Incidence of solid tumours among pesticide applicators exposed to the organophosphate insecticide diazinon in the Agricultural Health Study: an updated analysis

Occup Environ Med. 2015 Jul;72(7):496-503. doi: 10.1136/oemed-2014-102728. Epub 2015 Apr 23.


Objective: Diazinon, a common organophosphate insecticide with genotoxic properties, was previously associated with lung cancer in the Agricultural Health Study (AHS) cohort, but few other epidemiological studies have examined diazinon-associated cancer risk. We used updated diazinon exposure and cancer incidence information to evaluate solid tumour risk in the AHS.

Methods: Male pesticide applicators in Iowa and North Carolina reported lifetime diazinon use at enrolment (1993-1997) and follow-up (1998-2005); cancer incidence was assessed through 2010(North Carolina)/2011(Iowa). Among applicators with usage information sufficient to evaluate exposure-response patterns, we used Poisson regression to estimate adjusted rate ratios (RRs) and 95% CI for cancer sites with ≥10 exposed cases for both lifetime (LT) exposure days and intensity-weighted (IW) lifetime exposure days (accounting for factors impacting exposure).

Results: We observed elevated lung cancer risks (N=283) among applicators with the greatest number of LT (RR=1.60; 95% CI 1.11 to 2.31; P(trend)=0.02) and IW days of diazinon use (RR=1.41; 95% CI 0.98 to 2.04; P(trend)=0.08). Kidney cancer (N=94) risks were non-significantly elevated (RR(LT) days=1.77; 95% CI 0.90 to 3.51; P(trend)=0.09; RR(IW) days 1.37; 95% CI 0.64 to 2.92; P(trend)=0.50), as were risks for aggressive prostate cancer (N=656).

Conclusions: Our updated evaluation of diazinon provides additional evidence of an association with lung cancer risk. Newly identified links to kidney cancer and associations with aggressive prostate cancer require further evaluation.

Keywords: diazinon; insecticides; neoplasms; organophosphate.

Publication types

  • Research Support, N.I.H., Intramural

MeSH terms

  • Adult
  • Agricultural Workers' Diseases / epidemiology
  • Agricultural Workers' Diseases / etiology*
  • Agriculture*
  • Diazinon / adverse effects*
  • Humans
  • Incidence
  • Iowa / epidemiology
  • Kidney Neoplasms / epidemiology
  • Kidney Neoplasms / etiology
  • Lung Neoplasms / epidemiology
  • Lung Neoplasms / etiology*
  • Male
  • Middle Aged
  • North Carolina / epidemiology
  • Occupational Exposure / adverse effects*
  • Organophosphorus Compounds / adverse effects
  • Pesticides / adverse effects*
  • Prospective Studies
  • Prostatic Neoplasms / epidemiology
  • Prostatic Neoplasms / etiology*


  • Organophosphorus Compounds
  • Pesticides
  • Diazinon