2,4-dichlorophenoxyacetic acid (2,4-D) and risk of non-Hodgkin lymphoma: a meta-analysis accounting for exposure levels

Adam M. Smith, Martyn T. Smith, Michele La Merrill, Jane Liaw, Craig Steinmaus

Research output: Contribution to journalReview article

10 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)281-289.e4
JournalAnnals of Epidemiology
Volume27
Issue number4
DOIs
StatePublished - Apr 1 2017

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2,4-Dichlorophenoxyacetic Acid
Non-Hodgkin's Lymphoma
Meta-Analysis
Herbicides
Confidence Intervals
Observational Studies
Case-Control Studies
Epidemiologic Studies
Epidemiology
Cohort Studies

Keywords

  • 2,4-D
  • Lymphoma
  • Meta-analysis
  • Non-Hodgkin's
  • Occupational

ASJC Scopus subject areas

  • Epidemiology

Cite this

2,4-dichlorophenoxyacetic acid (2,4-D) and risk of non-Hodgkin lymphoma : a meta-analysis accounting for exposure levels. / Smith, Adam M.; Smith, Martyn T.; La Merrill, Michele; Liaw, Jane; Steinmaus, Craig.

In: Annals of Epidemiology, Vol. 27, No. 4, 01.04.2017, p. 281-289.e4.

Research output: Contribution to journalReview article

Smith, Adam M. ; Smith, Martyn T. ; La Merrill, Michele ; Liaw, Jane ; Steinmaus, Craig. / 2,4-dichlorophenoxyacetic acid (2,4-D) and risk of non-Hodgkin lymphoma : a meta-analysis accounting for exposure levels. In: Annals of Epidemiology. 2017 ; Vol. 27, No. 4. pp. 281-289.e4.
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abstract = "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.",
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