高农药暴露事件与自我报告及测量的嗅觉功能障碍
High Pesticide Exposure Events and Self-Reported and Measured Olfactory Dysfunction.
文献信息
| PMID | 42720923 |
|---|---|
| 原文 | 在 PubMed 查看原文 ↗ |
| 发表日期 | 2026 |
| 作者 | Shengfang Song |
| 作者单位 | Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing. |
| 期刊 | JAMA otolaryngology-- head & neck surgery |
| SCI 分区 | Q1 |
| IF | 7.3 |
| 研究类型 | 临床研究 · 临床 |
| 所属专科 | 鼻科 |
中文摘要
重要性： 农药暴露可能导致成人嗅觉功能障碍，但实证证据有限。
目的： 探讨高农药暴露事件与农民嗅觉功能障碍之间的关联。
设计、设置和参与者： 本调查性研究使用了农业健康研究（AHS）的一个亚队列——农药与嗅觉（PASS）研究的数据，该研究于2020年1月至2021年10月进行。参与者包括来自爱荷华州和北卡罗来纳州的农民，他们在2019年6月时仍存活，并且在AHS第4阶段调查中报告了嗅觉功能障碍，或者从报告嗅觉正常的农民中随机抽样。统计分析于2023年8月至2025年12月进行。
暴露： 在PASS研究和AHS第1至3阶段调查中自我报告的高农药暴露事件。
主要结局和测量指标： 主要结局是嗅觉功能障碍，首先通过自我报告，然后使用12项简要气味识别测试进行测量（定义为得分≤8）。为了将PASS研究结果外推到目标人群，构建了逆概率权重以考虑死亡和研究不参与。
结果： 本分析纳入了完成研究活动（包括调查和气味识别测试）的4629名农民中的2545名（55.0%）（平均[标准差]年龄，70.3[9.6]岁；2467[96.9%]为男性）。在有高农药暴露事件史的农民中，自我报告嗅觉功能障碍的加权患病率为21.2%（95%置信区间，18.1%-24.3%），而在无高农药暴露事件史的农民中为15.1%（95%置信区间，12.9%-17.3%），对应的相对风险（RR）为1.30（95%置信区间，1.04-1.62）。暴露与气味测试识别的嗅觉功能障碍无关（RR，0.97；95%置信区间，0.83-1.15），也与农民感知的测试体验无关，包括报告在识别气味物质方面有较大困难（RR，0.94；95%置信区间，0.78-1.13）和报告气味物质微弱（RR，1.01；95%置信区间，0.78-1.30）。当使用来自先前AHS调查的暴露数据时，结果相似。
结论和意义： 本调查性研究发现，高农药暴露事件与农民主观报告的嗅觉丧失有关，但与其测量的气味识别无关。这些发现强调了在流行病学研究中纳入客观和主观嗅觉测量的重要性。
英文摘要
IMPORTANCE: Pesticide exposure may contribute to olfactory dysfunction in adults, but empirical evidence is limited.
OBJECTIVES: To examine the association between high pesticide exposure events and olfactory dysfunction in farmers.
DESIGN, SETTING, AND PARTICIPANTS: This survey study used data from a subcohort of the Agricultural Health Study (AHS), the Pesticide and Sense of Smell (PASS) Study, conducted from January 2020 to October 2021. Participants included farmers from Iowa and North Carolina, were alive as of June 2019, and either reported olfactory dysfunction in the AHS phase 4 survey or were randomly sampled from those reporting normal olfaction. Statistical analysis was conducted from August 2023 to December 2025.
EXPOSURE: High pesticide exposure events self-reported in the PASS Study and the AHS phase 1 through 3 surveys.
MAIN OUTCOMES AND MEASURES: The main outcome was olfactory dysfunction first self-reported and then measured using the 12-item Brief Smell Identification Test (defined as a score ≤8). To extrapolate PASS Study findings to the target population, inverse probability weights were constructed to account for death and study nonparticipation.
RESULTS: This analysis included 2545 of 4629 farmers (55.0%) who completed the study activities, including a survey and a smell identification test (mean [SD] age, 70.3 [9.6] years; 2467 [96.9%] male). The weighted prevalence of self-reported olfactory dysfunction was 21.2% (95% CI, 18.1%-24.3%) among farmers with a history of HPEEs and 15.1% (95% CI, 12.9%-17.3%) among those without, corresponding to a relative risk (RR) of 1.30 (95% CI, 1.04-1.62). The exposure was not associated with olfactory dysfunction identified from the smell test (RR, 0.97; 95% CI, 0.83-1.15) or with the farmers' perceived testing experience, including reporting substantial difficulty in identifying odorants (RR, 0.94; 95% CI, 0.78-1.13) and reporting the odorants as weak (RR, 1.01; 95% CI, 0.78-1.30). Results were similar when using exposure data from previous AHS surveys.
CONCLUSIONS AND RELEVANCE: This survey study found that HPEEs were associated with subjective reports of olfactory loss among farmers but not with their measured smell identification. These findings underscore the importance of incorporating both objective and subjective measures of olfaction in epidemiologic research.