Background
Several studies have suggested a link between occupational pesticide exposure and cancer, mainly in temperate regions and for specific compounds. Few studies have examined the effects of combined exposure to multiple pesticides in tropical settings.
Objective
We aimed to investigate the association between occupational exposure to pesticide mixtures and cancer risk in a cohort of banana workers from Guadeloupe and Martinique.
Methods
The study included 11,182 workers, followed for cancer incidence from 1981 to 2019. Exposure to 17 pesticides was estimated using a crop-exposure matrix. Principal component analysis, followed by hierarchical clustering, identified pesticide exposure profiles. Cox proportional hazards models, adjusted for age, department of residence, and sex, were used to examine associations between exposure profiles and cancer risk.
Results
Four pesticide exposure profiles were identified: a low-exposure reference group; a group with high lindane and low chlordecone and glyphosate exposure (profile 2); a group highly exposed to multiple pesticides except bitertanol (profile 3); and a group highly exposed to all pesticides (profile 4). Profile 4 was associated with increased risks of prostate cancer (RR=2.21; 95% CI 1.43–3.42), hematologic malignancies (RR=3.99; 95% CI 1.43–11.13), and colorectal cancer (RR=5.03; 95% CI 2.12–11.96). Elevated bladder cancer risk was observed in profiles 2 and 3 (RR=2.03; 95% CI 0.93–4.45; RR=3.16; 95% CI 1.55–6.42, respectively).
Conclusion/Implications for practice or policy
Our results suggest that combined exposure to multiple pesticides may increase cancer risk among banana plantation workers. These findings have broader implications for other agricultural sectors, as most of these pesticides are also used in the cultivation of other crops.