{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:32:58Z","timestamp":1790767978869,"version":"4.1.0"},"reference-count":29,"publisher":"MDPI AG","issue":"14","license":[{"start":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T00:00:00Z","timestamp":1594944000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Spanish Ministry of Economy and Competitiveness - Carlos III Institute of Health cofunded by FEDER funds\/European Regional Develpment Fund (ERDF)","award":["PI08\/1770, PI08\/0533, PI08\/1359, PS09\/00773-Cantabria, PI11\/01403, PI11\/02213, PI14\/1219, PI17\/01280, RTIC RD06\/0020\/0095, RD12\/0036\/0036,  SV-09-CLINIC-1\u00a0 and CIBERESP)"],"award-info":[{"award-number":["PI08\/1770, PI08\/0533, PI08\/1359, PS09\/00773-Cantabria, PI11\/01403, PI11\/02213, PI14\/1219, PI17\/01280, RTIC RD06\/0020\/0095, RD12\/0036\/0036,  SV-09-CLINIC-1\u00a0 and CIBERESP)"]}]},{"DOI":"10.13039\/501100019270","name":"Fundaci\u00f3n Marques de Valdecilla","doi-asserted-by":"publisher","award":["API 10\/09"],"award-info":[{"award-number":["API 10\/09"]}],"id":[{"id":"10.13039\/501100019270","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Obra Social \u00a0CAJASTUR","award":["SV-CAJASTUR-1"],"award-info":[{"award-number":["SV-CAJASTUR-1"]}]},{"name":"Recercaixa","award":["2010ACUP 00310"],"award-info":[{"award-number":["2010ACUP 00310"]}]},{"name":"Secretariat for Universities and Research of the Ministry of Business and Knowledge of the Government of Catalonia","award":["2017SGR1085"],"award-info":[{"award-number":["2017SGR1085"]}]},{"name":"Spanish Ministerio de Econom\u00eda y Competitividad (MINECO) through the Instituto de Salud Carlos III (ISCIII)","award":["PMP15\/00007 and CIBERONC"],"award-info":[{"award-number":["PMP15\/00007 and CIBERONC"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>We aimed to study the association between occupational exposure to pesticides and chronic lymphocytic leukemia (CLL) in Spain. Occupational exposure to pesticides (four insecticides, four herbicides and two fungicides) was evaluated using a job-exposure matrix for the Spanish population (MatEmESp) among 302 CLL cases and 1567 population controls in five regions of Spain, 2010\u20132013. Cumulative exposure scores (CES) were obtained by summing across the exposed jobs the product of prevalence, intensity and duration of exposure to each active substance. Principal components analysis (PCA) and logistic regression models adjusted for age, sex, region, education and occupational exposure to solvents were used. Around 20% of controls and 29% of cases were exposed to one or more pesticides. Compared to non-exposed, subjects in the highest tertile (3rd tertile) of CES of insecticides, herbicides, fungicides were more likely to have CLL [OR (95% CI), P-trend; 2.10 (1.38; 3.19), 0.002; 1.77 (1.12; 2.80), 0.12; and 1.67 (1.06; 2.64), 0.10, respectively). Following PCA, the first component (PC1, explaining 70% of the variation) equally led by seven active substances (the insecticide pyrethrin, all herbicides, all fungicides) was associated with a 26% higher odds of having CLL for 1-standard deviation increase in PC1 (95% CI: 1.14 to 1.40). These results confirm previous associations between CLL and exposure to pesticides and provide additional evidence by application groups and active substance. However, more research is needed to disentangle independent effects of individual active substances.<\/jats:p>","DOI":"10.3390\/ijerph17145174","type":"journal-article","created":{"date-parts":[[2020,7,17]],"date-time":"2020-07-17T10:22:02Z","timestamp":1594981322000},"page":"5174","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["Occupational Exposure to Pesticides and Chronic Lymphocytic Leukaemia in the MCC-Spain Study"],"prefix":"10.3390","volume":"17","author":[{"given":"Yolanda","family":"Benavente","sequence":"first","affiliation":[{"name":"Cancer Epidemiology Research Programme, Institut Catal\u00e0 d\u2019Oncologia (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Costas","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Research Programme, Institut Catal\u00e0 d\u2019Oncologia (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Maria","family":"Rodr\u00edguez-Suarez","sequence":"additional","affiliation":[{"name":"Public Health Department, University of Oviedo, 33011 Oviedo, Spain"},{"name":"Occupational Risk Prevention Service, Hospital Central University of Asturias, Public Health Service of the Principado of Asturias (SESPA), 33006 Oviedo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2703-9725","authenticated-orcid":false,"given":"Juan","family":"Alguacil","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"Centro de Investigaci\u00f3n en Recursos Naturales, Salud y Medio Ambiente (RENSMA), Universidad de Huelva, 21071 Huelva, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miguel","family":"Santib\u00e1\u00f1ez","sequence":"additional","affiliation":[{"name":"Faculty of Nursing, University of Cantabria\u2014IDIVAL, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Javier","family":"Vila","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"ISGlobal, 08903 Barcelona, Spain"},{"name":"Departament de Ci\u00e8ncies Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia","family":"Robles","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Research Programme, Institut Catal\u00e0 d\u2019Oncologia (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esther","family":"Alonso","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Universitari de Bellvitge, L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esmeralda","family":"de la Banda","sequence":"additional","affiliation":[{"name":"Department of Pathology, Hospital Universitari de Bellvitge, L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1323-1508","authenticated-orcid":false,"given":"Eva","family":"Gonzalez-Barca","sequence":"additional","affiliation":[{"name":"Hematology, Institut Catal\u00e0 d\u2019 Oncologia (IDIBELL), Universitat de Barcelona, L\u2019 Hospitalet de Llobregat, 08908 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trinidad","family":"Dierssen-Sotos","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"Faculty of Medicine, University of Cantabria\u2014IDIVAL, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Gimeno Vazquez","sequence":"additional","affiliation":[{"name":"Hematology, Hospital del Mar, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Aymerich","sequence":"additional","affiliation":[{"name":"Hematopathology Unit\/Hemato-Oncology Department, Instituto de Investigaciones Biom\u00e9dicas August Pi i Sunyer (IDIBAPS), 08001 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de C\u00e1ncer (CIBERONC), 28001 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elias","family":"Campo","sequence":"additional","affiliation":[{"name":"Hematopathology Unit\/Hemato-Oncology Department, Instituto de Investigaciones Biom\u00e9dicas August Pi i Sunyer (IDIBAPS), 08001 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red de C\u00e1ncer (CIBERONC), 28001 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7917-6145","authenticated-orcid":false,"given":"Jos\u00e9 J.","family":"Jim\u00e9nez-Mole\u00f3n","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"Department of Preventive Medicine and Public Health, University of Granada, 18071 Granada, Spain"},{"name":"Instituto de Investigaci\u00f3n Biosanitaria de Granada, Servicio Andaluz de Salud, Universidad de Granada, 18012 Granada, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9824-3657","authenticated-orcid":false,"given":"Rafael","family":"Marcos-Gragera","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"Epidemiology Unit and Girona Cancer Registry, Oncology Coordination Plan, Department of Health, Autonomous Government of Catalonia, Catalan Institute of Oncology, Girona Biomedical Research Institute (IdiBGi), 17007 Girona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4468-1816","authenticated-orcid":false,"given":"Gemma","family":"Casta\u00f1o-Vinyals","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"ISGlobal, 08903 Barcelona, Spain"},{"name":"Departament de Ci\u00e8ncies Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain"},{"name":"Hospital del Mar Medical Research Institute (IMIM), 08001 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nuria","family":"Aragon\u00e9s","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"Department of Health of Madrid, Epidemiology Section, Public Health Division, 28035 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marina","family":"Pollan","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"National Center for Epidemiology, Carlos III Institute of Health, 28001 Madrid, Spain"},{"name":"Instituto de Investigaci\u00f3n Sanitaria (IIS) de Hierro, 28220 Majadahonda, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Silvia","family":"de Sanjose","sequence":"additional","affiliation":[{"name":"Cancer Epidemiology Research Programme, Institut Catal\u00e0 d\u2019Oncologia (IDIBELL), L\u2019Hospitalet de Llobregat, 08908 Barcelona, Spain"},{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"Sexual and Reproductive Health, PATH, Seattle, WA 98121, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Manolis","family":"Kogevinas","sequence":"additional","affiliation":[{"name":"Centro de Investigaci\u00f3n Biom\u00e9dica en Red: Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"},{"name":"ISGlobal, 08903 Barcelona, Spain"},{"name":"Departament de Ci\u00e8ncies Experimentals i de la Salut, Universitat Pompeu Fabra (UPF), 08002 Barcelona, Spain"},{"name":"Hospital 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Epidemiolog\u00eda y Salud P\u00fablica (CIBERESP), 28001 Madrid, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2020,7,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"5446","DOI":"10.1182\/blood-2007-06-093906","article-title":"Guidelines for the diagnosis and treatment of chronic lymphocytic leukemia: A report from the International Workshop on Chronic Lymphocytic Leukemia updating the National Cancer Institute-Working Group 1996 guidelines","volume":"111","author":"Hallek","year":"2008","journal-title":"Blood"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"931","DOI":"10.1016\/S1470-2045(14)70282-7","article-title":"Survival for haematological malignancies in Europe between 1997 and 2008 by region and age: Results of EUROCARE-5, a population-based study","volume":"15","author":"Sant","year":"2014","journal-title":"Lancet 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