| Depression and Pesticide Exposures among Private Pesticide Applicators Enrolled in the Agricultural Health Study Cheryl L. Beseler,1,2,3 Lorann Stallones,1 Jane A. Hoppin,4 Michael C.R. Alavanja,5 Aaron Blair,5 Thomas Keefe,6 and Freya Kamel4 1Colorado Injury Control Research Center, Department of Psychology, Colorado State University, Fort Collins, Colorado, USA; 2Epidemiology Department, College of Public Health, and 3Department of Environmental, Agricultural and Occupational Health, University of Nebraska Medical Center, Omaha, Nebraska, USA; 4Epidemiology Branch, National Institutes of Environmental Health Sciences, National Institutes of Health, Department of Health and Human Services, Research Triangle Park, North Carolina, USA; 5Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Department of Health and Human Services, Rockville, Maryland, USA; 6Department of Environmental and Radiological Health Sciences, Colorado State University, Fort Collins, Colorado, USA Abstract
Background: We evaluated the relationship between diagnosed depression and pesticide exposure using information from private pesticide applicators enrolled in the Agricultural Health Study between 1993 and 1997 in Iowa and North Carolina. Methods: There were 534 cases who self-reported a physician-diagnosed depression and 17,051 controls who reported never having been diagnosed with depression and did not feel depressed more than once a week in the past year. Lifetime pesticide exposure was categorized in three mutually exclusive groups: low (< 226 days, the reference group) , intermediate (226–752 days) , and high (> 752 days) . Two additional measures represented acute high-intensity pesticide exposures: an unusually high pesticide exposure event (HPEE) and physician-diagnosed pesticide poisoning. Logistic regression analyses were performed relating pesticide exposure to depression. Results: After adjusting for state, age, education, marital status, doctor visits, alcohol use, smoking, solvent exposure, not currently having crops or animals, and ever working a job off the farm, pesticide poisoning was more strongly associated with depression [odds ratio (OR) = 2.57 ; 95% confidence interval (CI) , 1.74–3.79] than intermediate (OR = 1.07 ; 95% CI, 0.87–1.31) or high (OR = 1.11 ; 95% CI, 0.87–1.42) cumulative exposure or an HPEE (OR = 1.65 ; 95% CI, 1.33–2.05) . In analysis of a subgroup without a history of acute poisoning, high cumulative exposure was significantly associated with depression (OR = 1.54 ; 95% CI, 1.16–2.04) . Conclusion: These findings suggest that both acute high-intensity and cumulative pesticide exposure may contribute to depression in pesticide applicators. Our study is unique in reporting that depression is also associated with chronic pesticide exposure in the absence of a physician-diagnosed poisoning. Key words: cumulative exposure, depression, farm applicators, pesticides, pesticide poisoning. Environ Health Perspect 116:1713–1719 (2008) . doi:10.1289/ehp.11091 available via http://dx.doi.org/ [Online 9 September 2008]
Address correspondence to C.L. Beseler, College of Public Health, University of Nebraska Medical Center, 984395 UNMC, Omaha, NE 68198-4395 USA. Telephone: (402) 559-3976. Fax: (402) 559-7259. E-mail: cbeseler@unmc.edu The Agricultural Health Study was conducted by the field stations in Iowa (University of Iowa: C. Lynch, N. Logsden-Sackett, P. Gillette, and E. Heywood) and North Carolina (Battelle: C. Knott, J. Herrington, and M. Hayslip) , with central coordination provided by Westat (P. Schroeder, S. Legum, and M. Dunn) . S. Long (Westat) provided programming support. This research was supported in part by the National Institutes of Health (NIH) Intramural Research Program (Division of Cancer Epidemiology and Genetics, National Cancer Institute, and the National Institute of Environmental Health Sciences) . The authors declare they have no competing financial interests. Received 20 November 2007 ; accepted 9 September 2008.
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