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THREE AGENCIES TO COOPERATE IN AGRICULTURAL HEALTH STUDY

 WASHINGTON, Jan. 25 /PRNewswire/ -- The National Cancer Institute (NCI), the Environmental Protection Agency (EPA), and the National Institute of Environmental Health Sciences (NIEHS) announced the initiation of a joint study that will be the nation's largest ever epidemiologic study of farmers and their families.
 The Agricultural Health Study will identify and assess factors that may account for previously reported cancer excesses among farmers. About 100,000 farmers, spouses of farmers, and pesticide applicators will be involved in the $15 million study, which is planned to last at least 10 years. The research will also assess non-cancer health endpoints (e.g., reproductive and neurologic) that may also be associated with farm practices and lifestyles.
 Farmers tend to live longer and healthier lives than other people. But evidence has shown that they have higher than normal rates of several cancers. These cancers include leukemia, multiple myeloma, non-Hodgkin's lymphoma, and cancers of the brain, prostate, stomach, skin, and lip. (See references 2,3,8). This phenomenon may be due in part to farmers' chronic exposures to potentially harmful compounds such as pesticides (insecticides, fungicides, rodenticides, herbicides, and others), chemical solvents, engine exhausts, animal viruses, sunlight, and other substances common to agriculture.
 Although some of these agents have been linked to the development of cancer, reasons for farmers' increased risks for many types of cancer are still unclear. These same agents may also be associated with other health effects, such as neurologic or kidney diseases, conditions not yet well studied in farmers.
 In addition to studying occupational exposures of farmers themselves, the investigators will study the health of farm family members who may also be exposed to lower levels of the same potential farming hazards. This portion of the study may be especially relevant to the general population. Chemicals traditionally associated with agriculture (pesticides, fertilizers) can now be commonly found in urban areas. Furthermore, some cancers excessive among farmers appear to be increasing in the general population.
 As a result of a competitive process, five-year contracts were awarded to study two states. Contractors are the University of Iowa College of Medicine, Iowa City, and Survey Research Associates, Durham, N.C. These two states were chosen as field sites based on their populations of farmers and pesticide applicators and their types of farm products, as well as the level of representation of minority participants. Subjects will be enrolled in the study over a three-year period, as they renew pesticide applicator's licenses. All participants will come from Iowa and North Carolina.
 Of the 100,000 study subjects, 46 percent will be farmers who apply pesticides to their crops and lives tock, 34 percent will be spouses of farmers, and 20 percent will be other pesticide applicators. It is estimated that 60 percent of the subjects will be male and 40 percent will be female. Information on the children of the farmers will also be included.
 Because this is a prospective study, investigators will collect data on exposures and disease as they occur, instead of relying entire ly on information from the past. This approach helps to reduce errors associated with trying to remember events, and will make conclusions more valid. A prospective design also provides the opportunity to evaluate a wide variety of endpoints that may relate to agricultural factors.
 The study itself is composed of several parts. In the main study, the farmers, their dependents, and the pesticide applicators will be followed for 10 years or longer. Investigators will compare the number of cases of cancer that are expected to appear in this population to the number that actually appear. They will also compare disease risks in individuals exposed to specific substances to risks in unexposed individuals.
 Over the first five-year period, as cancer cases are identified, those of particular interest will be incorporated into special studies, which will obtain even more detailed information on possible risk factors. Researchers will also be looking for markers that might identify people who are especially susceptible to the effects of environmental hazards.
 Each participant will provide information on agricultural exposures and diet, as well as a complete occupational history, and family and personal medical histories. The collection of dietary information may provide an opportunity to test current hypotheses about diet and cancer, including how dietary factors might modify risks associated with specific farm chemicals.
 To obtain quantitative measures of exposure from different farm tasks and from diet, water, and air, a subset of the study population will be studied in more detail.
 Approximately 200 households will be monitored at least twice, once during the growing season and once off-season. Monitoring will include environmental (air, water, food, soil, house dust), and biological (urine, blood) sampling, which will be coupled with information obtained from interviews and diaries. Researchers plan to monitor about 20 different pesticide-related activities and assess the average exposure and implications of each activity.
 An advisory committee composed of epidemiologists, biostatisticians, exposure assessment specialists, and farmers is being organized to provide advice and oversight to the agencies during the study. The study will be directed by Michael Alavanja, Dr.P.H., of NCI and Elaine Grose, Ph.D., of EPA. Dale Sandler, Ph.D., of NIEHS will oversee the NIEHS aspect of the study.
 References:
 1. Alavanja MCR, Blair A, Masters MN: Cancer mortality in the U.S. flour industry. JNCI 82:840-847, 1990.
 2. Blair A, Zahm SK: Cancer among farmers. State of the Art Reviews: Occup Med 6:335-354, 1991.
 3. Blair A, Malker H, Cantor KP, Burmeister L, Wiklund K: Cancer among farmers: A review. Scand J Work Environ Health 11:397- 407, 1985.
 4. Blair A, Zahm SH, Pearce NE, Heineman EF, Fraumeni JF Jr: Clues to cancer etiology from studies of farmers. Scand J Work Environ Health (In press), 1992.
 5. Cordes DH, Rea DF. (Eds.) Health Hazards of Farming. Hanley and Belfus, Inc., Philadelphia, 1991.
 6. Dosman JA, Cockroft DW. (Eds.) Principles of Health and Safety in Agriculture. CRC Press, Inc., Boca Raton, Fla. 1989.
 7. Hoar SK, Blair A, Holmes FF, et al: Agricultural herbicide use and risk of lymphoma and soft-tissue sarcoma. JAMA 256:1141-1147, 1986.
 8. Pearce N, Reif JS: Epidemiologic studies of cancer in agricultural workers. Am J Ind Med 18:133-148, 1991.
 9. Zahm SH, Weisenburger DD, Babbitt PA et al: A case-control study of non-Hodgkin's lymphoma and the herbicide 2,4- dichlorophenoxyacetic acid (2,4-D) in eastern Nebraska. Epidemiology 1:349-356, 1990.
 -0- 1/25/93
 /CONTACT: NCI Press Office, 301-496-6641/


CO: National Cancer Institute; Environmental Protection Agency
 National Institute of Environmental Health Sciences ST: Iowa, North Carolina IN: HEA SU:


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