Occupational mortality from inflammatory bowel disease in the United States 1991-1996

OBJECTIVE: The occupational distribution of inflammatory bowel disease (IBD ) may help to shed light on its yet unknown etiology. The U.S. vital statis tics offer the opportunity to study cause of death by occupation and indust ry. METHODS: The numbers of deaths from Crohn's disease and ulcerative colitis were retrieved from the computerized 1991-1996 data files of the National C enter for Health Statistics. Deaths were grouped by gender, ethnicity, dise ase type, occupation, and industry. Mortality by occupation and industry we re expressed as proportional mortality ratio (PMR), adjusted for gender and ethnicity. RESULTS: Between 1991 and 1996, 2399 subjects died from Crohn's disease and 2419 subjects died from ulcerative colitis. Significant correlations were found between the PMR values of ulcerative colitis and Crohn's disease rega rding their distribution by occupation, r = 0.36 and p < 0.05, as well as b y industry, r = 0.37, p < 0.01. IBD mortality by occupation was significant ly reduced among farmers (PMR: 70, 95% confidence interval [CI]: 42-97), mi ning machine operators (31, 95% CI: 0-74), and laborers (71, 95% CI: 45-98) . A nonsignificant increase was found among sales persons (117, 95% CI: 95- 139) and secretaries (122, 95% CI: 83-161). IBD mortality by industry was s ignificantly reduced in agricultural production of livestock (39, 95% CI: 1 -78), mining (46, 95% CI: 9-83), grocery stores (55, 95% CI: 17-94), and wo rk in private households (64, 95% CI: 30-97). A nonsignificant increase was found in food production (128, 95% CI: 74-182), investment and insurance b usiness (137, 95% CI: 77-198), and administration (122, 95% CI: 81-163). CONCLUSIONS: IBD mortality is low in occupations associated with manual wor k and farming and relatively high in sedentary occupations associated with indoor work. Crohn's disease and ulcerative colitis show a similar distribu tion. (Am J Gastroenterol 2001;96:1101-1105. (C) 2001 by Am. Coll. of Gastr oenterology).