TY - JOUR
T1 - 2,4-dichlorophenoxyacetic acid (2,4-D) and risk of non-Hodgkin lymphoma
T2 - a meta-analysis accounting for exposure levels
AU - Smith, Adam M.
AU - Smith, Martyn T.
AU - La Merrill, Michele
AU - Liaw, Jane
AU - Steinmaus, Craig
PY - 2017/4/1
Y1 - 2017/4/1
N2 - 2,4-Dichlorophenoxyacetic acid (2,4-D) is one of the most commonly used selective herbicides in the world. A number of epidemiology studies have found an association between 2,4-D exposure and non-Hodgkin lymphoma (NHL) but these results are inconsistent and controversial. A previous meta-analysis found no clear association overall but did not specifically examine high-exposure groups. We conducted a systematic review and meta-analysis of the peer-reviewed epidemiologic studies of the associations between 2,4-D and NHL, with a particular focus on high-exposure groups, and evaluations of heterogeneity, dose-response, and bias. A total of 12 observational studies, 11 case-control studies, and one cohort study, were included. The summary relative risk for NHL using study results comparing subjects who were ever versus never exposed to 2,4-D was 1.38 (95% confidence interval (CI), 1.07–1.77). However, in analyses focusing on results from highly exposed groups, the summary relative risk for NHL was 1.73 (95% CI, 1.10–2.72). No clear bias based on study design, exposure assessment methodology, or outcome misclassification was seen. Overall, these findings provide new evidence for an association between NHL and exposure to the herbicide 2,4-D.
AB - 2,4-Dichlorophenoxyacetic acid (2,4-D) is one of the most commonly used selective herbicides in the world. A number of epidemiology studies have found an association between 2,4-D exposure and non-Hodgkin lymphoma (NHL) but these results are inconsistent and controversial. A previous meta-analysis found no clear association overall but did not specifically examine high-exposure groups. We conducted a systematic review and meta-analysis of the peer-reviewed epidemiologic studies of the associations between 2,4-D and NHL, with a particular focus on high-exposure groups, and evaluations of heterogeneity, dose-response, and bias. A total of 12 observational studies, 11 case-control studies, and one cohort study, were included. The summary relative risk for NHL using study results comparing subjects who were ever versus never exposed to 2,4-D was 1.38 (95% confidence interval (CI), 1.07–1.77). However, in analyses focusing on results from highly exposed groups, the summary relative risk for NHL was 1.73 (95% CI, 1.10–2.72). No clear bias based on study design, exposure assessment methodology, or outcome misclassification was seen. Overall, these findings provide new evidence for an association between NHL and exposure to the herbicide 2,4-D.
KW - 2,4-D
KW - Lymphoma
KW - Meta-analysis
KW - Non-Hodgkin's
KW - Occupational
UR - http://www.scopus.com/inward/record.url?scp=85018995849&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=85018995849&partnerID=8YFLogxK
U2 - 10.1016/j.annepidem.2017.03.003
DO - 10.1016/j.annepidem.2017.03.003
M3 - Review article
C2 - 28476329
AN - SCOPUS:85018995849
VL - 27
SP - 281-289.e4
JO - Annals of Epidemiology
JF - Annals of Epidemiology
SN - 1047-2797
IS - 4
ER -