title: Occupation and environmental heat-associated deaths in Maricopa county, Arizona: a case-control study.
abstract: BACKGROUND
  Prior research shows that work in agriculture and construction/extraction occupations increases the risk of environmental heat-associated death.
  
  
  OBJECTIVE
  To assess the risk of environmental heat-associated death by occupation.
  
  
  METHODS
  This was a case-control study. Cases were heat-caused and heat-related deaths occurring from May-October during the period 2002-2009 in Maricopa County, Arizona. Controls were selected at random from non-heat-associated deaths during the same period in Maricopa County. Information on occupation, age, sex, and race-ethnicity was obtained from death certificates. Logistic regression analysis was used to estimate odds ratios for heat-associated death.
  
  
  RESULTS
  There were 444 cases of heat-associated deaths in adults (18+ years) and 925 adult controls. Of heat-associated deaths, 332 (75%) occurred in men; a construction/extraction or agriculture occupation was described on the death certificate in 115 (35%) of these men. In men, the age-adjusted odds ratios for heat-associated death were 2.32 (95% confidence interval 1.55, 3.48) in association with construction/extraction and 3.50 (95% confidence interval 1.94, 6.32) in association with agriculture occupations. The odds ratio for heat-associated death was 10.17 (95% confidence interval 5.38, 19.23) in men with unknown occupation. In women, the age-adjusted odds ratio for heat-associated death was 6.32 (95% confidence interval 1.48, 27.08) in association with unknown occupation. Men age 65 years and older in agriculture occupations were at especially high risk of heat-associated death.
  
  
  CONCLUSIONS
  The occurrence of environmental heat-associated death in men in agriculture and construction/extraction occupations in a setting with predictable periods of high summer temperatures presents opportunities for prevention.
authors.affiliation: Department of Biomedical Informatics, Arizona State University, Tempe, Arizona, USA. Diana.Petitti@yahoo.com
authors.forename: Diana B
authors.initials: DB
authors.lastname: Petitti
authors.forename: Sharon L
authors.initials: SL
authors.lastname: Harlan
authors.forename: Gerardo
authors.initials: G
authors.lastname: Chowell-Puente
authors.forename: Darren
authors.initials: D
authors.lastname: Ruddell
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000383:Agriculture; D001130:Arizona / Q000453:epidemiology; D016022:Case-Control Studies; D002423:Cause of Death; D060389:Construction Industry; D003644:Death Certificates; D004777:Environment; D005260:Female; D006358:Hot Temperature / Q000009:adverse effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016273:Occupational Exposure / Q000009:adverse effects*; D009790:Occupations; D011634:Public Health / Q000706:statistics & numerical data; D062486:Public Health Surveillance / Q000379:methods; D012044:Regression Analysis; D012307:Risk Factors; D012621:Seasons; D055815:Young Adult