TY - JOUR T1 - The effect of occupational pesticide exposure on lung function: A systematic review with meta-analysis JF - European Respiratory Journal JO - Eur Respir J VL - 44 IS - Suppl 58 SP - P1117 AU - Thomas Sanctuary AU - Cosetta Minelli AU - Andre Amaral AU - Peter Burney Y1 - 2014/09/01 UR - http://erj.ersjournals.com/content/44/Suppl_58/P1117.abstract N2 - Exposure to pesticides has been associated with low lung function. We conducted a systematic review and meta-analysis to summarise evidence currently available on the effect of occupational pesticide exposure on spirometryMethods: Through electronic searches of MEDLINE, Embase and Web of Science we identified 28 papers, reporting on non-specific pesticide exposure, organophosphates or paraquat. Of these, we meta-analysed 14 studies with results available for FVC and FEV1, 13 for FEV1/FVC, 10 for FEF25-75 and fewer for other measures. As spirometry outcomes were reported in different ways, we performed meta-analyses on standardised mean differences between exposed and non-exposed subjectsResults: Pesticide exposure had a negative effect on all spirometry measures, but there was extreme heterogeneity across studies. A reason for heterogeneity was differences in the definition of exposure, with lower effect estimates from studies on subjects exposed to lower pesticide levels, or using cruder definitions of exposure with higher measurement error, as one might expect. The type of pesticides evaluated also explained some heterogeneity, with stronger and more consistent effects for organophosphates, in particularly on FEV1, compared with paraquat or non-specific pesticide exposureSummary: Overall there is evidence of a negative effect of occupational pesticide exposure on lung function, with stronger effects for organophosphates. It is difficult to draw firm conclusions on the magnitude of these effects due to the large heterogeneity of findings between studies, which was partly explained by differences in exposure level and type, as well as accuracy in the definition of the exposure. ER -