title: Suicide mortality among agricultural workers in a region with intensive tobacco farming and use of pesticides in Brazil.
abstract: OBJECTIVE
  To investigate whether suicide risk among agricultural workers is higher in regions with heavier pesticide use and/or presence of tobacco farming.
  
  
  METHODS
  Suicide mortality data were gathered from residents of the Brazilian state of Alagoas. Agricultural census data were used to arrange and classify Alagoas cities into distribution groups on the basis of variables concerning pesticide use and/or tobacco farming. Mortality odds ratio calculations were then used to compare suicide risk among agricultural and nonagricultural workers in different groups.
  
  
  RESULTS
  Suicide risk was higher among agricultural workers than among nonagricultural workers, elevated in regions that used more pesticides, and greatest in regions that produced more tobacco.
  
  
  CONCLUSIONS
  This is one of the first studies of its kind to suggest that combined effects of pesticide and tobacco exposure may be linked to higher suicide risk among agricultural workers.
authors.affiliation: From the Department of Preventative Medicine (Ms Krawczyk and Ms Fonseca), Icahn School of Medicine at Mount Sinai, New York, NY; Institute for Studies in Collective Health (Dr Meyer), Universidade Federal do Rio de Janeiro; and Department of Biochemistry (Dr Lima), Universidade Federal do Estado do Rio de Janeiro, RJ, Brazil.
authors.forename: Noa
authors.initials: N
authors.lastname: Krawczyk
authors.forename: Armando
authors.initials: A
authors.lastname: Meyer
authors.forename: Maíra
authors.initials: M
authors.lastname: Fonseca
authors.forename: Jaime
authors.initials: J
authors.lastname: Lima
mesh_terms: D000383:Agriculture; D001938:Brazil / Q000453:epidemiology; D005260:Female; D006801:Humans; D008297:Male; D010575:Pesticides / Q000009:adverse effects*; D018570:Risk Assessment; D013405:Suicide / Q000706:statistics & numerical data*; D014026:Nicotiana / Q000009:adverse effects*
chemical_list: D010575:Pesticides