PT  - JOURNAL ARTICLE
AU  - Jate Ratanachina
AU  - Sara De Matteis
AU  - Paul Cullinan
AU  - Peter Burney
TI  - Pesticide exposure and lung function: a systematic review and meta-analysis
AID  - 10.1183/13993003.congress-2019.PA5244
DP  - 2019 Sep 28
TA  - European Respiratory Journal
PG  - PA5244
VI  - 54
IP  - suppl 63
4099  - http://erj.ersjournals.com/content/54/suppl_63/PA5244.short
4100  - http://erj.ersjournals.com/content/54/suppl_63/PA5244.full
SO  - Eur Respir J2019 Sep 28; 54
AB  - Epidemiological studies have reported associations between pesticide exposure and respiratory health, but the specific causal agents and the quantitative impact on lung function are unclear. To address this, we undertook a systematic review of the available literature reporting on pesticide exposures and lung function.Aim: To examine, systematically and by meta-analysis, available literature on the relationship between pesticide exposures and lung function.Methods: MEDLINE, EMBASE, and Web of Science electronic databases were searched to 1 October 2017. We searched by a combination of MeSH terms and free text for pesticide exposures and lung function using our protocol registered in PROSPERO. We assessed the quality of the reports using a modified Newcastle-Ottawa scale. We converted outcome measures to standard mean differences (SMD) and undertook meta-analyses by the metan command in Stata 15 with fixed-effect models where I² from test for heterogeneity<50%.Results: We retrieved 2,356 articles; of these, 56 met our criteria for inclusion and review; 19, 22 and 22 papers were pooled in meta-analyses of FEV1/FVC, FVC and FEV1 respectively. We found no effect for paraquat exposure on FEV1/FVC (SMD=0.05; 95%CI 0.04, 0.15). Cholinesterase (ChE) inhibiting pesticides showed a significant negative effect on FEV1/FVC (SMD=-0.27; 95%CI -0.39, -0.14).Conclusion: Respiratory surveillance should be enhanced in those exposed to ChE-inhibiting pesticides which reduce FEV1/FVC according to the meta-analysis. Our review is limited by heterogeneity between studies from variable exposure assessments and limited adjustment for potential confounders. Further studies with more accurate exposure assessment are indicated.FootnotesCite this article as: European Respiratory Journal 2019; 54: Suppl. 63, PA5244.This is an ERS International Congress abstract. No full-text version is available. Further material to accompany this abstract may be available at www.ers-education.org (ERS member access only).