{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T18:14:12Z","timestamp":1791310452418,"version":"4.3.1"},"reference-count":32,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2011,1,4]],"date-time":"2011-01-04T00:00:00Z","timestamp":1294099200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Public Health"],"published-print":{"date-parts":[[2011,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>The causality of lymphohaematopoietic cancers (LHC) is multifactorial and studies investigating the association between chemical exposure and LHC have produced variable results. The aim of this study was to investigate the relationships between exposure to pesticides and LHC in an agricultural region of Greece.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>A structured questionnaire was employed in a hospital-based case control study to gather information on demographics, occupation, exposure to pesticides, agricultural practices, family and medical history and smoking. To control for confounders, backward conditional and multinomial logistic regression analyses were used. To assess the dose-response relationship between exposure and disease, the chi-square test for trend was used.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Three hundred and fifty-four (354) histologically confirmed LHC cases diagnosed from 2004 to 2006 and 455 sex- and age-matched controls were included in the study. Pesticide exposure was associated with total LHC cases (OR 1.46, 95% CI 1.05-2.04), myelodysplastic syndrome (MDS) (OR 1.87, 95% CI 1.00-3.51) and leukaemia (OR 2.14, 95% CI 1.09-4.20). A dose-response pattern was observed for total LHC cases (P = 0.004), MDS (P = 0.024) and leukaemia (P = 0.002). Pesticide exposure was independently associated with total LHC cases (OR 1.41, 95% CI 1.00 - 2.00) and leukaemia (OR 2.05, 95% CI 1.02-4.12) after controlling for age, smoking and family history (cancers, LHC and immunological disorders). Smoking during application of pesticides was strongly associated with total LHC cases (OR 3.29, 95% CI 1.81-5.98), MDS (OR 3.67, 95% CI 1.18-12.11), leukaemia (OR 10.15, 95% CI 2.15-65.69) and lymphoma (OR 2.72, 95% CI 1.02-8.00). This association was even stronger for total LHC cases (OR 18.18, 95% CI 2.38-381.17) when eating simultaneously with pesticide application.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Lymphohaematopoietic cancers were associated with pesticide exposure after controlling for confounders. Smoking and eating during pesticide application were identified as modifying factors increasing the risk for LHC. The poor pesticide work practices identified during this study underline the need for educational campaigns for farmers.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1186\/1471-2458-11-5","type":"journal-article","created":{"date-parts":[[2011,1,5]],"date-time":"2011-01-05T20:03:32Z","timestamp":1294257812000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Pesticide exposure and lymphohaematopoietic cancers: a case-control study in an agricultural region (Larissa, Thessaly, Greece)"],"prefix":"10.1186","volume":"11","author":[{"given":"Maria","family":"Kokouva","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Bitsolas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Georgios M","family":"Hadjigeorgiou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Rachiotis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nikolaos","family":"Papadoulis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christos","family":"Hadjichristodoulou","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2011,1,4]]},"reference":[{"issue":"Suppl 6","key":"2725_CR1","doi-asserted-by":"publisher","first-page":"409","DOI":"10.1080\/00313020500370192","volume":"37","author":"AE Grulich","year":"2005","unstructured":"Grulich AE, Vajdic CM: The epidemiology of non-Hodgkin lymphoma. Pathology. 2005, 37 (Suppl 6): 409-19. 10.1080\/00313020500370192.","journal-title":"Pathology"},{"issue":"Suppl 11","key":"2725_CR2","doi-asserted-by":"publisher","first-page":"1912","DOI":"10.1038\/sj.leu.2403945","volume":"19","author":"SS Storm","year":"2005","unstructured":"Storm SS, Gu Y, Gruschkus SK, Pierce SA, Estey EH: Risk factors of myelodysplastic syndromes: a case-control study. Leukemia. 2005, 19 (Suppl 11): 1912-8. 10.1038\/sj.leu.2403945.","journal-title":"Leukemia"},{"issue":"Suppl 8","key":"2725_CR3","doi-asserted-by":"publisher","first-page":"939","DOI":"10.1007\/s10552-005-2301-3","volume":"16","author":"A Descatha","year":"2005","unstructured":"Descatha A, Jenabian A, Conso F, Ameille J: Occupational exposures and haematological malignancies: overview on human recent data. Cancer Causes Control. 2005, 16 (Suppl 8): 939-53. 10.1007\/s10552-005-2301-3.","journal-title":"Cancer Causes Control"},{"key":"2725_CR4","doi-asserted-by":"publisher","first-page":"17","DOI":"10.1136\/oem.2005.020453","volume":"63","author":"B Mester","year":"2006","unstructured":"Mester B, Nieters A, Deeg E, Elsner G, Becker N, Seidler A: Occupation and malignant lymphoma: a population based case control study in Germany. Occup Environ Med. 2006, 63: 17-26. 10.1136\/oem.2005.020453.","journal-title":"Occup Environ Med"},{"issue":"Suppl 10","key":"2725_CR5","doi-asserted-by":"publisher","first-page":"1209","DOI":"10.1007\/s10552-007-9061-1","volume":"18","author":"M Merhi","year":"2007","unstructured":"Merhi M, Raynal H, Cahuzac E, Vinson F, Cravedi JP, Gamet-Payrastre L: Occupational exposure to pesticides and risk of hematopoietic cancers: meta-analysis of case-control studies. Cancer Causes Control. 2007, 18 (Suppl 10): 1209-26. 10.1007\/s10552-007-9061-1.","journal-title":"Cancer Causes Control"},{"issue":"Suppl 5","key":"2725_CR6","doi-asserted-by":"publisher","first-page":"457","DOI":"10.1007\/s10552-007-0122-2","volume":"18","author":"G Van Maele-Fabry","year":"2007","unstructured":"Van Maele-Fabry G, Duhayon S, Lison D: A systematic review of myeloid leukemias and occupational pesticide exposure. Cancer Causes Control. 2007, 18 (Suppl 5): 457-78. 10.1007\/s10552-007-0122-2.","journal-title":"Cancer Causes Control"},{"issue":"Suppl 11","key":"2725_CR7","doi-asserted-by":"publisher","first-page":"3123","DOI":"10.1158\/1055-9965.EPI-08-0343","volume":"17","author":"V Lope","year":"2008","unstructured":"Lope V, Perez-Gomez B, Aragones N, Lopez-Abente G, Gustavsson P, Plato N, Zock JP, Pollan M: Occupation, exposure to chemicals, sensitizing agents, and risk of multiple myeloma in Sweden. Cancer Epidemiol Biomarkers Prev. 2008, 17 (Suppl 11): 3123-7. 10.1158\/1055-9965.EPI-08-0343.","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"key":"2725_CR8","doi-asserted-by":"publisher","first-page":"726","DOI":"10.1136\/oem.2005.021550","volume":"62","author":"MA Svec","year":"2005","unstructured":"Svec MA, Ward MH, Dosemeci M, Checkoway H, De Roos AJ: Risk of lymphatic or haematopoietic cancer mortality with occupational exposure to animals or the public. Occup Environ Med. 2005, 62: 726-35. 10.1136\/oem.2005.021550.","journal-title":"Occup Environ Med"},{"issue":"Suppl 3","key":"2725_CR9","doi-asserted-by":"publisher","first-page":"215","DOI":"10.5271\/sjweh.782","volume":"30","author":"D Baris","year":"2004","unstructured":"Baris D, Silverman DT, Brown LM, Swanson GM, Hayes RB, Schwartz AG, Liff JM, Schoenberg JB, Pottern LM, Greenberg RS, Stewart PA: Occupation, pesticide exposure and risk of multiple myeloma. Scand J Work Environ Health. 2004, 30 (Suppl 3): 215-22.","journal-title":"Scand J Work Environ Health"},{"issue":"Suppl 6","key":"2725_CR10","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1023\/A:1016331128897","volume":"13","author":"L Fritschi","year":"2002","unstructured":"Fritschi L, Johnson KC, Kliewer EV, Fry R, Canadian Cancer Registries Epidemiology Research Group: Animal-related occupations and the risk of leukemia, myeloma, and non-Hodgkin's lymphoma in Canada. Cancer Causes Control. 2002, 13 (Suppl 6): 563-71. 10.1023\/A:1016331128897.","journal-title":"Cancer Causes Control"},{"key":"2725_CR11","doi-asserted-by":"publisher","first-page":"2","DOI":"10.1186\/1745-6673-2-2","volume":"2","author":"A Seidler","year":"2007","unstructured":"Seidler A, Mohner M, Berger J, Mester B, Deeg E, Elsner G, Nieters A, Becker N: Solvent exposure and malignant lymphoma: a population-based case-control study in Germany. J Occup Med Toxicol. 2007, 2: 2-10.1186\/1745-6673-2-2.","journal-title":"J Occup Med Toxicol"},{"issue":"Suppl 4","key":"2725_CR12","doi-asserted-by":"publisher","first-page":"1363","DOI":"10.1182\/blood-2005-12-008755","volume":"108","author":"BC Chiu","year":"2006","unstructured":"Chiu BC, Dave BJ, Blair A, Gapstur SM, Zahm SH, Weisenburger DD: Agricultural pesticide use and risk of t(14;18)-defined subtypes of non-Hodgkin lymphoma. Blood. 2006, 108 (Suppl 4): 1363-9. 10.1182\/blood-2005-12-008755.","journal-title":"Blood"},{"key":"2725_CR13","doi-asserted-by":"publisher","first-page":"2264","DOI":"10.1158\/0008-5472.CAN-03-3604","volume":"64","author":"S Roulland","year":"2004","unstructured":"Roulland S, Lebailly P, Lecluse Y, Briand M, Pottier D, Gauduchon P: Characterization of the t(14;18) BCL2-IGH translocation in farmers occupationally exposed to pesticides. Cancer Res. 2004, 64: 2264-69. 10.1158\/0008-5472.CAN-03-3604.","journal-title":"Cancer Res"},{"issue":"Suppl 7","key":"2725_CR14","doi-asserted-by":"publisher","first-page":"1473","DOI":"10.1084\/jem.20082842","volume":"206","author":"J Agopian","year":"2009","unstructured":"Agopian J, Navarro JM, Gac AC, Lecluse Y, Briand M, Grenot P, Gauduchon P, Ruminy P, Lebailly P, Nadel B, Roulland S: Agricultural pesticide exposure and the molecular connection to lymphomagenesis. J Exp Med. 2009, 206 (Suppl 7): 1473-83. 10.1084\/jem.20082842.","journal-title":"J Exp Med"},{"issue":"Suppl 13","key":"2725_CR15","doi-asserted-by":"publisher","first-page":"1275","DOI":"10.1289\/ehp.7070","volume":"112","author":"I Kato","year":"2004","unstructured":"Kato I, Watanabe-Meserve H, Koerg KL, Baptiste MS, Lillquist PP, Frizzera G, Burke JS, Moseson M, Shore RE: Pesticide product use and risk of non-Hodgkin lymphoma in women. Environ Health Perspect. 2004, 112 (Suppl 13): 1275-81. 10.1289\/ehp.7070.","journal-title":"Environ Health Perspect"},{"key":"2725_CR16","first-page":"1155","volume":"10","author":"HH McDuffie","year":"2001","unstructured":"McDuffie HH, Pahwa P, McLaughlin JR, Spinelli JJ, Fincham S, Dosman JA, Robson D, Skinnider LF, Choi NW: Non-Hodgkin's lymphoma and specific pesticide exposure in men: cross-Canada study of pesticide and health. Cancer Epidemiol Biomarkers Prev. 2001, 10: 1155-63.","journal-title":"Cancer Epidemiol Biomarkers Prev"},{"issue":"Suppl 7","key":"2725_CR17","doi-asserted-by":"publisher","first-page":"823","DOI":"10.1007\/s10552-005-2703-2","volume":"16","author":"PK Mills","year":"2005","unstructured":"Mills PK, Yang R, Riordan D: Lymphohematopoietic cancers in the United Farm Workers of America (UFW), 1988-2001. Cancer Causes Control. 2005, 16 (Suppl 7): 823-30. 10.1007\/s10552-005-2703-2.","journal-title":"Cancer Causes Control"},{"key":"2725_CR18","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1136\/oem.2005.024026","volume":"63","author":"E Van Balen","year":"2006","unstructured":"Van Balen E, Font R, Cavalle' N, Font L, Garcia-Villanueva M, Benavente Y, Brennar P, De Sanjose S: Exposure to non-arsenic pesticides is associated with lymphoma among farmers in Spain. Occup Environ Med. 2006, 63: 663-8. 10.1136\/oem.2005.024026.","journal-title":"Occup Environ Med"},{"issue":"Suppl 5","key":"2725_CR19","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1136\/oem.2008.040972","volume":"66","author":"L Orsi","year":"2009","unstructured":"Orsi L, Delabre L, Monnereau A, Delval P, Berthou C, Fenaux P, Marit G, Soubeyran P, Huguet F, Milpied N, Leporrier M, Hemon D, Troussard X, Clevel J: Occupational exposure to pesticides and lymphoid neoplasms among men: results of a French case-control study. Occup Environ Med. 2009, 66 (Suppl 5): 291-298. 10.1136\/oem.2008.040972.","journal-title":"Occup Environ Med"},{"key":"2725_CR20","unstructured":"Usual resident population - Population distribution 2001. [http:\/\/www.statistics.gr\/portal\/page\/portal\/ESYE\/PAGE-themes?p_param=A1602&r_param=SAM01&y_param=2001_00&mytabs=0]"},{"key":"2725_CR21","unstructured":"Centers for Disease Control and Prevention-CDC: CDC-NCHS-National Center for Health Statistics \"Data definitions\" Current smoker, Alcohol consumption. Atlanta USA. [updated 2002 June; accessed 2003 May]. Not available anymore in the form used, [http:\/\/www.cdc.gov]"},{"key":"2725_CR22","unstructured":"Food and Drug Administration-FDA: http:\/\/www.fda.gov Glossary of Pesticide Chemicals. June 2005. USA FDA: Division of Pesticide and Industrial Chemicals. [accessed 2010 Dec], [http:\/\/www.fda.gov\/downloads\/Food\/FoodSafety\/FoodContaminantsAdulteration\/Pesticides\/ucm114655.pdf]"},{"key":"2725_CR23","first-page":"43","volume-title":"SPSS 16.0 Advanced Statistical Procedures","author":"M Norusis","year":"2007","unstructured":"Norusis M: Multinomial logistic regression analysis. SPSS 16.0 Advanced Statistical Procedures. Edited by: Norusis M. 2007, Companion Upper Saddle-River, N.J: Prentice Hall, Inc, 43-68."},{"issue":"Suppl 2","key":"2725_CR24","doi-asserted-by":"publisher","first-page":"125","DOI":"10.1080\/10599240902779436","volume":"14","author":"A Blair","year":"2009","unstructured":"Blair A, Freeman LB: Epidemiologic studies of cancer in agricultural populations: observations and future directions. J Agromedicine. 2009, 14 (Suppl 2): 125-131. 10.1080\/10599240902779436.","journal-title":"J Agromedicine"},{"issue":"Suppl 1","key":"2725_CR25","doi-asserted-by":"publisher","first-page":"39","DOI":"10.1300\/J096v12n01_05","volume":"12","author":"MC Alavanja","year":"2007","unstructured":"Alavanja MC, Ward MH, Reynolds P: Carcinogenicity of agricultural pesticides in adults and children. J Agromedicine. 2007, 12 (Suppl 1): 39-56. 10.1300\/J096v12n01_05.","journal-title":"J Agromedicine"},{"issue":"Suppl 2","key":"2725_CR26","doi-asserted-by":"publisher","first-page":"141","DOI":"10.13031\/2013.18180","volume":"11","author":"A Blair","year":"2005","unstructured":"Blair A, Sandler D, Thomas K, Hoppin JA, Kamel F, Coble J, Lee WJ, Rusiecki J, Knott C, Dosemeci M, Lynch CF, Lubin J, Alanvaja M: Disease and injury among participants in the agricultural health study. J Agric Saf Health. 2005, 11 (Suppl 2): 141-50.","journal-title":"J Agric Saf Health"},{"key":"2725_CR27","first-page":"1704","volume":"53","author":"KL Bassil","year":"2007","unstructured":"Bassil KL, Vakil C, Sanborn M, Cole DC, Kaur JS, Kerr KJ: Cancer health effects of pesticides. Systematic review. Can Fam Physician. 2007, 53: 1704-1711.","journal-title":"Can Fam Physician"},{"key":"2725_CR28","doi-asserted-by":"publisher","first-page":"e11","DOI":"10.1136\/oem.60.9.e11","volume":"60","author":"AJ De Roos","year":"2003","unstructured":"De Roos AJ, Zahm SH, Cantor KP, Weisenburger DD, Holmes FF, Burmeister LF, Blair A: Integrative assessment of multiple pesticides as risk factors for non-Hodgkin's lymphoma among men. Occup Environ Med. 2003, 60: e11-10.1136\/oem.60.9.e11.","journal-title":"Occup Environ Med"},{"issue":"Suppl 4","key":"2725_CR29","doi-asserted-by":"publisher","first-page":"217","DOI":"10.1007\/s004110050075","volume":"36","author":"H Zeeb","year":"1998","unstructured":"Zeeb H, Blettner M: Adult leukemia: what is the role of currently known risk factors?. Radiat Envioron Biophys. 1998, 36 (Suppl 4): 217-28. 10.1007\/s004110050075.","journal-title":"Radiat Envioron Biophys"},{"issue":"Suppl 1","key":"2725_CR30","doi-asserted-by":"publisher","first-page":"154","DOI":"10.1111\/j.1365-2141.1995.tb05261.x","volume":"91","author":"J Clavel","year":"1995","unstructured":"Clavel J, Mandereau L, Cordier S, Le Goaster C, Hemon D, Conso F, Flandrin G: Hairy cell leukaemia, occupation, and smoking. Br J Haematol. 1995, 91 (Suppl 1): 154-61. 10.1111\/j.1365-2141.1995.tb05261.x.","journal-title":"Br J Haematol"},{"key":"2725_CR31","first-page":"95","volume":"49","author":"M Eriksson","year":"1992","unstructured":"Eriksson M, Karlson M: Occupational and other environmental factors and multiple myeloma: a population-based case-control study. Br J Ind Med. 1992, 49: 95-103.","journal-title":"Br J Ind Med"},{"issue":"Suppl 5","key":"2725_CR32","doi-asserted-by":"crossref","first-page":"724","DOI":"10.1289\/ehp.5885","volume":"111","author":"J Beard","year":"2003","unstructured":"Beard J, Sladden T, Morgan G, Berry G, Brooks L, McMichael A: Health impact of pesticide exposure in a cohort of outdoor workers. Environ Health Perspect. 2003, 111 (Suppl 5): 724-730.","journal-title":"Environ Health Perspect"}],"container-title":["BMC Public Health"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-11-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-2458-11-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-11-5","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-2458-11-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,9,1]],"date-time":"2021-09-01T06:33:40Z","timestamp":1630478020000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcpublichealth.biomedcentral.com\/articles\/10.1186\/1471-2458-11-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2011,1,4]]},"references-count":32,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2011,12]]}},"alternative-id":["2725"],"URL":"https:\/\/doi.org\/10.1186\/1471-2458-11-5","relation":{},"ISSN":["1471-2458"],"issn-type":[{"value":"1471-2458","type":"electronic"}],"subject":[],"published":{"date-parts":[[2011,1,4]]},"assertion":[{"value":"7 April 2010","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2011","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 January 2011","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"5"}}