Environment/occupation. #49 Mortality among farmers and spouses in the agricultural health study.

摘要

PURPOSE: In the Agricultural Health Study we evaluated the mortality experience of 52,395 farmers and 32,347 of their spouses in Iowa and North Carolina obtain information on cancer and other chronic disease risks from agricultural exposures and other factors associated with rural lifestyle.METHODS: Standardized mortality ratios (SMRs) adjusted for race, gender, age, and calendar time were computed for the prospective cohort, using the general population in each state as the referent.RESULTS: After an average follow-up of 3.7 years, the SMRs for most causes of death were significantly less than 1.0. Significant deficits were observed for all causes (SMR = 0.5), all cancers combined (SMR = 0.5), and for cancers of the lung (SMR = 0.3), female genital organs (SMR = 0.4), prostate (SMR = 0.6) and bladder (SMR = 0.6), as well as diabetes (SMR = 0.3), cardiovascular disease (SMR = 0.5), and chronic obstructive pulmonary disease (SMR = 0.2). Non-significant excesses involving at least 3 deaths occurred for liver cancer (SMR = 2.1), multiple myeloma (SMR = 1.6), leukemia (SMR = 1.4), and Parkinson's disease among spouses (SMR = 2.7. Among farmers elevated SMRs were noted for Hodgkin's disease (SMR = 2.9) and cancer of the thyroid gland (SMR = 2.9), and non-motor vehicle accidents (SMR = 1.1). Soft tissue sarcoma (SMR = 1.1 for spouses; SMR = 1.6 for applicators) was elevated in both groups. NHL had an SMR of 1.0 among applicators and spouses. Stratification by presence of livestock or corn on the farm, farm size, and duration of handling pesticides revealed no obvious mortality differences.CONCLUSION: Despite a very low initial mortality experience compared to the general population, Agricultural Health Study farmers and their spouses appear to have rates for some cancers and chronic diseases that deserve continued monitoring and further scrutiny.