environmental Epidemiology Branch, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Bethesda, Maryland, USA; ⁵Battelle, Durham, North Carolina, USA; ⁶Westat, Durham, North Carolina, USA

Abstract
Parental exposure to pesticides may contribute to childhood cancer risk. Through the Agricultural Health Study, a prospective study of pesticide applicators in Iowa and North Carolina, we examined childhood cancer risk and associations with parental pesticide application. Identifying information for 17,357 children of Iowa pesticide applicators was provided by parents via questionnaires (1993-1997) and matched against the Iowa Cancer Registry. Fifty incident childhood cancers were identified (1975-1998) . Risk of all childhood cancers combined was increased [standardized incidence ratio (SIR) = 1.36 ; 95% confidence interval (CI) , 1.03-1.79]. Risk of all lymphomas combined was also increased (SIR = 2.18 ; 95% CI, 1.13-4.19) , as was risk of Hodgkin's lymphoma (SIR = 2.56 ; 95% CI, 1.06-6.14) . We used logistic regression to explore associations between self-reported parental pesticide application practices and childhood cancer risk. No association was detected between frequency of parental pesticide application and childhood cancer risk. An increased risk of cancer was detected among children whose fathers did not use chemically resistant gloves [odds ratio (OR) = 1.98 ; 95% CI, 1.05-3.76] compared with children whose fathers used gloves. Of 16 specific pesticides used by fathers prenatally, ORs were increased for aldrin (OR = 2.66) , dichlorvos (OR = 2.06) , and ethyl dipropylthiocarbamate (OR = 1.91) . However, these results were based on small numbers and not supported by prior biologic evidence. Identification of excess lymphoma risk suggests that farm exposures including pesticides may play a role in the etiology of childhood lymphoma. Key words: agricultural workers, cancer, children, occupational exposure, pesticides. Environ Health Perspect 112:631-635 (2004) . doi:10.1289/ehp.6586 available via http://dx.doi.org/ [Online 22 December 2003]

Address correspondence to K.B. Flower, CB #7105, The University of North Carolina-Chapel Hill, Chapel Hill, NC 27599-7105. Telephone: (919) 966-1274. Fax: (919) 843-9237. E-mail: kori_flower@med.unc.edu

We thank S. Long for data management, L. Margolis for manuscript review, and the Iowa and North Carolina Field Stations and Cancer Registries.

The study was funded by the intramural programs of the National Institute of Environmental Health Sciences (NIEHS) , the National Cancer Institute, and the U.S. Environmental Protection Agency, and grant P30 ES05605 from the NIEHS.

The authors declare they have no competing financial interests.

Received 11 July 2003 ; accepted 22 December 2003.