Impact of occupational pesticide exposure assessment method on rist estimates for prostate cancer, non-Hodgkin's lymphoma and Parkinson's disease - results of three meta-analyses

Research output: Contribution to journalArticlepeer-review

  • External authors:
  • Johan Ohlander
  • Samuel Fuhrimann
  • John W Cherrie
  • Karen S Galea
  • Anne-Helen Harding
  • Kate Jones
  • Roel Vermeulen
  • Anke Huss
  • Hans Kromhout


Objective: Assessment of occupational pesticide exposure in epidemiological studies of chronic diseases is challenging. Biomonitoring of current pesticide levels might not correlate with past exposure relevant to disease etiology, and indirect methods often rely on workers’ imperfect recall of exposures, or job titles. We investigated how applied exposure assessment method (EAM) influenced risk estimates for some chronic diseases.

Methods: In three meta-analyses the influence of EAM type on the summary risk ratio (sRR) of prostate cancer (25 articles), Non-Hodgkin’s lymphoma (NHL) (30 articles), and Parkinson’s disease (PD) (32 articles) was investigated. EAM types analysed were: group-level assessments (e.g. job titles), self-reported exposures, expert-level assessments (e.g. job-exposure matrices),
and biomonitoring (e.g. blood, urine). Additionally, sRRs were estimated by study design, publication year period, and geographic location where the study was conducted.

Results: EAM types were not associated with statistically significant different sRRs across any of the health outcomes. Heterogeneity in results varied from high in cancer studies to moderate and low in PD studies. Overall, case-control designs showed significantly higher sRR estimates than prospective cohort designs. Later NHL publications showed significantly higher sRR estimates than earlier. For prostate cancer, studies from North America showed significantly higher sRR estimates than studies from Europe.

Conclusion: Exposure assessment method applied in studies of occupational pesticides appears not to have a significant effect on risk estimates for prostate cancer, NHL, and PD. In systematic reviews of chronic health effects of occupational exposure to pesticides, epidemiological study design, publication year, and geographic location, should primarily be considered.

Bibliographical metadata

Original languageEnglish
JournalOccupational and Environmental Medicine
Publication statusAccepted/In press - 6 Mar 2022