{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T10:47:49Z","timestamp":1785408469001,"version":"3.56.0"},"reference-count":30,"publisher":"AOSIS","issue":"1","license":[{"start":{"date-parts":[[2025,3,8]],"date-time":"2025-03-08T00:00:00Z","timestamp":1741392000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:p>Background: Several studies have reported an increase in the incidence of multiple myeloma among farmers following pesticide use.\n\nAim: This study aimed to seek an association between pesticide exposure and monoclonal gammopathy of undetermined significance (MGUS) in young pesticide applicators.\n\nSetting: The setting for this study was the Souss Massa region of the Kingdom of Morocco.\n\nMethods: We conducted a case-control study among 239 young male pesticide applicators with known exposure to pesticides (male pesticide applicators = exposed group) and 157 males with no direct exposure to pesticides (unexposed group). Serum protein electrophoresis was performed on all sera, and when monoclonal proteins were detected, they were characterised by serum protein immunofixation electrophoresis.\n\nResults: We found that the prevalence of MGUS was significantly higher in the exposed group older than 40 years 4.03% (95% confidence interval [CI]: 1.49\u20139.62) compared with the control group 0.91% (95% CI: 0.16\u20134.97), with no cases reported before this age. However, the odds ratio did not reach statistical significance 3.33 (95% CI: 0.39\u201328.78), which can be explained by the size of the population and the mean age \u00b1 s.d. of the pesticide applicators of 39.54 \u00b1 11.51. In contrast, the international studies found the same results with all recruited patients over 50 years. This selection was made at the beginning of the study. Monoclonal proteins in the exposed group were characterised as follows: immunoglobulin G\u03bb 3 (1.25%), IgG\u03ba 1 (0.41%) and biclonal IgG\u03ba + IgG\u03ba 1 (0.41%).\n\nConclusion: We recommend mandatory screening for monoclonal gammopathy in pesticide applicators over the age of 40 years. Further studies are needed to investigate the association between pesticide molecules and MGUS.\n\nContribution: The results of this study can be used by the Ministry of Health and the Ministry of Agriculture to provide baseline data to help develop appropriate prevention measures and awareness programmes against the misuse of pesticides.<\/jats:p>","DOI":"10.4102\/jphia.v16i1.714","type":"journal-article","created":{"date-parts":[[2025,3,10]],"date-time":"2025-03-10T10:30:32Z","timestamp":1741602632000},"update-policy":"https:\/\/doi.org\/10.4102\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Screening for monoclonal gammopathies of undetermined significance: A prospective study"],"prefix":"10.4102","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5573-6988","authenticated-orcid":false,"given":"Aissam","family":"El Maataoui","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/006sgpv47","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 Ibn Zohr"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7395-3855","authenticated-orcid":false,"given":"Sofia","family":"Farhat","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/006sgpv47","id-type":"ROR","asserted-by":"publisher"}],"name":"Universit\u00e9 Ibn Zohr"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2580","published-online":{"date-parts":[[2025,3,8]]},"reference":[{"key":"ref0","doi-asserted-by":"crossref","unstructured":"Rajkumar SV. Multiple myeloma: 2020 update on diagnosis, risk-stratification and management. Am J Hematol. 2020;95(5):548\u2013567. https:\/\/doi.org\/10.1002\/ajh.25791","DOI":"10.1002\/ajh.25791"},{"key":"ref1","doi-asserted-by":"crossref","unstructured":"Kyle RA, Therneau TM, Rajkumar SV, Larson DR, Plevak MF, Melton LJ. Incidence of multiple myeloma in Olmsted County, Minnesota: Trend over 6 decades. Cancer. 2004;101(11):2667\u20132674. https:\/\/doi.org\/10.1002\/cncr.20652","DOI":"10.1002\/cncr.20652"},{"key":"ref2","doi-asserted-by":"crossref","unstructured":"Ouzzif Z, Doghmi K, Bouhsain S, et al. Monoclonal gammopathies in a Moroccan military hospital. Rheumatol Int. 2012;32(10):3303\u20133307. https:\/\/doi.org\/10.1007\/s00296-011-2093-6","DOI":"10.1007\/s00296-011-2093-6"},{"key":"ref3","doi-asserted-by":"crossref","unstructured":"Landgren O, Rajkumar SV, Pfeiffer RM, et al. Obesity is associated with an increased risk of monoclonal gammopathy of undetermined significance among black and white women. Blood. 2010;116(7):1056\u20131059. https:\/\/doi.org\/10.1182\/blood-2010-01-262394","DOI":"10.1182\/blood-2010-01-262394"},{"key":"ref4","doi-asserted-by":"crossref","unstructured":"Landgren O, Katzmann JA, Hsing AW, et al. Prevalence of monoclonal gammopathy of undetermined significance among men in Ghana. Mayo Clin Proc. 2007;82(12):1468\u20131473. https:\/\/doi.org\/10.1016\/S0025-6196(11)61089-6","DOI":"10.1016\/S0025-6196(11)61089-6"},{"key":"ref5","doi-asserted-by":"crossref","unstructured":"Kyle RA, Larson DR, Therneau TM, et al. Long-term follow-up of monoclonal gammopathy of undetermined significance. N Engl J Med. 2018;378(3):241\u2013249. https:\/\/doi.org\/10.1056\/NEJMoa1709974","DOI":"10.1056\/NEJMoa1709974"},{"key":"ref6","doi-asserted-by":"crossref","unstructured":"Raab MS, Podar K, Breitkreutz I, Richardson PG, Anderson KC. Multiple myeloma. Lancet. 2009;374(9686):324\u2013339. https:\/\/doi.org\/10.1016\/S0140-6736(09)60221-X","DOI":"10.1016\/S0140-6736(09)60221-X"},{"key":"ref7","doi-asserted-by":"crossref","unstructured":"Sharma A, Shukla A, Attri K, et al. Global trends in pesticides: A looming threat and viable alternatives. Ecotoxicol Environ Saf. 2020;201:110812. https:\/\/doi.org\/10.1016\/j.ecoenv.2020.110812","DOI":"10.1016\/j.ecoenv.2020.110812"},{"key":"ref8","doi-asserted-by":"crossref","unstructured":"Fuhrimann S, Winkler MS, Staudacher P, et al. Exposure to pesticides and health effects on farm owners and workers from conventional and organic agricultural farms in Costa Rica: Protocol for a cross-sectional study. JMIR Res Protoc. 2019;8(1):e10914. https:\/\/doi.org\/10.2196\/10914","DOI":"10.2196\/10914"},{"key":"ref9","doi-asserted-by":"crossref","unstructured":"Alhanti B, Van Wendel de Joode B, Soto Martinez M, et al. Environmental exposures contribute to respiratory and allergic symptoms among women living in the banana growing regions of Costa Rica. Occup Environ Med. 2021;72:469\u2013477. https:\/\/doi.org\/10.1136\/oemed-2021-107611","DOI":"10.1136\/oemed-2021-107611"},{"key":"ref10","doi-asserted-by":"crossref","unstructured":"Lemarchand C, Tual S, Lev\u00eaque-Morlais N, et al. Cancer incidence in the AGRICAN cohort study (2005\u20132011). Cancer Epidemiol. 2017;49:175\u2013185. https:\/\/doi.org\/10.1016\/j.canep.2017.06.003","DOI":"10.1016\/j.canep.2017.06.003"},{"key":"ref11","doi-asserted-by":"crossref","unstructured":"Lerro CC, Koutros S, Andreotti G, et al. Cancer incidence in the agricultural health study after 20 years of follow-up. Cancer Causes Contr. 2019;30(4):311\u2013322. https:\/\/doi.org\/10.1007\/s10552-019-01140-y","DOI":"10.1007\/s10552-019-01140-y"},{"key":"ref12","doi-asserted-by":"crossref","unstructured":"Pasqualetti P, Collacciani A, Casale R. Risk of monoclonal gammopathy of undetermined significance: A case-referent study. Am J Hematol. 1996;52(3):217\u2013220. https:\/\/doi.org\/10.1002\/(SICI)1096-8652(199607)52:3%3C217::AID-AJH15%3E3.0.CO;2-C","DOI":"10.1002\/(SICI)1096-8652(199607)52:3<217::AID-AJH15>3.0.CO;2-C"},{"key":"ref13","doi-asserted-by":"crossref","unstructured":"Landgren O, Kyle RA, Hoppin JA, et al. \u2018Pesticide exposure and risk of monoclonal gammopathy of undetermined significance in the agricultural health study\u2019, Blood. 2009;113(25):6386\u20136391. https:\/\/doi.org\/10.1182\/blood-2009-02-203471","DOI":"10.1182\/blood-2009-02-203471"},{"key":"ref14","unstructured":"Alavanja MC, Sandler DP, Lynch CF, et al. Cancer incidence in the agricultural health study. Scand J Work Environ Health. 2005; 31(suppl. 1):39\u201345."},{"key":"ref15","doi-asserted-by":"crossref","unstructured":"Szalat R, Munshi NC. Genomic heterogeneity in multiple myeloma. Curr Opin Genet Dev. 2015;30:56\u201365. https:\/\/doi.org\/10.1016\/j.gde.2015.03.008","DOI":"10.1016\/j.gde.2015.03.008"},{"key":"ref16","doi-asserted-by":"crossref","unstructured":"Gold LS, De Roos AJ, Brown EE, et al. Associations of common variants in genes involved in metabolism and response to exogenous chemicals with risk of multiple myeloma. Cancer Epidemiol. 2009;33(3\u20134):276\u2013280. https:\/\/doi.org\/10.1016\/j.canep.2009.08.005","DOI":"10.1016\/j.canep.2009.08.005"},{"key":"ref17","doi-asserted-by":"crossref","unstructured":"Hallen J. Frequency of \u201cabnormal\u201d serum globulins (M-components) in the aged. Acta Med Scand. 1963;173(6):737\u2013744. https:\/\/doi.org\/10.1111\/j.0954-6820.1963.tb17460.x","DOI":"10.1111\/j.0954-6820.1963.tb17460.x"},{"key":"ref18","doi-asserted-by":"crossref","unstructured":"Presutti R, Harris SA, Kachuri L, et al. Pesticide exposures and the risk of multiple myeloma in men: An analysis of the North American Pooled Project. Int J Cancer. 2016;139(8):1703\u20131714. https:\/\/doi.org\/10.1002\/ijc.30218","DOI":"10.1002\/ijc.30218"},{"key":"ref19","doi-asserted-by":"crossref","unstructured":"Perrotta C, Staines A, Cocco P. Multiple myeloma and farming. A systematic review of 30 years of research. Where next? J Occup Med Toxicol. 2008;3(1):27. https:\/\/doi.org\/10.1186\/1745-6673-3-27","DOI":"10.1186\/1745-6673-3-27"},{"key":"ref20","doi-asserted-by":"crossref","unstructured":"Hofmann JN, Beane Freeman LE, Murata K, et al. Lifetime pesticide use and monoclonal gammopathy of undetermined significance in a prospective cohort of male farmers. Environ Health Perspect. 2021;129(1):1\u201310. https:\/\/doi.org\/10.1289\/EHP6960","DOI":"10.1289\/EHP6960"},{"key":"ref21","doi-asserted-by":"crossref","unstructured":"Hofmann JN, Beane Freeman LE, Lynch CF, et al. The Biomarkers of Exposure and Effect in Agriculture (BEEA) study: Rationale, design, methods, and participant characteristics. J Toxicol Environ Health A. 2015;78(21\u201322):1338\u20131347. https:\/\/doi.org\/10.1080\/15287394.2015.1091414","DOI":"10.1080\/15287394.2015.1091414"},{"key":"ref22","doi-asserted-by":"crossref","unstructured":"Landgren O, Graubard BI, Katzmann JA, et al. Racial disparities in the prevalence of monoclonal gammopathies: A population-based study of 12,482 persons from the National Health and Nutritional Examination Survey. Leukemia. 2014;28(7):1537\u20131542. https:\/\/doi.org\/10.1038\/leu.2014.34","DOI":"10.1038\/leu.2014.34"},{"key":"ref23","doi-asserted-by":"crossref","unstructured":"Alavanja MCR, Ross MK, Bonner MR. Increased cancer burden among pesticide applicators and others due to pesticide exposure. CA Cancer J Clin. 2013;63(2):120\u2013142. https:\/\/doi.org\/10.3322\/caac.21170","DOI":"10.3322\/caac.21170"},{"key":"ref24","doi-asserted-by":"crossref","unstructured":"Jorsaraei SGA, Maliji G, Azadmehr A, Moghadamnia AA, Faraji AA. Immunotoxicity effects of carbaryl in vivo and in vitro. Environ Toxicol Pharmacol. 2014;38(3):838\u2013844. https:\/\/doi.org\/10.1016\/j.etap.2014.09.004","DOI":"10.1016\/j.etap.2014.09.004"},{"key":"ref25","doi-asserted-by":"crossref","unstructured":"G\u00e1mez B, Edwards CM. Contributions of the bone microenvironment to monoclonal gammopathy of undetermined significance pathogenesis. Curr Osteoporos Rep. 2018;16(6):635\u2013641. https:\/\/doi.org\/10.1007\/s11914-018-0479-z","DOI":"10.1007\/s11914-018-0479-z"},{"key":"ref26","doi-asserted-by":"crossref","unstructured":"Zingone A, Kuehl WM. Pathogenesis of monoclonal gammopathy of undetermined significance and progression to multiple myeloma. Semin Hematol. 2011;48(1):4\u201312. https:\/\/doi.org\/10.1053\/j.seminhematol.2010.11.003","DOI":"10.1053\/j.seminhematol.2010.11.003"},{"key":"ref27","doi-asserted-by":"crossref","unstructured":"Mouhieddine TH, Weeks LD, Ghobrial IM. Monoclonal gammopathy of undetermined significance. Blood. 2019;133(23):2484\u20132494. https:\/\/doi.org\/10.1182\/blood.2019846782","DOI":"10.1182\/blood.2019846782"},{"key":"ref28","doi-asserted-by":"crossref","unstructured":"Mikulasova A, Wardell CP, Murison A, et al. The spectrum of somatic mutations in monoclonal gammopathy of undetermined significance indicates a less complex genomic landscape than that in multiple myeloma. Haematologica. 2017;102(9):1617\u20131625. https:\/\/doi.org\/10.3324\/haematol.2017.163766","DOI":"10.3324\/haematol.2017.163766"},{"key":"ref29","doi-asserted-by":"crossref","unstructured":"Kubiczkova L, Kryukov F, Slaby O, et al. Circulating serum micrornas as novel diagnostic and prognostic biomarkers for multiple myeloma and monoclonal gammopathy of undetermined significance. Haematologica. 2013;99(3):511\u2013518. https:\/\/doi.org\/10.3324\/haematol.2013.093500","DOI":"10.3324\/haematol.2013.093500"}],"container-title":["Journal of Public Health in Africa"],"original-title":[],"link":[{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/714\/html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/714\/epub","content-type":"application\/epub+zip","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/714\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/viewFile\/714\/pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/view\/714\/1583","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,25]],"date-time":"2026-05-25T13:48:54Z","timestamp":1779716934000},"score":1,"resource":{"primary":{"URL":"https:\/\/publichealthinafrica.org\/index.php\/jphia\/article\/view\/714"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,8]]},"references-count":30,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2025,1,1]]}},"URL":"https:\/\/doi.org\/10.4102\/jphia.v16i1.714","relation":{},"ISSN":["2038-9922","2038-9930"],"issn-type":[{"value":"2038-9922","type":"print"},{"value":"2038-9930","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,8]]},"article-number":"a714"}}