PDF(Pubmed)
Abstract：
BACKGROUND: We evaluated the relationship between diagnosed depression and pesticide exposure using information from private pesticide applicators enrolled in the Agricultural Health Study between 1993 and 1997 in Iowa and North Carolina.
METHODS: There were 534 cases who self-reported a physician-diagnosed depression and 17,051 controls who reported never having been diagnosed with depression and did not feel depressed more than once a week in the past year. Lifetime pesticide exposure was categorized in three mutually exclusive groups: low (< 226 days, the reference group), intermediate (226-752 days), and high (> 752 days). Two additional measures represented acute high-intensity pesticide exposures: an unusually high pesticide exposure event (HPEE) and physician-diagnosed pesticide poisoning. Logistic regression analyses were performed relating pesticide exposure to depression.
RESULTS: After adjusting for state, age, education, marital status, doctor visits, alcohol use, smoking, solvent exposure, not currently having crops or animals, and ever working a job off the farm, pesticide poisoning was more strongly associated with depression [odds ratio (OR) = 2.57; 95% confidence interval (CI), 1.74-3.79] than intermediate (OR = 1.07; 95% CI, 0.87-1.31) or high (OR = 1.11; 95% CI, 0.87-1.42) cumulative exposure or an HPEE (OR = 1.65; 95% CI, 1.33-2.05). In analysis of a subgroup without a history of acute poisoning, high cumulative exposure was significantly associated with depression (OR = 1.54; 95% CI, 1.16-2.04).
CONCLUSIONS: These findings suggest that both acute high-intensity and cumulative pesticide exposure may contribute to depression in pesticide applicators. Our study is unique in reporting that depression is also associated with chronic pesticide exposure in the absence of a physician-diagnosed poisoning.
METHODS: There were 534 cases who self-reported a physician-diagnosed depression and 17,051 controls who reported never having been diagnosed with depression and did not feel depressed more than once a week in the past year. Lifetime pesticide exposure was categorized in three mutually exclusive groups: low (< 226 days, the reference group), intermediate (226-752 days), and high (> 752 days). Two additional measures represented acute high-intensity pesticide exposures: an unusually high pesticide exposure event (HPEE) and physician-diagnosed pesticide poisoning. Logistic regression analyses were performed relating pesticide exposure to depression.
RESULTS: After adjusting for state, age, education, marital status, doctor visits, alcohol use, smoking, solvent exposure, not currently having crops or animals, and ever working a job off the farm, pesticide poisoning was more strongly associated with depression [odds ratio (OR) = 2.57; 95% confidence interval (CI), 1.74-3.79] than intermediate (OR = 1.07; 95% CI, 0.87-1.31) or high (OR = 1.11; 95% CI, 0.87-1.42) cumulative exposure or an HPEE (OR = 1.65; 95% CI, 1.33-2.05). In analysis of a subgroup without a history of acute poisoning, high cumulative exposure was significantly associated with depression (OR = 1.54; 95% CI, 1.16-2.04).
CONCLUSIONS: These findings suggest that both acute high-intensity and cumulative pesticide exposure may contribute to depression in pesticide applicators. Our study is unique in reporting that depression is also associated with chronic pesticide exposure in the absence of a physician-diagnosed poisoning.
摘要：
背景：我们使用1993年至1997年在爱荷华州和北卡罗来纳州参加农业健康研究的私人农药施用者的信息，评估了诊断出的抑郁症与农药暴露之间的关系。
方法：有534例自我报告医生诊断的抑郁症和17,051例对照组报告从未被诊断出患有抑郁症，并且在过去一年中每周没有感到抑郁超过一次。终生农药暴露分为三个相互排斥的组：低(<226天，参考组)，中级（226-752天），高（>752天）。另外两项措施代表急性高强度农药暴露：异常高的农药暴露事件（HPEE）和医生诊断的农药中毒。进行了将农药暴露与抑郁症相关的Logistic回归分析。
结果：调整状态后，年龄,教育,婚姻状况,看医生,酒精使用,吸烟,溶剂暴露,目前没有农作物或动物，曾经在农场外工作，农药中毒与抑郁症的相关性更强[优势比（OR）=2.57；95％置信区间（CI），1.74-3.79]高于中间（OR=1.07；95%CI，0.87-1.31）或高（OR=1.11；95%CI，0.87-1.42）累积暴露或HPEE（OR=1.65；95%CI，1.33-2.05）。在对没有急性中毒史的亚组的分析中，高累积暴露与抑郁显著相关(OR=1.54;95%CI,1.16-2.04).
结论：这些研究结果表明，急性高强度和累积农药暴露都可能导致农药施用者的抑郁。我们的研究独特之处在于，在没有医生诊断中毒的情况下，抑郁症也与慢性农药暴露有关。
方法：有534例自我报告医生诊断的抑郁症和17,051例对照组报告从未被诊断出患有抑郁症，并且在过去一年中每周没有感到抑郁超过一次。终生农药暴露分为三个相互排斥的组：低(<226天，参考组)，中级（226-752天），高（>752天）。另外两项措施代表急性高强度农药暴露：异常高的农药暴露事件（HPEE）和医生诊断的农药中毒。进行了将农药暴露与抑郁症相关的Logistic回归分析。
结果：调整状态后，年龄,教育,婚姻状况,看医生,酒精使用,吸烟,溶剂暴露,目前没有农作物或动物，曾经在农场外工作，农药中毒与抑郁症的相关性更强[优势比（OR）=2.57；95％置信区间（CI），1.74-3.79]高于中间（OR=1.07；95%CI，0.87-1.31）或高（OR=1.11；95%CI，0.87-1.42）累积暴露或HPEE（OR=1.65；95%CI，1.33-2.05）。在对没有急性中毒史的亚组的分析中，高累积暴露与抑郁显著相关(OR=1.54;95%CI,1.16-2.04).
结论：这些研究结果表明，急性高强度和累积农药暴露都可能导致农药施用者的抑郁。我们的研究独特之处在于，在没有医生诊断中毒的情况下，抑郁症也与慢性农药暴露有关。
