Proportionate Mortality Among Current and Former Members of the United Farm Workers of America, AFL-CIO, in California 1973-2000

摘要

Context: To further investigate mortality among farm workers, a proportionate mortality ratio (PMR) analysis was conducted among the membership of the United Farmworkers of America (UFW), a farm worker labor union, for the years 1973-2000 in the stateof California. Purpose: This report compares proportionate mortality for 118 causes of death in the UFW and the general United States population, adjusting for age, sex, race and calendar year of death. In addition, an exploratory analysis was conductedcomparing deaths in the UFW to deaths in the California Hispanic population. Methods: A roster of members of the UFW was compared to the death certificate master files of the state of California for the years 1973 to 2000. Matches were detected using automated techniques and visual review. PMR and associated confidence intervals were calculated using the National Institute for Occupational Safety and Health Life Table Analysis System using deaths in the U.S. as the standard. A similar analysis was conducted liting attention to the time period 1988-2000 and using deaths in the California Hispanic population as the standard. Findings: There were a total of 139,662 members of the union included in the linkage that yielded 3,977 deaths in the time period1973-2000. Proportionate mortality in the farm workers was significantly elevated for respiratory tuberculosis, malignant neoplasms of the stomach, biliary passages, liver and gallbladder, and uterine cervix, diabetes mellitus, cerebrovascular disease, cirrhosis of the liver, and "other diseases of the digestive system." Transportation injuries including motor vehicles deaths, deaths from machine injuries, unintentional poisonings and assault and homicide were significantly elevated as well. Farm workers were at significantly lower risk of death from TV-related disease, malignant neoplasms of the esophagus, intestine, pancreas, lung, urinary bladder, melanoma, and brain, all cancer deaths, "other diseases of the nervous system," ischemic heart disease,conductive di rder, "other diseases of the heart," emphysema, "other respiratory diseases," and symptoms and ill-defined conditions. These results were similar when using California Hispanic deaths as the standard for the years 1988-2000. There was still excess proportionate mortality from tuberculosis, cerebrovascular disease and unintentional injuries among the UFW members and lowered mortality from HIV related deaths, all cancer deaths combined and diseases of the heart. onclusions: These results include some unique findings in regard to both excess and deficits of mortality that may be explained by the Hispanic ethnicity and recent immigration of the cohort.