Environment and Breast Cancer: Science Review

Evidence From Humans
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Reported residential pesticide use and breast cancer risk on Long Island, New York
Teitelbaum, S. L., Gammon, M. D., Britton, J. A., Neugut, A. I., Levin, B., Stellman, S. D. Am J Epidemiol. 2007. 165:6, 643-51.
Topic area
Environmental pollutant - Household Pesticides
Study design
Population based case-control
Funding agency
Study Participants
Menopausal Status
The menopausal status of women included in this study is listed here.
Stratified analysis based on menopausal status
Number of Controls
Controls: 1,553
Participant selection: Inclusion and exclusion criteria
Criteria used to select participants in the study.
Female residents of Nassau and Suffolk Counties (Long Island), NY, participating in the Long Island Breast Cancer Study Project, age 20 or older, English-speaking, newly diagnosed with in situ or invasive breast cancer in 1996-1997. Cases identified by regional hospital pathology laboratories. Controls had no breast cancer history and were matched by 5-year age group, identified by random-digit-dialing or Medicare records (for women 65 and older). Three cases and three controls who did not provide pesticide use information were excluded.
Exposure Investigated
Exposures investigated
At-home pesticide use patterns were obtained by questionnaire and categorized into ever/never use as well as into subcategories based on pest type, applicant, and application type.
How exposure was measured
Questionnaire, in person
Exposure assessment comment
The questionnaire data allowed for aggregation of exposures over many years prior to diagnosis, but did not allow analysis of any specific exposure windows, including possible critical periods of breast development. Details about specific products or chemicals used in pesticide application were not collected because women could not recall them in pilot testing.
Breast cancer outcome investigated
Primary incident breast cancer
Confounders considered
Other breast cancer risk factors, such as family history, age at first birth, and hormone replacement therapy use, that were taken into account in the study.
Race, marital status, education, age, religion, income, age at menarche, parity, age at first birth, lactation, menopausal status, oral contraceptive use, HRT, family history of breast cancer, history of benign breast disease, BMI at reference age, BMI at
Genetic characterization included
If the study analyzed relationships between environmental factors and inherited genetic variations, this field will be marked “Yes.” “No”, if not.
Strength of associations reported
Number of lifetime applications of all lawn/pesticides combined, compared to those who never used lawn/garden pesticides:
2nd quintile vs. 1st quintile: aOR 1.30 (95% CI 1.03-1.64)
3rd quintile vs. 1st quintile: aOR 1.39 (95% CI 1.10-1.76)
4th quintile vs. 1st quintile: aOR 1.49 (95% CI 1.19-1.88)
5th quintile vs. 1st quintile: aOR 1.37 (95% CI 1.08-1.72)

Lawn and garden pesticides:
4th quartile vs. 1st quartile: aOR 1.38 (95% CI 1.09-1.75)

Nuisance-pest combined groups:
4th quartile vs. 1st quartile: aOR 1.16 (95% CI 0.85-1.58)

Ever use (Ref = never used any lawn and garden pesticides):
Weeds aOR 1.43 (95% CI 1.17-1.75)
Lawn insects aOR 1.48 (95% CI 1.20-1.82)
Insects or diseases of trees aOR 1.46 (95% CI 1.17-1.81)
Pests in vegetable or fruit gardens aOR 1.58 (95% CI 1.24-2.01)
Insects or diseases of outdoor plants aOR 1.54 (95% CI 1.20-1.98)
Insects or diseases of indoor plants aOR 1.48 (95% CI 1.08-2.02)

Ever use (Ref = never used any nuisance-pest pesticides):
Bees or wasps: aOR 1.05 (95% CI 0.77-1.43)
Flies or mosquitoes: aOR 1.12 (95% CI 0.81-1.55)
Results Comments
Authors state that analyses by menopausal status, length of residence, age group, and nuisance-pest type did not yield estimates that differed from the overall sample analyses, but the data were not shown. No significant results were seen for use of other types nuisance pest pesticides considered.
Author address
Department of Community Medicine, Mount Sinai School of Medicine, One Gustave Levy Place, New York, NY 10029, USA. susan.teitelbaum@mssm.edu
Reviewers Comments
The authors note that this was the first study to suggest an association between breast cancer risk and self-reported pesticide use.