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Mortality in the Agricultural Health Study, 1993-2007.

Authors
Waggoner-JK; Kullman-GJ; Henneberger-PK; Umbach-DM; Blair-A; Alavanja-MCR; Kamel-F; Lynch-CF; Knott-C; London-SJ; Hines-CJ; Thomas-KW; Sandler-DP; Lubin-JH; Beane Freeman-LE; Hoppin-JA
Source
Am J Epidemiol 2011 Jan; 173(1):71-83
NIOSHTIC No.
20038238
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 (SMRapplicators = 0.54, 95% confidence interval (CI): 0.52, 0.55; SMRspouses = 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.
Keywords
Agriculture; Agricultural-workers; Farmers; Worker-health; Families; Information-retrieval-systems; Surveillance-programs; Pesticides-and-agricultural-chemicals; Mortality-data; Mortality-rates; Traumatic-injuries; Accident-statistics; Machine-operation; Motor-vehicles; Lymphatic-system; Hematopoietic-system; Cancer; Cancer-rates; Heart; Cardiovascular-disease; Neoplasms; Pesticides; Statistical-analysis; Author Keywords: agriculture; healthy worker effect; mortality; neoplasms; pesticides; wounds and injuries
Contact
Dr. Jane A. Hoppin, National Institute of Environmental Health Sciences, Epidemiology Branch, MD A3-05, P.O. Box 12233, Research Triangle Park, NC 27709-2233
CODEN
AJEPAS
Publication Date
20110101
Document Type
Journal Article
Email Address
hoppin1@niehs.nih.gov
Fiscal Year
2011
NTIS Accession No.
NTIS Price
Issue of Publication
1
ISSN
0002-9262
NIOSH Division
DRDS; DSHEFS
Priority Area
Agriculture, Forestry and Fishing
Source Name
American Journal of Epidemiology
State
WV; NC; MD; IA; OH
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