Mortality in a cohort of licenced pesticide applicators in Florida

Objectives-Although the primary hazard to humans associated with pesticide exposure is acute poisoning, there has been considerable concern surroundin g the possibility of cancer and other chronic health effects in humans. Giv en the huge volume of pesticides now used throughout the world, as well as environmental and food residue contamination leading to chronic low level e xposure, the study of possible chronic human health effects is important. Methods-This was a retrospective cohort study, analysed by general standard ised mortality ratio (SMR) of licenced pesticide applicators in Florida com pared with the general population of Florida. A cohort of 33 658 (10% femal e) licenced pesticide applicators assembled through extensive data linkages yielded 1874 deaths with 320 250 person-years from 1 January 1975 to 31 De cember 1993. Results-The pesticide applicators were consistently and significantly healt hier than the general population of Florida. As with many occupational coho rts, the risks of cardiovascular disease and of diseases associated with al cohol and tobacco use were significantly lower, even in the subpopulations- for example, men, women, and licence subcategories. Among male applicators, prostate cancer mortality (SMR 2.38 (95% confidence interval (95% CI) 1.83 to 3.04)) was significantly increased. No cases of soft tissue sarcoma wer e confirmed in this cohort, and non-Hodgkin's lymphoma was not increased. T he number of female applicators was small, as were the numbers of deaths. M ortality from cervical cancer and breast cancer was not increased. Addition al subcohort and exposure analyses were performed. Conclusions-Consistent with previous publications on farmers but at odds wi th current theories about the protective effects of vitamin D, prostate can cer was increased in these pesticide applicators. Female breast cancer was not increased despite theories linking risk of breast cancer with exposure to oestrogen disrupters-such as the organochlorines. The lack of cases of s oft tissue sarcoma is at odds with previous publications associating the us e of the phenoxy herbicides with an increased risk of these cancers.