Cancer Risk Among Residents of Rhineland-Palatinate Winegrowing Communities - Recent Advances and Issues in Environmental Science - page 103

in regions of intensive fruit and wine cultivation. However, the authors do not indi-
cate the significance level of their findings. Another ecological study among French
agricultural workers reveals a significant association between pesticide exposure in
vineyards and brain cancer mortality [31]. The results of our ecological study do not
support an increased brain cancer risk of residents in winegrowing regions (RR in the
primary analysis for large vs. a small area under cultivation = 1.06 (95% CI 0.72-1.57)
among men; RR = 1.21 (95% CI 0.79-1.86) among women).
Rectum Cancer
Some previous studies point to a potentially elevated rectum cancer risk [32, 33], other
studies find reduced colorectal cancer risks among farmers [34] or farm residents [35].
Altogether, there is very little evidence to date for a possible relationship between
pesticide exposure and rectum cancer. Our finding of an increased cancer incidence
of the rectosigmoid junction (but not of rectum cancer in all) among males living in
winegrowing communities might be alternatively explained by life-style (e.g., dietary)
or medical (participation at screening) factors, by inhomogeneous reporting behavior,
or by chance.
Non-Hodgkin Lymphoma
The increased NHL incidence among male, but not among female inhabitants of com-
munities with a medium or large area under wine cultivation suggests a potential occu-
pational rather than residential aetiology. However, in communities with a medium or
a large area under cultivation, only two male NHL patients (=2% of male NHL patients
with known occupation, missing values 55%) and one female NHL patient (=1.3%
of female NHL patients with known occupation, missing values 44%) had worked as
wine-growers, making an occupational aetiology improbable.
Our fi nding of an increased NHL incidence among potentially pesticide-exposed
residents of winegrowing communities is in accordance with the literature. However,
most previous studies are related to agricultural workers in general, not to winegrow-
ing workers. In a large Italian multicenter case-control study [36], orchard, vineyard,
and related tree and shrub workers appeared to be at increased risk for hematolympho-
poietic malignancies. The carcinogenic effects of pesticides may be associated with
their genotoxicity and immunotoxicity [37-39], increased cell proliferation [40], and
association with chromosomal aberrations [41]. Because of the lack of a positive asso-
ciation between potential residential pesticide exposure and NHL in females (actually
with a signifi cantly decreased RR for follicular NHL in winegrowing communities
with a large area under cultivation), our study does not defi nitely support the hypoth-
esis of an elevated NHL risk among the residential population in Rhineland-Palatinate
winegrowing communities.
Bladder Cancer
To date, there is inconclusive evidence for a relationship between pesticide exposure
and bladder cancer. In a retrospective cohort study among 32,600 employees of a
lawn care company, Zahm [42] finds a significantly increased bladder cancer mortal-
ity. However, bladder cancer numbers are very small; furthermore, two of the three
observed deaths had no direct occupational contact with pesticides. Rusiecki et al. [16]