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MORTALITY AMONG PARTICIPANTS IN THE AGRICULTURAL HEALTH STUDY
Citation:
Blair, A., D. P. Sandler, R. Tarone, J. Lubin, K W. Thomas, J. A. Hoppin, C. Samanic, J. Coble, F. Kamel, C. Knott, M. Dosemeci, S. H. Zahm, C. Lynch, N. Rothman, AND M. Alavanja. MORTALITY AMONG PARTICIPANTS IN THE AGRICULTURAL HEALTH STUDY. ANNALS OF EPIDEMIOLOGY. Elsevier Science Ltd, New York, NY, 15(4):279-285, (2004).
Impact/Purpose:
The primary goal of the AHS Pesticide Exposure Study (AHS/PES) is to measure exposure to applied pesticides for a subset of the cohort of private pesticide applicators and to provide data to evaluate exposure algorithms developed for exposure classification in the study cohort.
Description:
Purpose: This analysis of the Agricultural Health Study cohort assesses the mortality experience of licensed pesticide applicators and their spouses.
Methods: This report is based on 52,393 private applicators (who are mostly farmers) and 32,345 spouses of farmers in Iowa and North Carolina. At enrollment, each pesticide applicator completed a 21-page enrollment questionnaire. Mortality assessment from enrollment (1994 to 1997) through 2000 provided an average follow-up of about 5.3 years, 447,154 person-years, and 2,055 deaths.
Results: Compared to the general population in the two states, the cohort experienced a very low mortality rate. Standardized mortality ratios (SMRs) for total mortality, cardiovascular disease, diabetes, COPD, total cancer, and cancers of the esophagus, stomach, and lung were 0.6 or lower for both farmers and spouses. These deficits varied little by farm size, type of crops or livestock on the farm, years of handling pesticides, holding a non-farm job, or length of follow up. SMRs among ever smokers were not as low as among never smokers, but were still less than 1.0 for all smoking-related causes of death. No statistically significant excesses occurred, but slightly elevated SMRs, or those near 1.0, were noted for diseases that have been associated with farming in previous studies.
Conclusions: Several factors may contribute to the low mortality observed in this population, including the healthy worker effect typically seen in cohorts of working populations (which may decline in future years), a short follow-up interval and a healthier lifestyle manifested through lower cigarette use and an occupation that has traditionally required high levels of physical activity.
The United States Environmental Protection Agency through its Office of Research and Development partially funded and collaborated in the research described here under Contracts 68-D99-011 to Battelle Memorial Institute and 68-D99-012 to RTI International; and by Interagency Agreement DW-75-93912801-0 to the National Cancer Institute. It has been subjected to Agency review and approved for publication.