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

Srishti Shrestha; Christine G Parks; Alexander P Keil; David M Umbach; Catherine C Lerro; Charles F Lynch; Honglei Chen; Aaron Blair; Stella Koutros; Jonathan N Hofmann; Laura E Beane Freeman; Dale P Sandler

doi:10.1136/oemed-2019-105724

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

Journal article

Peer reviewed

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

Srishti Shrestha, Christine G Parks, Alexander P Keil, David M Umbach, Catherine C Lerro, Charles F Lynch, Honglei Chen, Aaron Blair, Stella Koutros, Jonathan N Hofmann, …

Occupational and environmental medicine (London, England), Vol.76(9), pp.632-643

09/2019

DOI: 10.1136/oemed-2019-105724

PMCID: PMC7803095

PMID: 31413186

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https://www.ncbi.nlm.nih.gov/pmc/articles/7803095View

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Abstract

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. 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. 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. 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.

Adolescent

Adult

Aged

Aged, 80 and over

Agricultural Workers' Diseases - mortality

Farmers

Female

Humans

Iowa - epidemiology

Male

Middle Aged

Mortality

North Carolina - epidemiology

Occupational Exposure - adverse effects

Occupational Health

Pesticides - adverse effects

Spouses

Surveys and Questionnaires

Survival Rate - trends

Young Adult

Details

Title: Subtitle: Overall and cause-specific mortality in a cohort of farmers and their spouses
Creators: Srishti Shrestha - Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
Christine G Parks - Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
Alexander P Keil - Department of Epidemiology, University of North Carolina School of Public Health, Chapel Hill, North Carolina, USA
David M Umbach - Biostatistics and Computational Biology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA
Catherine C Lerro - Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
Charles F Lynch - Department of Epidemiology, University of Iowa College of Public Health, Iowa City, Iowa, USA
Honglei Chen - Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, East Lansing, Michigan, USA
Aaron Blair - Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
Stella Koutros - Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
Jonathan N Hofmann - Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
Laura E Beane Freeman - Occupational and Environmental Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, Maryland, USA
Dale P Sandler - Epidemiology Branch, National Institute of Environmental Health Sciences, Research Triangle Park, North Carolina, USA sandler@niehs.nih.gov
Resource Type: Journal article
Publication Details: Occupational and environmental medicine (London, England), Vol.76(9), pp.632-643
DOI: 10.1136/oemed-2019-105724
PMID: 31413186
PMCID: PMC7803095
NLM abbreviation: Occup Environ Med
ISSN: 1351-0711
eISSN: 1470-7926
Grant note: Z01 CP010119 / Intramural NIH HHS Z01 ES049030 / NIEHS NIH HHS Z01 CP010119 / NCI NIH HHS Z01 ES049030 / Intramural NIH HHS
Language: English
Date published: 09/2019
Academic Unit: Epidemiology
Record Identifier: 9984214836502771

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