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Selection bias in case–control studies on household exposure to pesticides and childhood acute leukemia

Journal of Exposure Science & Environmental Epidemiology volume 20, pages 299–309 (2010)Cite this article

Abstract

The goal of this study was to investigate the potential for selection bias in published case–control studies on household exposure to pesticides and childhood acute leukemia; most studies have reported positive findings. Items to evaluate the potential for selection bias were first developed. They focused on the source populations that gave rise to cases and controls, the probabilistic selection of subjects from the source, and the losses of the subjects actually selected. A quantitative assessment of bias was also carried out. Potential sources of selection bias were found in all the studies, but none of them were observed across all the studies. Main sources of potential bias were a non-concurrent selection of controls with respect to cases, the use of control diagnoses possibly caused by pesticide exposure in hospital-based studies, and non-participation of selected eligible subjects. A quantitative assessment of bias concluded that non-participation alone could not explain the reported positive associations. We conclude that overall, selection bias, as a likely source of bias in these studies, does not seem to explain their positive findings. Our analysis provides arguments strengthening the conclusions on associations reported in earlier studies.

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Acknowledgements

This work was supported by a grant from the Association pour la Recherche sur le Cancer (ARC) and was partially carried out while Jérémie Rudant was on post-doctoral training with Claire Infante-Rivard in the Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Canada.

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Authors and Affiliations

  1. Department of Epidemiology, Biostatistics and Occupational Health, Faculty of Medicine, McGill University, Montréal, H3A 1A3, Québec, Canada

    Jérémie Rudant & Claire Infante-Rivard

  2. Univ Paris-Sud, UMR-S754, INSERM, IFR69, Villejuif Cedex, France

    Jérémie Rudant & Jacqueline Clavel

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  1. Jérémie Rudant
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Correspondence to Jérémie Rudant.

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Appendix 1. Calculation of the prevalence of exposure among all the eligible controls who were selected (the method is similar for the cases).

Appendix 1. Calculation of the prevalence of exposure among all the eligible controls who were selected (the method is similar for the cases).

Let PRControls denotes the participation rate in controls, PEPartControls the prevalence of exposure in participating controls, PENPartControls the prevalence of exposure in non-participating controls, PEControls the prevalence of exposure among all the eligible controls who were selected and ORExpPartControls the odds ratio for association between household exposure to pesticides and participation status in controls.

PENPartControls is related to PEPartControls and ORExpPartControls by

ORExpPartControls=[PEPartControls * (1−PENPartControls)]/[(1−PEPartControls) * PENPartControls]

and hence, PENPartControls=1/[1+(ORExpPartControls * (1−PEPartControls)/PEPartControls)]

Then, PEControls is obtained by the following equation:

PEControls=PEPartControls * PRControls+PENPartControls *(1−PRControls)

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Rudant, J., Clavel, J. & Infante-Rivard, C. Selection bias in case–control studies on household exposure to pesticides and childhood acute leukemia. J Expo Sci Environ Epidemiol 20, 299–309 (2010). https://doi.org/10.1038/jes.2009.61

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