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Blood, 18 June 2009, Vol. 113, No. 25, pp. 6386-6391.
Prepublished online as a Blood First Edition Paper on April 22, 2009; DOI 10.1182/blood-2009-02-203471.


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Submitted February 3, 2009
Accepted April 16, 2009

Pesticide exposure and risk of monoclonal gammopathy of undetermined significance (MGUS) in the Agricultural Health Study

Ola Landgren*, Robert A. Kyle, Jane A. Hoppin, Laura E. Beane Freeman, James R. Cerhan, Jerry A. Katzmann, S. Vincent Rajkumar, and Michael C. Alavanja

Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, Bethesda, MD, United States
College of Medicine, Mayo Clinic, Rochester, MN, United States
National Institute of Environmental Health Sciences, NIH, Research Triangle Park, NC, United States

* Corresponding author; email: landgreo{at}mail.nih.gov.

Pesticides have been associated with excess risk of multiple myeloma (MM), albeit inconclusively. We included 678 men (30-94 years) from a well-characterized prospective cohort of restricted use pesticide applicators to assess the risk of monoclonal gammopathy of undetermined significance (MGUS). Serum samples from all subjects were analyzed by electrophoresis performed on agarose gel; samples with a discrete or localized band were subjected to immunofixation. Age-adjusted prevalence estimates of MGUS were compared with MGUS prevalence in 9,469 men from Minnesota. Associations between pesticide exposures and MGUS prevalence were assessed by logistic regression models adjusted for age and education level. Among study participants >50 years (n=555), 38 were found to have MGUS, yielding a prevalence of 6.8% (5.0-9.3). Compared with men from Minnesota, the age-adjusted prevalence of MGUS was 1.9-fold (1.3-2.7) higher among male pesticide applicators. Among applicators, a 5.6-fold (1.9-16.6), 3.9-fold (1.5-10.0), and 2.4-fold (1.1-5.3) increased risk of MGUS was observed among users of the chlorinated insecticide dieldrin, the fumigant mixture carbon-tetrachloride/carbon disulfide, and the fungicide chlorothalonil, respectively. In summary, the prevalence of MGUS among pesticide applicators was twice that in a population-based sample of men from Minnesota, adding support to the hypothesis that specific pesticides are etiologically linked to myelomagenesis.


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R. A. Kyle and S. Kumar
The significance of monoclonal gammopathy of undetermined significance
Haematologica, December 1, 2009; 94(12): 1641 - 1644.
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