title: Mortality in the agricultural health study, 1993-2007.
abstract: Comparing agricultural cohorts with the general population is challenging because the general healthiness of farmers may mask potential adverse health effects of farming. Using data from the Agricultural Health Study, a cohort of 89,656 pesticide applicators and their spouses (N = 89, 656) in North Carolina and Iowa, the authors computed standardized mortality ratios (SMRs) comparing deaths from time of the enrollment (1993-1997) through 2007 to state-specific rates. To compensate for the cohort's overall healthiness, relative SMRs were estimated by calculating the SMR for each cause relative to the SMR for all other causes. In 1,198,129 person-years of follow-up, 6,419 deaths were observed. The all-cause mortality rate was less than expected (SMR(applicators) = 0.54, 95% confidence interval (CI): 0.52, 0.55; SMR(spouses) = 0.52, 95% CI: 0.50, 0.55). SMRs for all cancers, heart disease, and diabetes were significantly below 1.0. In contrast, applicators experienced elevated numbers of machine-related deaths (SMR = 4.15, 95% CI: 3.18, 5.31), motor vehicle nontraffic accidents (SMR = 2.80, 95% CI: 1.81, 4.14), and collisions with objects (SMR = 2.12, 95% CI: 1.25, 3.34). In the relative SMR analysis for applicators, the relative mortality ratio was elevated for lymphohematopoietic cancers, melanoma, and digestive system, prostate, kidney, and brain cancers. Among spouses, relative SMRs exceeded 1.0 for lymphohematopoietic cancers and malignancies of the digestive system, brain, breast, and ovary. Unintentional fatal injuries remain an important risk for farmers; mortality ratios from several cancers were elevated relative to other causes.
authors.affiliation: Division of Respiratory Disease Studies, National Institute for Occupational Safety and Health, Morgantown, West Virginia, USA.
authors.forename: Jenna K
authors.initials: JK
authors.lastname: Waggoner
authors.forename: Greg J
authors.initials: GJ
authors.lastname: Kullman
authors.forename: Paul K
authors.initials: PK
authors.lastname: Henneberger
authors.forename: David M
authors.initials: DM
authors.lastname: Umbach
authors.forename: Aaron
authors.initials: A
authors.lastname: Blair
authors.forename: Michael C R
authors.initials: MC
authors.lastname: Alavanja
authors.forename: Freya
authors.initials: F
authors.lastname: Kamel
authors.forename: Charles F
authors.initials: CF
authors.lastname: Lynch
authors.forename: Charles
authors.initials: C
authors.lastname: Knott
authors.forename: Stephanie J
authors.initials: SJ
authors.lastname: London
authors.forename: Cynthia J
authors.initials: CJ
authors.lastname: Hines
authors.forename: Kent W
authors.initials: KW
authors.lastname: Thomas
authors.forename: Dale P
authors.initials: DP
authors.lastname: Sandler
authors.forename: Jay H
authors.initials: JH
authors.lastname: Lubin
authors.forename: Laura E
authors.initials: LE
authors.lastname: Beane Freeman
authors.forename: Jane A
authors.initials: JA
authors.lastname: Hoppin
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000382:Agricultural Workers' Diseases / Q000401:mortality*; D002423:Cause of Death / Q000639:trends; D005260:Female; D006801:Humans; D007484:Iowa / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D009657:North Carolina / Q000453:epidemiology; D016273:Occupational Exposure / Q000009:adverse effects*; D010575:Pesticides / Q000009:adverse effects*; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends
chemical_list: D010575:Pesticides