The association between household pesticide exposure and anemia is modified by dietary selenium intake: a population-based study

BACKGROUND: While the detrimental health effects of occupational pesticide exposure are well-documented, the association between household pesticide use and anemia in the general adult population remains underexplored. Furthermore, the potential for dietary factors, such as selenium, to modulate this relationship is unknown. METHODS: We conducted a cross-sectional analysis using data from 14,708 adults (≥18 years) who participated in the National Health and Nutrition Examination Survey (NHANES) from 2013 to 2018. Household pesticide exposure was self-reported. Anemia was defined according to World Health Organization criteria (hemoglobin <13 g/dL for men, <12 g/dL for women). Dietary selenium intake was categorized as low (<125 µg/day) or high (≥125 µg/day). Multivariable logistic regression models were used to evaluate the association between pesticide exposure and anemia. The modifying effect of selenium was assessed using an interaction term and stratified analyses. RESULTS: = 0.032). Among participants with low selenium intake, pesticide exposure increased anemia risk (OR = 1.31; 95% CI: 1.06-1.61), whereas no association was found in the high selenium group (OR = 0.74; 95% CI: 0.49-1.11). CONCLUSION: This study provides novel evidence that household pesticide exposure is associated with a modestly increased prevalence of anemia in the general U.S. adult population. Furthermore, our findings suggest that adequate dietary selenium intake may mitigate this hematological risk.