title: Mortality among participants in the agricultural health study.
abstract: OBJECTIVE
  This analysis of the Agricultural Health Study cohort assesses the mortality experience of licensed pesticide applicators and their spouses.
  
  
  METHODS
  This report is based on 52,393 private applicators (who are mostly farmers) and 32,345 spouses of farmers in Iowa and North Carolina. At enrollment, each pesticide applicator completed a 21-page enrollment questionnaire. Mortality assessment from enrollment (1994-1997) through 2000 provided an average follow-up of about 5.3 years, 447,154 person-years, and 2055 deaths.
  
  
  RESULTS
  Compared with the general population in the two states, the cohort experienced a very low mortality rate. Standardized mortality ratios (SMRs) for total mortality, cardiovascular disease, diabetes, COPD, total cancer, and cancers of the esophagus, stomach, and lung were 0.6 or lower for both farmers and spouses. These deficits varied little by farm size, type of crops or livestock on the farm, years of handling pesticides, holding a non-farm job, or length of follow up. SMRs among ever smokers were not as low as among never smokers, but were still less than 1.0 for all smoking-related causes of death. No statistically significant excesses occurred, but slightly elevated SMRs, or those near 1.0, were noted for diseases that have been associated with farming in previous studies.
  
  
  CONCLUSIONS
  Several factors may contribute to the low mortality observed in this population, including the healthy worker effect typically seen in cohorts of working populations (which may decline in future years), a short follow-up interval, and a healthier lifestyle manifested through lower cigarette use and an occupation that has traditionally required high levels of physical activity.
authors.affiliation: Division of Cancer Epidemiology and Genetics, National Cancer Institute, NIH, DHHS, Bethesda, MD, USA. blaira@mail.nih.gov
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.forename: Robert
authors.initials: R
authors.lastname: Tarone
authors.forename: Jay
authors.initials: J
authors.lastname: Lubin
authors.forename: Kent
authors.initials: K
authors.lastname: Thomas
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
authors.forename: Claudine
authors.initials: C
authors.lastname: Samanic
authors.forename: Joseph
authors.initials: J
authors.lastname: Coble
authors.forename: Freya
authors.initials: F
authors.lastname: Kamel
authors.forename: Charles
authors.initials: C
authors.lastname: Knott
authors.forename: Mustafa
authors.initials: M
authors.lastname: Dosemeci
authors.forename: Shelia Hoar
authors.initials: SH
authors.lastname: Zahm
authors.forename: Charles F
authors.initials: CF
authors.lastname: Lynch
authors.forename: Nathaniel
authors.initials: N
authors.lastname: Rothman
authors.forename: Michael C R
authors.initials: MC
authors.lastname: Alavanja
mesh_terms: D000383:Agriculture; D002423:Cause of Death; D015331:Cohort Studies; D004194:Disease / Q000145:classification*; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000145:classification / Q000453:epidemiology / Q000401:mortality*; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure; D010575:Pesticides / Q000506:poisoning*; D018454:Spouses
chemical_list: D010575:Pesticides