Evidence map›Paper›PMID 37862860›Full record

ArticleEnvironment international2023

High pesticide exposures events, pesticide poisoning, and shingles: A medicare-linked study of pesticide applicators in the agricultural health study.

Christine G Parks, Darya Leyzarovich, Shelly-Ann Love, Stuart Long, Jonathan N Hofmann, Laura E Beane Freeman, Dale P Sandler

Open access · goldAbstract read
In one paragraph

Article in Environment international, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed, 1 pooled it
4.3field-weighted citation impact, top 6% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 1 synthesis or guideline pooled it, 15 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 4 institutions in 1 country.

Christine G ParksEpidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA. Electronic address: parks1@niehs.nih.gov.
Darya LeyzarovichSocial&Scientific Systems, DHL, Silver Spring, MD, USA.
Shelly-Ann LoveSocial&Scientific Systems, DHL, Silver Spring, MD, USA.
Stuart LongWestat, Rockville, MD, USA.
Jonathan N HofmannOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Laura E Beane FreemanOccupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Dale P SandlerEpidemiology Branch, National Institute of Environmental Health Sciences, National Institutes of Health, Research Triangle Park, North Carolina, USA.
National Cancer Institute · USNational Institutes of Health · USSocial and Scientific Systems (United States) · USWestat (United States) · US

Funding

Studies of Occupational Cancer (Pesticides)ZIACP010119 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI BEANE FREEMAN, LAURA · 2009 to 2025
$46.1M
Health Effects Of Exposures In AgricultureZIAES049030 · NIEHS · NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES · PI SANDLER, DALE P · 2009 to 2025
$11.2M
STUDIES OF OCCUPATIONAL CANCER--PESTICIDESZ01CP010119 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI ALAVANJA, MICHAEL · 1996 to 2008
$5.0M
HEALTH EFFECTS OF EXPOSURES IN AGRICULTUREZ01ES049030 · NIEHS · NATIONAL INSTITUTE OF ENVIRONMENTAL HEALTH SCIENCES · PI SANDLER, DALE P · 1997 to 2008
$889k
Intramural NIH HHS Z01 CP010119Intramural NIH HHS Z01 ES049030Intramural NIH HHS Z99 ES999999
6 · The paper itself

Abstract

objectivesSelf-reported shingles was associated with history of high pesticide exposure events (HPEE) in licensed pesticide applicators aged >60 years in the Agricultural Health Study (AHS). In the current study, using AHS-linked Medicare claims data, we examined incident shingles in relation to pesticide-related illness and pesticide poisoning, as well as HPEE.

methodsWe studied 22,753 licensed private pesticide applicators (97% white males, enrolled in the AHS 1993-97), aged ≥66 years with >12 consecutive months of Medicare fee-for-service hospital and outpatient coverage between 1999 and 2016. Incident shingles was identified based on having ≥1 shingles claim(s) after 12 months without claims. At AHS enrollment, participants were asked if they ever sought medical care or were hospitalized for pesticide-related illness, and a supplemental questionnaire (completed by 51%) asked about HPEE and poisoning. Hazard ratios (HR) and 95% confidence intervals (CI) were estimated using Cox proportional hazards regression, adjusted for age, sex, race, state, and education.

resultsOver 192,053 person-years (PY), 2396 applicators were diagnosed with shingles (10.5%; age-standardized rate, 13.6 cases per 1,000PY), with higher rates among those reporting hospitalization for pesticide-related illness, pesticide poisoning, and HPEE (23.2, 22.5, and 16.6 per 1,000PY, respectively). In adjusted models, shingles was associated with hospitalization for pesticide-related illness (HR 1.69; 1.18, 2.39), poisoning (1.49; 1.08, 1.46), and HPEE (1.23; 95% CI = 1.03, 1.46), especially HPEE plus medical care/poisoning (1.78; 1.30, 2.43).

conclusionThese novel findings suggest that acute, high-level, and clinically impactful pesticide exposures may increase risk of shingles in subsequent years to decades following exposure.

Indexed as

Herpes ZosterOccupational ExposurePesticidesAgedAgricultureHumansIowaMaleMedicareNorth CarolinaUnited StatesPesticidesAcute pesticide exposureCohort studyEpidemiologyHerpes ZosterHumansInfections

Identifiers

PMID37862860
PMCPMC10836588
OpenAlexW4387426189

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.