Mortality among aerial pesticide applicators and flight instructors: Follow-up from 1965-1988

Background Vital status followup for a retrospective cohort mortality study of 9,961 male aerial pesticide applicators was extended beyond a previous study (1965-1979) (Cantor et al. 1991), through December 31, 1988. Methods Rate ratios (RR) were used to compare directly adjusted mortality r ates between applicators and a comparison cohort of 9,969 flight instructor s. Standardized mortality ratios (SMR) were calculated for comparisons with the U.S. white male population. Results Among applicator pilots, there were 1,441 deaths, and among instruc tors, 1,045. In both groups, aircraft accidents were the major cause of dea th (446 applicators; 234 instructors). Compared with flight instructors, ae rial applicator pilots were at significantly elevated risk for all causes o f death (risk ratio = 1.34) and for malignant neoplasms (1.18), non-motor v ehicle accidents (1.71), motor vehicle accidents (1.69), and stroke (1.91), Pancreatic cancer (2.71) and leukemia (3.35) were significantly elevated. Applicators were at lower risk of colon cancer (0.51) and multiple myeloma (0.23) mortality Based on U.S. rates, the SMR for an causes of death among applicators was 111 (95% confidence interval (CI) = 105-117) and among inst ructors, 81 (CI = 76-85), Conclusions Aircraft accidents were a major cause of mortality in both appl icator and flight instructor cohorts. Several other causes of death, some p ossibly related to pesticide exposure, were also elevated among pesticide a pplicator pilots. Am. J. Ind, Med, 36: 239-247, 1999, Published 1999 Wiley- Liss, Inc.dagger