Environment international · 2026
Pesticides associated with incident diabetes among licensed private pesticide applicators in the Agricultural Health Study cohort (1993-2021).
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Parks Christine G, Xiao Qian, Wilkerson Jesse, Hofmann Jonathan N, Beane Freeman Laura E, Sandler Dale P
Аннотация
BACKGROUND: Growing evidence suggests pesticides may increase risk of type 2 diabetes, but data are limited on many specific chemicals.
METHODS: In 29,527 private pesticide applicators in the Agricultural Health Study cohort (enrolled 1993-1997 in Iowa and North Carolina), 3,847 incident diabetes cases were identified by self-report during follow-up surveys in 1999-2003, 2005-2010, 2013-2015, and 2019-2021. We examined 50 pesticides reported at enrollment, updated in 1999-2003 or 2005-2010, prior to diabetes diagnosis or end of follow-up, using log-binomial regression to calculate relative risks (RR) and 95% confidence intervals (CI) for ever-use and intensity-weighted lifetime days (IWLD) use (tertiles, T1-3), adjusting for covariates and correlated pesticides.
FINDINGS: Greater diabetes risk was associated with 7 organochlorine insecticides: ever-use of DDT, aldrin, dieldrin, chlordane, heptachlor, and toxaphene (RRs 1.08-1.31), without monotonic exposure-response trends, and lower IWLD of lindane use (T1RR=1.32; 95%CI 1.12-1.57). Risk was associated with 5 organophosphate or carbamate insecticides: ever-use of diazinon and carbofuran, and exposure-response trends for malathion (T3RR=1.13;95%CI 1.02-1.25, p-trend=0.025), phorate (T3RR=1.22;95%CI 1.08-1.39, p-trend=0.001), and carbaryl (T3RR=1.26;95%CI 1.11-1.43, p-trend=0.005). Risk was associated with 2 phenoxy herbicides, 2,4,5-T (ever-use RR=1.25;95%CI 1.14-1.37) and 2,4,5-TP (T1RR=1.35;95%CI 1.04-1.76), and 3 other herbicides [butylate (T3RR=1.26;95%CI 1.10-1.44, p-trend<0.001), metribuzin (T3RR=1.16;95%CI 1.16-1.32, p-trend=0.022), chlorimuron ethyl (T3RR=1.16;95%CI 1.02-1.31, p-trend=0.033)], and the fumigant carbon tetrachloride/disulfide (RR=1.16;95%CI 1.02-1.33). Associations were not confounded by BMI and weight gain.
CONCLUSIONS: These results show greater diabetes risk associated with use of persistent organochlorine insecticides and banned phenoxy herbicides. Novel findings for widely used insecticides and other pesticides warrant further investigation.
METHODS: In 29,527 private pesticide applicators in the Agricultural Health Study cohort (enrolled 1993-1997 in Iowa and North Carolina), 3,847 incident diabetes cases were identified by self-report during follow-up surveys in 1999-2003, 2005-2010, 2013-2015, and 2019-2021. We examined 50 pesticides reported at enrollment, updated in 1999-2003 or 2005-2010, prior to diabetes diagnosis or end of follow-up, using log-binomial regression to calculate relative risks (RR) and 95% confidence intervals (CI) for ever-use and intensity-weighted lifetime days (IWLD) use (tertiles, T1-3), adjusting for covariates and correlated pesticides.
FINDINGS: Greater diabetes risk was associated with 7 organochlorine insecticides: ever-use of DDT, aldrin, dieldrin, chlordane, heptachlor, and toxaphene (RRs 1.08-1.31), without monotonic exposure-response trends, and lower IWLD of lindane use (T1RR=1.32; 95%CI 1.12-1.57). Risk was associated with 5 organophosphate or carbamate insecticides: ever-use of diazinon and carbofuran, and exposure-response trends for malathion (T3RR=1.13;95%CI 1.02-1.25, p-trend=0.025), phorate (T3RR=1.22;95%CI 1.08-1.39, p-trend=0.001), and carbaryl (T3RR=1.26;95%CI 1.11-1.43, p-trend=0.005). Risk was associated with 2 phenoxy herbicides, 2,4,5-T (ever-use RR=1.25;95%CI 1.14-1.37) and 2,4,5-TP (T1RR=1.35;95%CI 1.04-1.76), and 3 other herbicides [butylate (T3RR=1.26;95%CI 1.10-1.44, p-trend<0.001), metribuzin (T3RR=1.16;95%CI 1.16-1.32, p-trend=0.022), chlorimuron ethyl (T3RR=1.16;95%CI 1.02-1.31, p-trend=0.033)], and the fumigant carbon tetrachloride/disulfide (RR=1.16;95%CI 1.02-1.33). Associations were not confounded by BMI and weight gain.
CONCLUSIONS: These results show greater diabetes risk associated with use of persistent organochlorine insecticides and banned phenoxy herbicides. Novel findings for widely used insecticides and other pesticides warrant further investigation.