An ecological study regarding the association between paraquat exposure and end stage renal disease.

Beyond the 90th percentile exposure, the curves for the 10- and 20-year lags show a threshold response, the 15-year lag a decreasing trend in the rate (though still elevated to the no exposure level), and a continued rate increase for the 5-year lag; however, the observations beyond the 90th percentile are based on only a few counties and should be interpreted with caution.

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Subgroup analysis of low and high exposure groups suggested a positive exposure response trend that failed to reach statistical significance.

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