在过去的几十年里，巴西已成为世界领先的大豆生产国和世界领先的危险农药消费国。尽管已确定农药接触与致癌之间存在联系，但在巴西，关于农药集约化对更广泛人类健康的影响的人口层面研究却很少。我们利用 15 年的疾病死亡率数据估计了大豆生产扩大与相关社区接触农药与儿童癌症发病率之间的关系。我们发现，随着当地大豆生产的扩大，儿童白血病的发病率在统计上显着增加，但及时获得治疗可以缓解这种关系。我们表明，农药暴露可能是通过供水渗透发生的。我们的研究结果仅代表高投入作物生产和土地利用变化的巨大健康外部性的冰山一角。我们的研究结果对需要集约化粮食生产系统的发展环境特别感兴趣，并强调需要加强对农药的监管，并加强公共卫生对更广泛社区接触农药的关注。

Over the last several decades, Brazil has become both the world's leading soy producer and the world's leading consumer of hazardous pesticides. Despite identified links between pesticide exposure and carcinogenesis, there has been little population-level research on the effects of pesticide intensification on broader human health in Brazil. We estimate the relationship between expanded soy production-and related community exposure to pesticides-on childhood cancer incidence using 15 y of data on disease mortality. We find a statistically significant increase in pediatric leukemia following expanded local soy production, but timely access to treatment mitigates this relationship. We show that pesticide exposure likely occurs via water supply penetration. Our findings represent only the tip of the iceberg for substantial health externalities of high-input crop production and land use change. Our results are of particular interest in developing contexts with demand for intensified food production systems and underscore the need for stronger regulation of pesticides and increased public health attention to exposure in the broader community.