Pesticide use and incident hypothyroidism in pesticide applicators in the agricultural health study

Srishti Shrestha, Christine G. Parks, Whitney S Goldner, Freya Kamel, David M. Umbach, Mary H. Ward, Catherine C. Lerro, Stella Koutros, Jonathan N. Hofmann, Laura E. Beane Freeman, Dale P. Sandler

Research output: Contribution to journalArticle

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Abstract

B ACKGROUND : Though evidence suggests that some pesticides may have thyroid-disrupting properties, prospective studies of associations between specific pesticides and incident thyroid disease are limited. O BJECTIVE : We evaluated associations between use of specific pesticides and incident hypothyroidism in private pesticide applicators in the Agricultural Health Study (AHS). M ETHODS : Self-reported incident hypothyroidism (n = 829 cases) was studied in relation to ever-use and intensity-weighted cumulative days of pesticide use at study enrollment. We estimated adjusted hazard ratios (HRs) and 95% confidence intervals (CI) using Cox proportional hazards models applied to 35,150 male and female applicators followed over 20 y. All models were stratified by state and education to meet proportional hazards assumptions (p ≤ 0:10 for age x covariate interactions). Models of pesticides that did not meet proportional hazards assumptions were stratified by median attained age (62 y). RESULTS: Hypothyroidism risk was significantly increased with ever-vs. never-use of four organochlorine insecticides (aldrin, heptachlor, and lindane among participants with attained age >62 y; chlordane in all participants), four organophosphate insecticides (coumaphos in those >62 y; diazinon, dichlorvos, and malathion in all participants) and three herbicides (dicamba, glyphosate, and 2,4-D in all participants). HRs ranged from 1.21; 95% CI: 1.04, 1.41 (chlordane) to 1.54; 95% CI: 1.23, 19.4 (lindane in those >62 y). Hypothyroidism risk was greatest among those with higher intensity-weighted lifetime days of using chlordane, lindane, coumaphos (over age 62), diazinon, permethrin, and 2,4-D. CONCLUSIONS: Our findings support associations between exposure to several pesticides and increased hypothyroidism risk. These findings are generally consistent with prior analyses of prevalent hypothyroidism in the AHS. https://doi.org/10.1289/EHP3194

Original languageEnglish (US)
JournalEnvironmental Health Perspectives
Volume126
Issue number9
DOIs
StatePublished - Sep 1 2018

Fingerprint

Hypothyroidism
Pesticides
Chlordan
Health
Lindane
Coumaphos
Diazinon
2,4-Dichlorophenoxyacetic Acid
glyphosate
Confidence Intervals
Insecticides
Dicamba
Heptachlor
Aldrin
Dichlorvos
Permethrin
Malathion
Organophosphates
Thyroid Diseases
Herbicides

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Health, Toxicology and Mutagenesis

Cite this

Pesticide use and incident hypothyroidism in pesticide applicators in the agricultural health study. / Shrestha, Srishti; Parks, Christine G.; Goldner, Whitney S; Kamel, Freya; Umbach, David M.; Ward, Mary H.; Lerro, Catherine C.; Koutros, Stella; Hofmann, Jonathan N.; Beane Freeman, Laura E.; Sandler, Dale P.

In: Environmental Health Perspectives, Vol. 126, No. 9, 01.09.2018.

Research output: Contribution to journalArticle

Shrestha, S, Parks, CG, Goldner, WS, Kamel, F, Umbach, DM, Ward, MH, Lerro, CC, Koutros, S, Hofmann, JN, Beane Freeman, LE & Sandler, DP 2018, 'Pesticide use and incident hypothyroidism in pesticide applicators in the agricultural health study', Environmental Health Perspectives, vol. 126, no. 9. https://doi.org/10.1289/EHP3194
Shrestha, Srishti ; Parks, Christine G. ; Goldner, Whitney S ; Kamel, Freya ; Umbach, David M. ; Ward, Mary H. ; Lerro, Catherine C. ; Koutros, Stella ; Hofmann, Jonathan N. ; Beane Freeman, Laura E. ; Sandler, Dale P. / Pesticide use and incident hypothyroidism in pesticide applicators in the agricultural health study. In: Environmental Health Perspectives. 2018 ; Vol. 126, No. 9.
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N2 - B ACKGROUND : Though evidence suggests that some pesticides may have thyroid-disrupting properties, prospective studies of associations between specific pesticides and incident thyroid disease are limited. O BJECTIVE : We evaluated associations between use of specific pesticides and incident hypothyroidism in private pesticide applicators in the Agricultural Health Study (AHS). M ETHODS : Self-reported incident hypothyroidism (n = 829 cases) was studied in relation to ever-use and intensity-weighted cumulative days of pesticide use at study enrollment. We estimated adjusted hazard ratios (HRs) and 95% confidence intervals (CI) using Cox proportional hazards models applied to 35,150 male and female applicators followed over 20 y. All models were stratified by state and education to meet proportional hazards assumptions (p ≤ 0:10 for age x covariate interactions). Models of pesticides that did not meet proportional hazards assumptions were stratified by median attained age (62 y). RESULTS: Hypothyroidism risk was significantly increased with ever-vs. never-use of four organochlorine insecticides (aldrin, heptachlor, and lindane among participants with attained age >62 y; chlordane in all participants), four organophosphate insecticides (coumaphos in those >62 y; diazinon, dichlorvos, and malathion in all participants) and three herbicides (dicamba, glyphosate, and 2,4-D in all participants). HRs ranged from 1.21; 95% CI: 1.04, 1.41 (chlordane) to 1.54; 95% CI: 1.23, 19.4 (lindane in those >62 y). Hypothyroidism risk was greatest among those with higher intensity-weighted lifetime days of using chlordane, lindane, coumaphos (over age 62), diazinon, permethrin, and 2,4-D. CONCLUSIONS: Our findings support associations between exposure to several pesticides and increased hypothyroidism risk. These findings are generally consistent with prior analyses of prevalent hypothyroidism in the AHS. https://doi.org/10.1289/EHP3194

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