The Upper Midwest Health Study: A case-control study of primary intracranial gliomas in farm and rural residents

Avima M. Ruder, Martha A. Waters, Tania Carreón, Mary Ann Butler, Karen E. Davis-King, Geoffrey M. Calvert, Paul A. Schulte, Elizabeth M. Ward, L. Barbara Connally, John Lu, David Wall, Zach Zivkovich, Ellen F. Heineman, Jack S. Mandel, Roscoe F. Morton, Douglas J. Reding, Kenneth D. Rosenman, Tania Carreón Valencia, John M. Fajen, Everett LehmanA. Joan Levine, Martin Petersen, Wayne T. Sanderson, Teresa Schnorr, James Nelson, Karen Lappe, Joann Muldoon, Mary Jo Reilly, Amy Sims, Timothy Irby, Glenn Talaska, Rick Hornung, Matthew Leary, Rebecca A. Johnson, Teresa Hillmer, George Maldonado, Diane Kampa, Diana Echeverria, Nicholas Heyer

Research output: Contribution to specialist publicationArticle

48 Scopus citations


Since several studies indicated that farmers and agricultural workers had an excess risk of brain cancer, the National Institute for Occupational Safety and Health initiated the Upper Midwest Health Study to examine risk of intracranial glioma in the non-metropolitan population. This population-based, case-control study evaluated associations between gliomas and rural and farm exposures among adults (ages 18 to 80) in four upper midwestern states (Iowa, Michigan, Minnesota, Wisconsin). At diagnosis/selection, participants lived in non-metropolitan counties where the largest population center had fewer than 250,000 residents. Cases were diagnosed 1 January 1995 through 31 January 1997. Over 90% of 873 eligible ascertained cases and over 70% of 1670 eligible controls consented to participate. Participants and nonparticipants, evaluated for "critical questions" on main and refusant questionnaires, differed significantly in farming and occupational experience, ethnicity, education, and lifestyle. The 1175 controls were more likely than the 798 cases to have reported ever drinking alcohol (77% vs. 73%, adjusted odds ratio (OR) 0.73, 95% confidence interval (CI) 0.59-0.92) and having had panoramic dental x-rays (34% vs. 29%, OR 0.75, CI 0.61-0.92). Controls spent a greater percentage of their lives in non-metropolitan counties (78% vs. 75%, OR 0.81, CI 0.67-1.09). Among ever-farmers, controls were more likely to have had exposure to farm insecticides (57% vs. 50%, OR 0.75, CI 0.59-0.95) and farm animals (96% vs. 91%, OR 0.48, CI 0.25-0.90). Moving to a farm as an adolescent (ages 11 to 20) vs. as an adult was associated with a greater risk of glioma (OR 1.96, CI 1.13-3.39). In our study sample, farm or rural residence and summary farm exposures were associated with decreased glioma risk. However, nonparticipation by never-farming eligible controls could have affected results. Comparisons of farm chemical exposures may clarify associations between farming and glioma that others have reported.

Original languageEnglish (US)
Number of pages20
Specialist publicationJournal of Agricultural Safety and Health
StatePublished - Nov 2006


  • Agricultural workers
  • Agriculture
  • Agrochemicals
  • Case-control study
  • Glioma
  • Proxy
  • Study design


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