杀虫剂和强磁场都被怀疑是儿童白血病的风险因素。杀虫剂在商业植物苗圃中使用，有时占据在高压输电线下的区域。为了评估在植物苗圃使用的潜在杀虫剂暴露（意图使用、化学类别、活性成分）是否作为儿童白血病的独立风险因素，或者作为与高压输电线附近或磁场暴露相关的混杂因素，我们在加利福尼亚州开展了一项全州范围的基于记录的病例对照研究，纳入57888个儿童白血病病例和5788个对照，研究了具体的杀虫剂使用情况、磁场暴露和与输电线和植物苗圃的距离。暴露评估包括地理信息系统、空中卫星图像和其他历史信息。几种活性杀虫剂成分可能会增加儿童白血病的风险：氯氰菊酯（比值比（OR）1.49，95%置信区间（CI）（0.83-2.67）），氯氰菊磷（OR 1.29，95% CI 0.89-1.87），甲胺磷（OR 1.79，95% CI 0.85-3.76），曼可扎布（OR 1.41，95% CI 0.85-2.33），氧氟苯（OR 1.41，95% CI 0.75-2.66），奥基拜林（OR 1.60，95% CI 0.97-2.63）和苯硫丹（OR 1.82，95% CI 0.81-2.25）。杀鼠剂（OR 1.42，95% CI 0.78-2.66）和杀螺剂（OR 1.22，95% CI 0.82-1.81）的接触也可能增加儿童白血病的风险。在调整了杀虫剂暴露后，通过计算磁场或输电线附近的儿童白血病风险没有明显变化。当排除了杀虫剂暴露后，与输电线附近的儿童白血病风险保持类似。杀虫剂暴露可能是儿童白血病的独立风险因素。输电线附近和磁场暴露的儿童白血病风险不能由杀虫剂暴露解释。版权所有 © 2023. Elsevier Inc. 发布。

Both pesticides and high magnetic fields are suspected to be childhood leukemia risk factors. Pesticides are utilized at commercial plant nurseries, which sometimes occupy the areas underneath high-voltage powerlines.To evaluate whether potential pesticide exposures (intended use, chemical class, active ingredient) utilized at plant nurseries act as an independent childhood leukemia risk factor or as a confounder for proximity to, or magnetic fields exposure from, high-voltage powerlines.We conducted a state-wide records-based case-control study for California with 5,7888 childhood leukemia cases and 5788 controls that examined specific pesticide use, magnetic field exposures and distances to both powerlines and plant nurseries. Exposure assessment incorporated geographic information systems, aerial satellite images, and other historical information.Childhood leukemia risk was potentially elevated for several active pesticide ingredients: permethrin (odds ratio (OR) 1.49, 95% confidence interval (CI) (0.83-2.67), chlorpyrifos (OR 1.29, 95% CI 0.89-1.87), dimethoate (OR 1.79, 95% CI 0.85-3.76), mancozeb (OR 1.41, 95% CI 0.85-2.33), oxyfluorfen (OR 1.41, 95% CI 0.75-2.66), oryzalin (OR 1.60, 95% CI 0.97-2.63), and pendimethalin (OR 1.82, 95% CI 0.81-2.25). Rodenticide (OR 1.42, 95% CI 0.78-2.66) and molluscicide (OR 1.22, 95% CI 0.82-1.81) exposure also presented potentially elevated childhood leukemia risks. Childhood leukemia associations with calculated fields or powerline proximity did not materially change after adjusting for pesticide exposure. Childhood leukemia risks with powerline proximity remained similar when pesticide exposures were excluded.Pesticide exposure may be an independent childhood leukemia risk factor. Childhood leukemia risks for powerline proximity and magnetic fields exposure were not explained by pesticide exposure.Copyright © 2023. Published by Elsevier Inc.