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Susan E. Carozza,¹ Bo Li,² Kai Elgethun,³ and Ryan Whitworth⁴

¹Department of Epidemiology and Biostatistics, School of Rural Public Health, Texas A&M Health Science Center, College Station, Texas, USA; ²National Center for Atmospheric Research, Boulder, Colorado, USA; ³Department of Community and Environmental Health, Boise State University, Boise, Idaho, USA; ⁴Centers for Health Promotion and Prevention Research, School of Public Health, University of Texas Health Science Center at Houston, Houston, Texas, USA

Abstract
Background: The potential for widespread exposure to agricultural pesticides through drift during application raises concerns about possible health effects to exposed children living in areas of high agricultural activity.

Objectives: We evaluated whether residence in a county with greater agricultural activity was associated with risk of developing cancer in children < 15 years of age.

Methods: Incidence data for U.S. children 0–14 years of age diagnosed with cancer between 1995 and 2001 were provided by member registries of the North American Association of Central Cancer Registries. We determined percent cropland for each county using agricultural census data, and used the overall study distribution to classify agriculturally intense counties. We estimated odds ratios and 95% confidence intervals for all ages and 5-year age groups for total cancers and selected cancer sites using logistic regression.

Results: Our study results showed statistically significant increased risk estimates for many types of childhood cancers associated with residence at diagnosis in counties having a moderate to high level of agricultural activity, with a remarkably consistent dose–response effect seen for counties having ≥ 60% of the total county acreage devoted to farming. Risk for different cancers varied by type of crop.

Conclusions: Although interpretation is limited by the ecologic design, in this study we were able to evaluate rarer childhood cancers across a diverse agricultural topography. The findings of this exploratory study support a continued interest in the possible impact of long-term, low-level pesticide exposure in communities located in agriculturally intense areas.

Key words: agricultural pesticides, childhood cancers, farming, pediatric cancers. Environ Health Perspect 116:559–565 (2008) . doi:10.1289/ehp.9967 available via http://dx.doi.org/ [Online 10 January 2008]

Address correspondence to S.E. Carozza, Department of Epidemiology and Biostatistics, School of Rural Public Health, 1266 Texas A&M University, College Station, TX 77843-1266 USA. Telephone: (979) 845-2387. Fax: (979) 862-8371. E-mail: scarozza@srph.tamhsc.edu

This project has been funded by the National Cancer Institute, National Institutes of Health, and the Department of Health and Human Services, under contract N02-PC-44401.

The authors declare they have no competing financial interests.

Received 8 December 2006 ; accepted 10 January 2008.