Pesticides and Chemicals as Potential Risk Factors of Aplastic Anemia: A Case–Control Study Among a Pakistani Population

Figures & data

Table 1 Demographic Information and Socio-Economic Status for Cases and Controls

	Cases N=191 (%)	Controls N=696 (%)
Age Categories
1–15 years	40 (20.9%)	98 (14.1%)
16–30 years	84 (44.0%)	308 (44.3%)
31–50 years	48 (25.1%)	196 (28.2%)
>50 years	19 (9.9%)	94 (13.5%)
Gender
Male	129 (67.5%)	484 (69.5%)
Female	62 (32.4%)	212 (30.4%)
Social Classes
<10,000 rupees	34 (38.2%)	144 (40.7%)
10,000–20,000 rupees	29 (32.6%)	116 (32.8%)
>20,000 rupees	26 (29.2%)	94 (26.6%)
Education Level
No education	80 (41.9%)	190 (27.3%)
10-Year education	83 (43.5%)	298 (42.8%)
12-Year education	14 (7.3%)	134 (19.3%)
14 to 16-Year education	14 (7.3%)	74 (10.6%)
Family History
No	161 (84.3%)	672 (96.5%)
Yes	30 (15.7%)	24 (3.4%)
Employment Status
Unemployed	104 (54.5%)	438 (62.9%)
Own business	45 (23.6%)	52 (7.5%)
Job in private sector	32 (16.8%)	150 (21.6%)
Job in public sector	10 (5.2%)	56 (8.0%)
Ethnic Group
Sindhi	66 (34.6%)	222 (31.9%)
Seraiki/Gujrati/Hindko	39 (20.4%)	88 (12.6%)
Urdu	30 (15.7%)	132 (19.0%)
Punjabi	22 (11.5%)	136 (19.5%)
Balochi	22 (11.5%)	64 (9.2%)
Pashtu	12 (6.3%)	54 (7.8%)

Table 2 Risk Estimates for Aplastic Anemia with Family History of Aplastic Anemia and Other Blood Cancer

	Cases (%)	Controls (%)	OR	95% Lower–Upper
Positive Family History of Aplastic Anemia
Yes	30 (15.7%)	24 (3.4%)	5.2	2.96–9.16
No	161 (84.3%)	672 (96.5%)
Aplastic Anemia Among the First-Degree Relatives
Yes	21 (11%)	21 (3%)	4	2.5–9.4
No	170 (89%)	675 (97%)
Positive History of Other Blood Cancers Among the First-Degree Relatives
Yes	10 (5.2%)	14 (2%)	3	1.3—8.3
No	181 (94.8%)	682 (98%)
Positive family History of AA and Risk of Moderate type of Aplastic Anemia (Case n=94)*
Yes	10 (11%)	6 (1%)	13.6	4.8–38.6
No	84 (89%)	690 (99%)
Positive family Historyof AA and Risk of Severe type of Aplastic Anemia (Case n=59)**
Yes	11 (19%)	6 (1%)	26.3	9.3–74.3
No	48 (81%)	690 (99%)
Positive family History of AA and Risk of Very Severe type of Aplastic Anemia (Case n=38)***
Yes	9 (24%)	6 (1%)	35.6	11.9–106
No	29 (76%)	690 (99%)

Notes: *Moderate AA. ** Severe AA. ***Very severe AA.

Table 3 Risk Estimates for Aplastic Anemia with Exposure of Pesticides (Organophosphate, Dichlorodiphenyltrichloroethane (DDT), Mosquito Repellents and Insecticide)

	Case (%)	Control (%)	OR	95% C.I Lower–Upper
Pesticide Exposure
Yes	121 (63.4%)	226 (32.5%)	3.59	2.57–5.02
No	70 (36.6%)	470 (67.5%)
<5 Years Exposure to PesticideS
Yes	75 (39.3%)	181 (26%)	1.8	1.3–2.5
No	116 (60.7%)	515 (74%)
≥5 Years Exposure to Pesticides
Yes	46 (24%)	59 (8.5%)	3.4	2.2–5.2
No	145 (76%)	637 (92.5%)
Pesticide Exposure and Risk of Moderate type of Aplastic Anemia (Case n=94)*
Yes	56 (60%)	226 (32%)	3.0	1.9–4.7
No	38 (40%)	470 (68%)
Pesticide Exposure and Risk of Severe type of Aplastic Anemia (Case n=59)**
Yes	44 (75%)	226 (32%)	6.1	3.3–11.1
No	15 (25%)	470 (68%)
Pesticide Exposure and Risk of Very Severe type of Aplastic Anemia (Case n=38)***
Yes	21 (55%)	226 (32%)	2.5	1.3–4.9
No	17 (45%)	470 (68%)

Notes: *Moderate AA. ** Severe AA. ***Very severe AA.

Table 4 Risk Estimates for Aplastic Anemia with Exposure of Chemicals (Benzene and Glycol Ether)

	Case (%)	Control (%)	OR	95% C.I Lower–Upper
Chemical Exposure
Yes	55 (28.8%)	92 (13.3%)	2.66	1.811–3.892
No	136 (71.2%)	604 (86.8%)
<5 Year Exposure to Chemicals
Yes	15 (7.8%)	36 (5.1%)	1.56	0.83–2.91
No	176 (92%)	660 (94%)
≥5 Years Exposure to Chemicals
Yes	40 (20.9%)	56 (8%)	3.0	1.94–4.71
No	151 (79.1%)	640 (92%)
Chemical Exposure and Risk of Moderate type of Aplastic Anemia (Case n=94)*
Yes	28 (30%)	92 (13%)	2.7	1.7–4.5
No	66 (70%)	604 (87%)
Chemical Exposure and Risk of Severe type of Aplastic Anemia (Case n=59)**
Yes	21 (36%)	92 (13%)	3.6	2.0–6.4
No	38 (64%)	604 (87%)
Chemical Exposure and Risk of Very Severe type of Aplastic Anemia (Case n=38)***
Yes	6 (16%)	92 (13%)	1.2	0.5–3.0
No	32 (84%)	604 (87%)

Notes: *Moderate AA. ** Severe AA. ***Very severe AA.