Exposure to herbicides is associated with an increased risk for cutaneous melanoma, yet exposure to insecticides does not appear to be associated with this risk, study data in the Journal of the European Academy of Dermatology and Venereology suggest.
The study was a systematic review and meta-analysis of 7 cohort and 2 case-control studies, which comprised 184,389 individuals. Only studies that offered sufficient data to develop both a risk estimate and 95% CI for the correlation between pesticide exposure and melanoma incidence were included.
Pesticides, including herbicides and insecticides, were evaluated in the included studies. In addition to assessing the association between pesticide use and melanoma risk, the study also examined whether ≥1 pesticide category was implicated in this risk.
Spouses of private pesticide applicators (ie, farmers or nursery workers) had an increased incidence of cutaneous melanoma (standardized incidence ratio, 1.64; 95% CI, 1.27-2.09). Use or exposure to every herbicide was associated with an increased risk for cutaneous melanoma (summary relative risk [SRR], 1.85; 95% CI, 1.01-3.36). There was no association between an increased risk for cutaneous melanoma and ever exposure to insecticides (SSR, 1.57; 95% CI, 0.58-4.25), ever exposure to any pesticide (SSR, 1.31; 95% CI, 0.85-2.04), or high exposure to any pesticide (SSR, 2.17; 95% CI, 0.45-10.36).
Limitations of the study include potential publication bias as well as the recall and selection bias in the observational and case-control studies.
“A precautionary public health safety policy that includes preventive individual counselling and surveillance to workers exposed to pesticides may be advisable,” the researchers concluded.
Stanganelli I, De Felici MB, Mandel VD, et al; Italian Melanoma Intergroup. The association between pesticide use and cutaneous melanoma: a systematic review and meta-analysis [published online September 21, 2019]. J Eur Acad Dermatol Venereol. doi:10.1111/jdv.15964