Prenatal pesticide exposure and neuroblastoma - A statewide case-control study in California.

Background: Previous studies investigating neuroblastoma risk and parental pesticide exposure have had mixed findings, with some evidence linking maternal occupational or residential exposure to increased risk. However, most assessed pesticides broadly rather than evaluating specific compounds. To our knowledge, no studies have examined ambient residential exposure to individual pesticides and neuroblastoma risk.

Objective: To evaluate associations between childhood neuroblastoma and prenatal exposure to specific pesticides through residential proximity to agricultural applications.

Methods: We identified neuroblastoma cases from the California Cancer Registry and cancer-free controls from birth certificates. Analyses were restricted to children born 1998-2016 whose mothers lived within 4,000 meters of an agricultural pesticide application during pregnancy (199 cases, 202,796 controls). Probable and possible carcinogens were selected based on U.S. EPA classifications and pesticide use was collected from the California Pesticide Use Reporting system linked to land-use surveys. Exposures were assessed using a 4,000m buffer around geocoded residential addresses at birth. We used a distance decay model and considered pregnancies exposed when the poundage per acre applied exceeded the pesticide-specific median. We analyzed 68 pesticides with at least 5 exposed cases using unconditional logistic regression and hierarchical models co-adjusted for all pesticides.

Results: In hierarchical models, we observed elevated risks of neuroblastoma with prenatal exposure to flonicamid (aOR: 1.33; 95% CI: 1.02-1.73), benomyl (aOR: 1.53; 95% CI: 0.98-2.38), cypermethrin (aOR: 1.24; 95% CI: 0.96-1.60), and permethrin (aOR: 1.20; 95% CI: 0.96-1.50).

Conclusion: Our findings suggest that ambient exposure to certain pesticides during pregnancy may increase the risk of neuroblastoma.