Jane Hoppin

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Anna M. Czarnecka

Medical University of Warsaw

Don Beith

University of Maine

Johann A R Roduit

University of Zurich, Switzerland

Peixin Dong

Hokkaido University

Prof. Dr. Rasime Kalkan

European University of Lefke

Dr. Anika Niambi Al-Shura, BSc, MSOM, PhD

Independent Academic Research Studies

Mike Seed

University of Toronto

Peter Krell

University of Guelph

Ãsa Svenningsen

University of Southern Denmark

Markku Tammi

University of Eastern Finland

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Papers by Jane Hoppin

Pesticide Use and Relative Leukocyte Telomere Length in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

PLOS ONE, 2015

Some studies suggest that telomere length (TL) may be influenced by environmental exposures, incl... more Some studies suggest that telomere length (TL) may be influenced by environmental exposures, including pesticides. We examined associations between occupational pesticide use reported at three time points and relative telomere length (RTL) in the Agricultural Health Study (AHS), a prospective cohort study of pesticide applicators in Iowa and North Carolina. RTL was measured by qPCR using leukocyte DNA from 568 cancer-free male AHS participants aged 31-94 years with blood samples collected between 2006 and 2008. Self-reported information, including pesticide use, was collected at three time points: enrollment (1993-1997) and two follow-up questionnaires (1998-2003, 2005-2008). For each pesticide, we evaluated cumulative use (using data from all three questionnaires), and more recent use (using data from the last follow-up questionnaire). Multivariable linear regression was used to examine the associations between pesticide use (ever, lifetime days, intensity-weighted lifetime days (lifetime days*intensity score)) and RTL, adjusting for age at blood draw and use of other pesticides. Of the 57 pesticides evaluated with cumulative use, increasing lifetime days of 2,4-D (p-trend=0.001), diazinon (p-trend=0.002), and butylate (p-trend=0.01) were significantly associated with shorter RTL, while increasing lifetime days of alachlor was significantly associated with longer RTL (p-trend=0.03). Only the association with 2,4-D was significant after adjustment for multiple comparisons. Of the 40 pesticides evaluated for recent use, malathion was associated with shorter RTL (p=0.03), and alachlor with longer RTL (p=0.03). Our findings suggest that leukocyte TL may be impacted by cumulative use and recent use of certain pesticides.

Pesticide use and risk of end-stage renal disease among licensed pesticide applicators in the Agricultural Health Study

Occupational and Environmental Medicine, 2015

Experimental studies suggest a relationship between pesticide exposure and renal impairment, but ... more Experimental studies suggest a relationship between pesticide exposure and renal impairment, but epidemiological evidence is limited. We evaluated the association between exposure to 39 specific pesticides and end-stage renal disease (ESRD) incidence in the Agricultural Health Study, a prospective cohort study of licensed pesticide applicators in Iowa and North Carolina. Via linkage to the US Renal Data System, we identified 320 ESRD cases diagnosed between enrolment (1993-1997) and December 2011 among 55 580 male licensed pesticide applicators. Participants provided information on use of pesticides via self-administered questionnaires. Lifetime pesticide use was defined as the product of duration and frequency of use and then modified by an intensity factor to account for differences in pesticide application practices. Cox proportional hazards models, adjusted for age and state, were used to estimate associations between ESRD and: (1) ordinal categories of intensity-weighted lifetime use of 39 pesticides, (2) poisoning and high-level pesticide exposures and (3) pesticide exposure resulting in a medical visit or hospitalisation. Positive exposure-response trends were observed for the herbicides alachlor, atrazine, metolachlor, paraquat, and pendimethalin, and the insecticide permethrin. More than one medical visit due to pesticide use (HR=2.13; 95% CI 1.17 to 3.89) and hospitalisation due to pesticide use (HR=3.05; 95% CI 1.67 to 5.58) were significantly associated with ESRD. Our findings support an association between ESRD and chronic exposure to specific pesticides, and suggest pesticide exposures resulting in medical visits may increase the risk of ESRD. Clinicaltrials.gov NCT00352924.

Organophosphate insecticide use and cancer incidence among spouses of pesticide applicators in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, Jan 6, 2015

Organophosphates (OPs) are among the most commonly used insecticides. OPs have been linked to can... more Organophosphates (OPs) are among the most commonly used insecticides. OPs have been linked to cancer risk in some epidemiological studies, which have been largely conducted in predominantly male populations. We evaluated personal use of specific OPs and cancer incidence among female spouses of pesticide applicators in the prospective Agricultural Health Study cohort. At enrolment (1993-1997), spouses provided information about ever use of specific pesticides, including 10 OPs, demographic information, reproductive health history and other potential confounders. We used Poisson regression to estimate relative risks (RRs) and 95% CIs for all cancers diagnosed through 2010 for North Carolina and through 2011 for Iowa. Among 30 003 women, 25.9% reported OP use, and 718 OP-exposed women were diagnosed with cancer during the follow-up period. Any OP use was associated with an elevated risk of breast cancer (RR=1.20, 95% CI 1.01 to 1.43). Malathion, the most commonly reported OP, was assoc...

Cancer incidence and metolachlor use in the Agricultural Health Study: An update

by Michael Alavanja and Jane Hoppin

International Journal of Cancer, 2015

Metolachlor, a widely used herbicide, is classified as a Group C carcinogen by the U.S. Environme... more Metolachlor, a widely used herbicide, is classified as a Group C carcinogen by the U.S. Environmental Protection Agency based on increased liver neoplasms in female rats. Epidemiologic studies of the health effects of metolachlor have been limited. The Agricultural Health Study (AHS) is a prospective cohort study including licensed private and commercial pesticide applicators in Iowa and North Carolina enrolled 1993-7. We evaluated cancer incidence through 2010/2011 (NC/IA) for 49,616 applicators, 53% of whom reported ever using metolachlor. We used Poisson regression to evaluate relations between two metrics of metolachlor use (lifetime days, intensity-weighted lifetime days) and cancer incidence. We saw no association between metolachlor use and incidence of all cancers combined (n=5701 with a 5-year lag) or most site-specific cancers. For liver cancer, in analyses restricted to exposed workers, elevations observed at higher categories of use were not statistically significant. However, trends for both lifetime and intensity-weighted lifetime days of metolachor use were positive and statistically significant with an unexposed reference group. A similar pattern was observed for follicular-cell lymphoma, but no other lymphoma subtypes. An earlier suggestion of increased lung cancer risk at high levels of metolachlor use in this cohort was not confirmed in this update. This suggestion of an association between metolachlor and liver cancer among pesticide applicators is a novel finding and echoes observation of increased liver neoplasms in some animal studies. However, our findings for both liver cancer and follicular-cell lymphoma warrant follow-up to better differentiate effects of metolachlor use from other factors. This article is protected by copyright. All rights reserved.

Incidence of solid tumours among pesticide applicators exposed to the organophosphate insecticide diazinon in the Agricultural Health Study: an updated analysis

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, Jan 23, 2015

Diazinon, a common organophosphate insecticide with genotoxic properties, was previously associat... more Diazinon, a common organophosphate insecticide with genotoxic properties, was previously associated with lung cancer in the Agricultural Health Study (AHS) cohort, but few other epidemiological studies have examined diazinon-associated cancer risk. We used updated diazinon exposure and cancer incidence information to evaluate solid tumour risk in the AHS. Male pesticide applicators in Iowa and North Carolina reported lifetime diazinon use at enrolment (1993-1997) and follow-up (1998-2005); cancer incidence was assessed through 2010(North Carolina)/2011(Iowa). Among applicators with usage information sufficient to evaluate exposure-response patterns, we used Poisson regression to estimate adjusted rate ratios (RRs) and 95% CI for cancer sites with ≥10 exposed cases for both lifetime (LT) exposure days and intensity-weighted (IW) lifetime exposure days (accounting for factors impacting exposure). We observed elevated lung cancer risks (N=283) among applicators with the greatest number...

Single-nucleotide polymorphism data support the general unrelatedness of the males in the agricultural health study

by Michael Alavanja and Jane Hoppin

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2014

Farming is often a family and multigenerational business. Relatedness among farmers could bias ge... more Farming is often a family and multigenerational business. Relatedness among farmers could bias gene-environment interaction analysis. To evaluate the potential relatedness of farmers, we used data from a nested case-control study of prostate cancer conducted in the Agricultural Health Study (AHS), a prospective study of farmers in Iowa and North Carolina. We analyzed the genetic data for 25,009 SNPs (single-nucleotide polymorphisms) from 2,220 White participants to test for cryptic relatedness among these farmers. We used two software packages: (i) PLINK, to calculate inbreeding coefficients and identity-by-descent (IBD) statistics and (ii) EIGENSOFT, to perform a principal component analysis on the genetic data. Inbreeding coefficients estimates and IBD statistics show that the subjects are overwhelmingly unrelated, with little potential for cryptic relatedness in these data. Our analysis rejects the hypothesis that individuals in the case-control study exhibit cryptic relatedness....

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Cancer incidence among male pesticide applicators in the Agricultural Health Study cohort exposed to diazinon

American journal of epidemiology, 2005

Little is known about the potential carcinogenicity associated with routine application of diazin... more Little is known about the potential carcinogenicity associated with routine application of diazinon, a common organophosphate insecticide. The authors explored a possible association of diazinon exposure with cancer risk in the Agricultural Health Study, a prospective cohort of licensed pesticide applicators in Iowa and North Carolina enrolled in 1993-1997. A total of 23,106 male applicators provided information in a self-administered questionnaire. Among 4,961 applicators who reported using diazinon, 301 incident cancer cases were diagnosed during the follow-up period ending December 2002 compared with 968 cases among 18,145 participants who reported no use. Poisson regression was used to calculate rate ratios and 95% confidence intervals. Two quantitative exposure metrics were used: lifetime exposure days and intensity-weighted lifetime exposure days, a measure that incorporates probability of pesticide exposure with lifetime pesticide application frequency. When lifetime exposure...

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0105 Farm exposures, allergy symptoms and risk of non-Hodgkin lymphoma in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, 2014

Exposure to allergens and microorganisms in the agricultural environment has been linked to alter... more Exposure to allergens and microorganisms in the agricultural environment has been linked to altered immune response. Studies in the general population have reported reduced risks of non-Hodgkin lymphoma (NHL) among those with a history of atopic conditions, although results are inconsistent. To evaluate the allergy-NHL association in the context of farm exposures, we conducted an investigation in the Agricultural Health Study, a prospective cohort of farmers and spouses from North Carolina and Iowa. Our study included 49 656 farmers and spouses with crop and animal exposures and allergy symptoms reported at baseline (1993-1997). We identified 418 incident cases of NHL (including chronic lymphocytic leukaemia and multiple myeloma) during follow-up through 2010 in North Carolina and 2011 in Iowa. Hazard ratios (HR) and 95% confidence intervals (CI) were calculated using multivariable-adjusted proportional hazards models. At enrollment, over 80% of the study participants lived on farms...

Farm characteristics, allergy symptoms, and risk of non-hodgkin lymphoid neoplasms in the agricultural health study

by Michael Alavanja and Jane Hoppin

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2015

Because of unique exposures, studies among farmers may yield insights into the relationship betwe... more Because of unique exposures, studies among farmers may yield insights into the relationship between allergies and non-Hodgkin lymphoid (NHL) neoplasms. We evaluated farm characteristics, allergic symptoms and conditions, and risk of NHL including specific subtypes in the Agricultural Health Study, a prospective cohort of farmers and spouses from North Carolina and Iowa. We identified 710 incident cases of NHL (including chronic lymphocytic leukemia and multiple myeloma) among 82,370 participants with baseline data on crop and animal exposures, including 454 cases among 52,850 participants with baseline data on recent allergy symptoms (rhinitis) and living on a farm during childhood. HR and 95% confidence intervals (CI) were calculated using multivariable-adjusted proportional hazards models. We observed reduced risks of NHL among farmers and spouses with rhinitis at baseline (HR, 0.63; 95% CI, 0.51-0.79), related to growing soybeans (HR, 0.80; 95% CI, 0.67-0.96), and among farmers w...

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0286 Occupational use of insecticides, fungicides and fumigants and risk of non-Hodgkin lymphoma and multiple myeloma in the Agricultural Health Study0286 Occupational use of insecticides, fungicides and fumigants and risk of non-Hodgkin lymphoma and multiple myeloma in the Agricultural Health ...

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, 2014

Farming and exposure to pesticides have been linked to non-Hodgkin lymphoma (NHL), and multiple m... more Farming and exposure to pesticides have been linked to non-Hodgkin lymphoma (NHL), and multiple myeloma (MM) in previous studies. We evaluated use of insecticides, fungicides and fumigants and risk of NHL, including MM and other NHL sub-types in the Agricultural Health Study, a US-based prospective cohort study. A total of 527 cases occurred among 55 875 pesticide applicators from enrollment (1993-1997) through 2011 in Iowa and 2010 in North Carolina. Information on pesticide use, other agricultural exposures and other factors was obtained from questionnaires at enrollment and follow-up approximately five years later (1999-2005). Information from these questionnaires was used to create lifetime-days and intensity-weighted lifetime-days of pesticide use. Poisson regression and polytomous logit models were used to calculate relative risks (RR) and 95% confidence intervals (CI) to evaluate associations between 26 pesticides and NHL and five NHL-subtypes including multiple myeloma, whil...

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Impact of pesticide exposure misclassification on estimates of relative risks in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, 2011

The Agricultural Health Study (AHS) is a prospective study of licensed pesticide applicators and ... more The Agricultural Health Study (AHS) is a prospective study of licensed pesticide applicators and their spouses in Iowa and North Carolina. We evaluate the impact of occupational pesticide exposure misclassification on relative risks using data from the cohort and the AHS Pesticide Exposure Study (AHS/PES). We assessed the impact of exposure misclassification on relative risks using the range of correlation coefficients observed between measured post-application urinary levels of 2,4-dichlorophenoxyacetic acid (2,4-D) and a chlorpyrifos metabolite and exposure estimates based on an algorithm from 83 AHS pesticide applications. Correlations between urinary levels of 2,4-D and a chlorpyrifos metabolite and algorithm estimated intensity scores were about 0.4 for 2,4-D (n=64), 0.8 for liquid chlorpyrifos (n=4) and 0.6 for granular chlorpyrifos (n=12). Correlations of urinary levels with kilograms of active ingredient used, duration of application, or number of acres treated were lower an...

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Investing in prospective cohorts for etiologic study of occupational exposures

by Michael Alavanja and Jane Hoppin

American journal of industrial medicine, 2015

Prospective cohorts have played a major role in understanding the contribution of diet, physical ... more Prospective cohorts have played a major role in understanding the contribution of diet, physical activity, medical conditions, and genes to the development of many diseases, but have not been widely used for occupational exposures. Studies in agriculture are an exception. We draw upon our experience using this design to study agricultural workers to identify conditions that might foster use of prospective cohorts to study other occupational settings. Prospective cohort studies are perceived by many as the strongest epidemiologic design. It allows updating of information on exposure and other factors, collection of biologic samples before disease diagnosis for biomarker studies, assessment of effect modification by genes, lifestyle, and other occupational exposures, and evaluation of a wide range of health outcomes. Increased use of prospective cohorts would be beneficial in identifying hazardous exposures in the workplace. Occupational epidemiologists should seek opportunities to in...

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Association between Class III Obesity (BMI of 40–59 kg/m2) and Mortality: A Pooled Analysis of 20 Prospective Studies

PLoS Medicine, 2014

Background: The prevalence of class III obesity (body mass index [BMI]$40 kg/m 2 ) has increased ... more Background: The prevalence of class III obesity (body mass index [BMI]$40 kg/m 2 ) has increased dramatically in several countries and currently affects 6% of adults in the US, with uncertain impact on the risks of illness and death. Using data from a large pooled study, we evaluated the risk of death, overall and due to a wide range of causes, and years of life expectancy lost associated with class III obesity.

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Non-Hodgkin Lymphoma Risk and Insecticide, Fungicide and Fumigant Use in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

PLoS ONE, 2014

Farming and pesticide use have previously been linked to non-Hodgkin lymphoma (NHL), chronic lymp... more Farming and pesticide use have previously been linked to non-Hodgkin lymphoma (NHL), chronic lymphocytic leukemia (CLL) and multiple myeloma (MM). We evaluated agricultural use of specific insecticides, fungicides, and fumigants and risk of NHL and NHL-subtypes (including CLL and MM) in a U.S.-based prospective cohort of farmers and commercial pesticide applicators. A total of 523 cases occurred among 54,306 pesticide applicators from enrollment (1993-97) through December 31, 2011 in Iowa, and December 31, 2010 in North Carolina. Information on pesticide use, other agricultural exposures and other factors was obtained from questionnaires at enrollment and at follow-up approximately five years later (1999)(2000)(2001)(2002)(2003)(2004)(2005). Information from questionnaires, monitoring, and the literature were used to create lifetime-days and intensity-weighted lifetime days of pesticide use, taking into account exposure-modifying factors. Poisson and polytomous models were used to calculate relative risks (RR) and 95% confidence intervals (CI) to evaluate associations between 26 pesticides and NHL and five NHL-subtypes, while adjusting for potential confounding factors. For total NHL, statistically significant positive exposure-response trends were seen with lindane and DDT. Terbufos was associated with total NHL in ever/never comparisons only. In subtype analyses, terbufos and DDT were associated with small cell lymphoma/chronic lymphocytic leukemia/marginal cell lymphoma, lindane and diazinon with follicular lymphoma, and permethrin with MM. However, tests of homogeneity did not show significant differences in exposure-response among NHL-subtypes for any pesticide. Because 26 pesticides were evaluated for their association with NHL and its subtypes, some chance finding could have occurred. Our results showed pesticides from different chemical and functional classes were associated with an excess risk of NHL and NHL subtypes, but not all members of any single class of pesticides were associated with an elevated risk of NHL or NHL subtypes. These findings are among the first to suggest links between DDT, lindane, permethrin, diazinon and terbufos with NHL subtypes.

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Protective glove use and hygiene habits modify the associations of specific pesticides with Parkinson's disease

Environment international, 2015

Pesticides have been associated with Parkinson's disease (PD), and protective gloves and work... more Pesticides have been associated with Parkinson's disease (PD), and protective gloves and workplace hygiene can reduce pesticide exposure. We assessed whether use of gloves and workplace hygiene modified associations between pesticides and PD. The Farming and Movement Evaluation (FAME) study is a nested case-control study within the Agricultural Health Study. Use of protective gloves, other PPE, and hygiene practices were determined by questionnaire (69 cases and 237 controls were included). We considered interactions of gloves and hygiene with ever-use of pesticides for all pesticides with ≥5 exposed and unexposed cases and controls in each glove-use stratum (paraquat, permethrin, rotenone, and trifluralin). 61% of respondents consistently used protective gloves and 87% consistently used ≥2 hygiene practices. Protective glove use modified the associations of paraquat and permethrin with PD: neither pesticide was associated with PD among protective glove users, while both pestici...

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Respiratory disease in United States farmers

by Michael Alavanja and Jane Hoppin

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0127 Pesticide use and relative telomere length in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, 2014

Epidemiologic studies have linked pesticide use to various health outcomes, including cancer, but... more Epidemiologic studies have linked pesticide use to various health outcomes, including cancer, but underlying mechanisms remain unclear. In a previous analysis from the Agricultural Health Study (AHS), a prospective cohort study of pesticide applicators in the US, use of certain pesticides was linked to shorter relative telomere length (RTL) measured in buccal cell DNA. In this analysis we examined the associations between occupational pesticide use and RTL measured in blood DNA. We conducted an analysis of 80 pesticides and RTL in 568 cancer-free male participants aged 31-94 years in the AHS. We used self-reported pesticide use information collected at study enrollment (1993-1997) and two follow-up questionnaires administered approximately 5 years apart to construct exposure metrics, including intensity-weighted lifetime days (lifetime days*intensity score). Blood samples were collected in 2006-2008, and RTL was measured in DNA using qPCR. Multivariable linear regression was used to...

Ethnic-specific associations of rare and low-frequency DNA sequence variants with asthma

Nature communications, 2015

Common variants at many loci have been robustly associated with asthma but explain little of the ... more Common variants at many loci have been robustly associated with asthma but explain little of the overall genetic risk. Here we investigate the role of rare (<1%) and low-frequency (1-5%) variants using the Illumina HumanExome BeadChip array in 4,794 asthma cases, 4,707 non-asthmatic controls and 590 case-parent trios representing European Americans, African Americans/African Caribbeans and Latinos. Our study reveals one low-frequency missense mutation in the GRASP gene that is associated with asthma in the Latino sample (P=4.31 × 10(-6); OR=1.25; MAF=1.21%) and two genes harbouring functional variants that are associated with asthma in a gene-based analysis: GSDMB at the 17q12-21 asthma locus in the Latino and combined samples (P=7.81 × 10(-8) and 4.09 × 10(-8), respectively) and MTHFR in the African ancestry sample (P=1.72 × 10(-6)). Our results suggest that associations with rare and low-frequency variants are ethnic specific and not likely to explain a significant proportion o...

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Pesticide Exposure and Depression among Male Private Pesticide Applicators in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

Environmental Health Perspectives, 2014

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Dietary fat intake, pesticide use, and Parkinson's disease

Parkinsonism & Related Disorders, 2014

Background: Dietary fat intake may modify Parkinson's disease (PD) risk directly or by altering t... more Background: Dietary fat intake may modify Parkinson's disease (PD) risk directly or by altering the response to environmental neurotoxicants including pesticides. Methods: We conducted a case-control study of PD nested in the Agricultural Health Study (AHS), a cohort of pesticide applicators and spouses. We evaluated diet and pesticide use before diagnosis in 89 PD cases, confirmed by movement disorder specialists, or a corresponding date in 336 frequencymatched controls. Associations were evaluated using multivariate logistic regression to estimate odds ratios (ORs) and 95% confidence intervals (CIs). Results: In the AHS, PD was inversely associated with N-3 polyunsaturated fatty acids (PUFAs) (OR 0.4, 95% CI 0.2e0.8 for highest vs. lowest tertile) and the N-3 precursor a-linolenic acid (0.4, 0.2e0.8). In a meta-analysis of nine studies, including the present one, PD was inversely associated with a-linolenic acid (0.81, 0.68e0.96). In the AHS, associations of PD with the pesticides paraquat and rotenone were modified by fat intake. The OR for paraquat was 4.2 (1.5e12) in individuals with PUFA intake below the median but 1.2 (0.4e3.4) in those with higher intake (p-interaction ¼ 0.10). The OR for rotenone was 5.8 (2.3e15) in those with saturated fat intake above the median but 1.5 (0.5e4.2) in those with lower intake (p-interaction ¼ 0.02). Conclusions: PUFA intake was consistently associated with lower PD risk, and dietary fats modified the association of PD risk with pesticide exposure. If confirmed, these findings suggest that a diet high in PUFAs and low in saturated fats might reduce risk of PD.

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Pesticide Use and Relative Leukocyte Telomere Length in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

PLOS ONE, 2015

Pesticide use and risk of end-stage renal disease among licensed pesticide applicators in the Agricultural Health Study

Occupational and Environmental Medicine, 2015

Organophosphate insecticide use and cancer incidence among spouses of pesticide applicators in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, Jan 6, 2015

Cancer incidence and metolachlor use in the Agricultural Health Study: An update

by Michael Alavanja and Jane Hoppin

International Journal of Cancer, 2015

Incidence of solid tumours among pesticide applicators exposed to the organophosphate insecticide diazinon in the Agricultural Health Study: an updated analysis

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, Jan 23, 2015

Single-nucleotide polymorphism data support the general unrelatedness of the males in the agricultural health study

by Michael Alavanja and Jane Hoppin

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2014

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Cancer incidence among male pesticide applicators in the Agricultural Health Study cohort exposed to diazinon

American journal of epidemiology, 2005

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0105 Farm exposures, allergy symptoms and risk of non-Hodgkin lymphoma in the Agricultural Health Study

by Michael Alavanja and Jane Hoppin

Occupational and environmental medicine, 2014

Farm characteristics, allergy symptoms, and risk of non-hodgkin lymphoid neoplasms in the agricultural health study

by Michael Alavanja and Jane Hoppin

Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology, 2015

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