Maternal residential pesticide use and risk of childhoodleukemia in Costa Ric
Gunier, Robert B.
Bates, Michael N.
Ana M., Mora
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Evidence suggests that early-life exposure to pesticides inside the home may be associated with childhood leukemia, howeverdata from Latin American countries are limited. We examined whether self-reported maternal residential pesticide use andnearby pesticide applications–before and after child’s birth–were associated with acute lymphoblastic leukemia (ALL) in theCosta Rican Childhood Leukemia Study (CRCLS), a population-based case-control study (2001-2003). Cases (n5251 ALL)were diagnosed between 1995 and 2000 (age<15 years at diagnosis) and were identified through the Costa Rican CancerRegistry and National Children’s Hospital. Population controls (n5577) were drawn from the National Birth Registry. We fit-ted unconditional logistic regression models adjusted for child sex, birth year, and socioeconomic status to estimate theexposure-outcome associations and also stratified by child sex. We observed that self-reported maternal insecticide use insidethe home in the year before pregnancy, during pregnancy, and while breastfeeding was associated with increased odds of ALLamong boys [adjusted Odds Ratio (aOR)51.63 (95% confidence interval [95% CI]: 1.05–2.53), 1.75 (1.13–2.73), and 1.75(1.12–2.73), respectively. We also found evidence of exposure-response relationships between more frequent maternal insecti-cide use inside the home and increased odds of ALL among boys and girls combined. Maternal report of pesticide applicationson farms or companies near the home during pregnancy and at any time period were also associated with ALL. Our study inCosta Rica highlights the need for education to minimize pesticide exposures inside and around the home, particularly duringpregnancy and breastfeeding.