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Occup Environ Med. 2019 Sep;76(9):632-643. doi: 10.1136/oemed-2019-105724.

Overall and cause-specific mortality in a cohort of farmers and their spouses.

Author information

1
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.
2
Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina, USA.
3
Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA.
4
Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA.
5
Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA.
6
Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA.
7
Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA sandler@niehs.nih.gov.

Abstract

OBJECTIVES:

Lower mortality rates compared with the general population have been reported for Agricultural Health Study (AHS) participants (enrolled 1993-1997) followed through 2007. We extended analysis of mortality among AHS participants (51 502 private pesticide applicators, their 31 867 spouses and 4677 commercial pesticide applicators from North Carolina and Iowa) through 2015 and compared results using several analytical approaches.

METHODS:

We calculated standardised mortality ratios (SMRs), causal mortality ratios (CMR) and relative SMRs (rSMR) using state-specific mortality rates of the general populations as the referent.

RESULTS:

Over the average 16 years of follow-up (1999-2015), 9305 private applicators, 3384 spouses and 415 commercial applicators died. SMRs and CMRs, with expected deaths calculated using the person-time among the cohort and the general population, respectively, indicated lower overall mortality in all study subgroups (SMRs from 0.61 to 0.69 and CMRs from 0.74 to 0.89), although CMRs indicated elevated mortality in private applicators from North Carolina and in ever-smokers. In SMR analyses, there were fewer than expected deaths from many causes, but deaths from some external causes including transportation-related injuries and mechanical forces were elevated in private applicators. CMRs indicated higher than expected deaths from prostate cancer, lymphohaematopoietic cancers, Parkinson's and Alzheimer's disease, and chronic glomerulonephritis in private applicators, and non-Hodgkin's lymphoma in spouses (from 1.19 to 1.53). rSMR results were generally elevated, similar to CMR findings.

CONCLUSIONS:

AHS participants experienced lower overall mortality than the general population.Mortality from a few specific causes was increased in private applicators, specifically when CMR and rSMR approaches were used.

KEYWORDS:

Agricultural Health Study; causal mortality ratio; farmers; relative standardised mortality ratio; standardised mortality ratio

PMID:
31413186
DOI:
10.1136/oemed-2019-105724

Conflict of interest statement

Competing interests: None declared.

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