Pesticide use and fatal injury among farmers in the Agricultural Health Study

  • Jenna K. Waggoner
  • Paul K. Henneberger
  • Greg J. Kullman
  • David M. Umbach
  • Freya Kamel
  • Laura E. Beane Freeman
  • Michael C. R. Alavanja
  • Dale P. Sandler
  • Jane A. Hoppin
Original Article

Abstract

Purpose

To assess whether pesticide use practices were associated with injury mortality among 51,035 male farmers from NC and IA enrolled in the Agricultural Health Study.

Methods

We used Cox proportional hazards models adjusted for age and state to estimate fatal injury risk associated with self-reported use of 49 specific pesticides, personal protective equipment, specific types of farm machinery, and other farm factors collected 1–15 years preceding death. Cause-specific mortality was obtained through linkage to mortality registries.

Results

We observed 338 injury fatalities over 727,543 person-years of follow-up (1993–2008). Fatal injuries increased with days/year of pesticide application, with the highest risk among those with 60+ days of pesticide application annually [hazard ratio (HR) = 1.87; 95% confidence interval (CI) = 1.10, 3.18]. Chemical-resistant glove use was associated with decreased risk (HR = 0.73; 95% CI = 0.58, 0.93), but adjusting for glove use did not substantially change estimates for individual pesticides or pesticide use overall. Herbicides were associated with fatal injury, even after adjusting for operating farm equipment, which was independently associated with fatal injury. Ever use of five of 18 herbicides (2,4,5-T, paraquat, alachlor, metribuzin, and butylate) were associated with elevated risk. In addition, 2,4-D and cyanazine were associated with fatal injury in exposure–response analyses. There was no evidence of confounding of these results by other herbicides.

Conclusion

The association between application of pesticides, particularly certain herbicides, and fatal injuries among farmers should be interpreted cautiously but deserves further evaluation, with particular focus on understanding timing of pesticide use and fatal injury.

Keywords

Pesticides Mortality Wounds and injuries 

Abbreviations

AHS

Agricultural Health Study

CI

Confidence interval

HR

Hazard ratio

Notes

Acknowledgments

The authors thank Stuart Long for assistance with data analysis. This work was supported by the Association of Schools of Public Health/Centers for Disease Control Fellowship program; the National Institute for Occupational Safety and Health and the Intramural Research Program of the National Institutes of Health, National Institute of Environmental Health Sciences (Z01-ES049030) and the National Institutes of Health National Cancer Institute (Z01-CP010119).

Conflict of interest

The authors declare that they have no conflict of interest.

References

  1. Beard JD et al (2011) Suicide and pesticide use among pesticide applicators and their spouses in the Agricultural Health Study. Environ Health Perspect 119(1):1–30CrossRefGoogle Scholar
  2. Bernhardt JH, Langley RL (1999) Analysis of tractor-related deaths in North Carolina from 1979 to 1988. J Rural Health Off J Am Rural Health Assoc Natil Rural Health Care Assoc 15(3):285–295CrossRefGoogle Scholar
  3. Blair A, Zahm SH (1993) Patterns of pesticide use among farmers: implications for epidemiologic research. Epidemiology (Camb, MA) 4(1):55–62CrossRefGoogle Scholar
  4. Blair A et al (2002) Reliability of reporting on life-style and agricultural factors by a sample of participants in the Agricultural Health Study from Iowa. Epidemiology (Camb, MA) 13(1):94–99CrossRefGoogle Scholar
  5. Bureau of Labor Statistics (2010) Selected occupations with high fatal injury rates, 2008, p 19. In: Census of fatal occupational injuries. http://www.bls.gov/iif/oshwc/cfoi/cfch0007.pdf. Accessed 21 Mar 2011
  6. Crandall CS, Fullerton L, Olson L, Sklar DP, Zumwalt R (1997) Farm-related injury mortality in New Mexico, 1980–91. Accid Anal Prev 29(2):257–261CrossRefGoogle Scholar
  7. Cubbin C, LeClere FB, Smith GS (2000) Socioeconomic status and the occurrence of fatal and nonfatal injury in the United States. Am J Public Health 90(1):70–77CrossRefGoogle Scholar
  8. Day L et al (2009) Risk factors for work related injury among male farmers. Occup Environ Med 66(5):312–318. doi: 10.1136/oem.2008.040808 CrossRefGoogle Scholar
  9. Gomes J, Lloyd O, Revitt MD, Basha M (1998) Morbidity among farm workers in a desert country in relation to long-term exposure to pesticides. Scand J Work Environ Health 24(3):213–219CrossRefGoogle Scholar
  10. Hines CJ, Deddens JA, Coble J, Kamel F, Alavanja MC (2011) Determinants of captan air and dermal exposures among orchard pesticide applicators in the Agricultural Health Study. Ann Occup Hyg 55(6):620–633. doi: 10.1093/annhyg/mer008 CrossRefGoogle Scholar
  11. Hoppin JA, Yucel F, Dosemeci M, Sandler DP (2002) Accuracy of self-reported pesticide use duration information from licensed pesticide applicators in the Agricultural Health Study. J Expo Anal Environ Epidemiol 12(5):313–318. doi: 10.1038/sj.jea.7500232 CrossRefGoogle Scholar
  12. Kamel F et al (2005) Neurologic symptoms in licensed private pesticide applicators in the Agricultural Health Study. Environ Health Perspect 113(7):877–882CrossRefGoogle Scholar
  13. Kraus JF, Schaffer K, Chu L, Rice T (2005) Suicides at work: misclassification and prevention implications. Int J Occup Environ Health 11(3):246–253Google Scholar
  14. London L, Nell V, Thompson ML, Myers JE (1998) Effects of long-term organophosphate exposures on neurological symptoms, vibration sense and tremor among South African farm workers. Scand J Work Environ Health 24(1):18–29CrossRefGoogle Scholar
  15. London L et al (2012) Neurobehavioral and neurodevelopmental effects of pesticide exposures. Neurotoxicology 43(13):451–462. doi: 10.1016/j.neuro.2012.01.004 Google Scholar
  16. Moyer LA, Boyle CA, Pollock DA (1989) Validity of death certificates for injury-related causes of death. Am J Epidemiol 130(5):1024–1032Google Scholar
  17. Myers JR, Hard DL (1995) Work-related fatalities in the agricultural production and services sectors, 1980–1989. Am J Ind Med 27(1):51–63CrossRefGoogle Scholar
  18. Myers JR, Hendricks KJ (2009) Agricultural tractor overturn deaths: assessment of trends and risk. Am J Ind Med. doi: 10.1002/ajim.20775 Google Scholar
  19. Myers JR, Layne LA, Marsh SM (2009) Injuries and fatalities to US farmers and farm workers 55 years and older. Am J Ind Med 52(3):185–194. doi: 10.1002/ajim.20661 CrossRefGoogle Scholar
  20. Pilkington A et al (2001) An epidemiological study of the relations between exposure to organophosphate pesticides and indices of chronic peripheral neuropathy and neuropsychological abnormalities in sheep farmers and dippers. Occup Environ Med 58(11):702–710CrossRefGoogle Scholar
  21. Richardson D, Loomis D, Wolf SH, Gregory E (1997) Fatal agricultural injuries in North Carolina by race and occupation, 1977–1991. Am J Ind Med 31(4):452–458CrossRefGoogle Scholar
  22. Rockett IR et al (2010) Suicide and unintentional poisoning mortality trends in the United States, 1987–2006: two unrelated phenomena? BMC Public Health 10:705. doi: 10.1186/1471-2458-10-705 CrossRefGoogle Scholar
  23. Solomon C (2002) Accidental injuries in agriculture in the UK. Occup Med (Oxf, England) 52(8):461–466CrossRefGoogle Scholar
  24. Sprince NL et al (2002) Risk factors for machinery-related injury among Iowa farmers: a case–control study nested in the Agricultural Health Study. Int J Occup Environ Health 8(4):332–338Google Scholar
  25. Sprince NL et al (2003a) Risk factors for animal-related injury among Iowa large-livestock farmers: a case–control study nested in the Agricultural Health Study. J Rural Health 19(2):165–173CrossRefGoogle Scholar
  26. Sprince NL et al (2003b) Risk factors for falls among Iowa farmers: a case–control study nested in the Agricultural Health Study. Am J Ind Med 44(3):265–272. doi: 10.1002/ajim.10267 CrossRefGoogle Scholar
  27. Tarone RE et al (1997) The Agricultural Health Study: factors affecting completion and return of. Am J Ind Med 31(2):233–242CrossRefGoogle Scholar
  28. Thomas KW et al (2010) Urinary biomarker, dermal, and air measurement results for 2,4-D and chlorpyrifos farm applicators in the Agricultural Health Study. J Eposure Sci Environ Epidemiol 20(2):119–134. doi: 10.1038/jes.2009.6 CrossRefGoogle Scholar
  29. Voaklander DC, Hartling L, Pickett W, Dimich-Ward H, Brison RJ (1999) Work-related mortality among older farmers in Canada. Can Fam Physician 45:2903–2910Google Scholar
  30. Waggoner JK et al (2011) Mortality in the Agricultural Health Study, 1993–2007. Am J Epidemiol 173(1):71–83. doi: 10.1093/aje/kwq323 CrossRefGoogle Scholar

Copyright information

© Springer-Verlag (outside the USA) 2012

Authors and Affiliations

  • Jenna K. Waggoner
    • 1
    • 2
  • Paul K. Henneberger
    • 1
  • Greg J. Kullman
    • 1
  • David M. Umbach
    • 3
  • Freya Kamel
    • 2
  • Laura E. Beane Freeman
    • 4
  • Michael C. R. Alavanja
    • 4
  • Dale P. Sandler
    • 2
  • Jane A. Hoppin
    • 2
  1. 1.Division of Respiratory Disease StudiesNIOSH, CDC, DHHSMorgantownUSA
  2. 2.Epidemiology BranchNIEHS, NIH, DHHSResearch Triangle ParkUSA
  3. 3.Biostatistics BranchNIEHS, NIH, DHHSResearch Triangle ParkUSA
  4. 4.Division of Cancer Epidemiology and GeneticsNCI, NIH, DHHSRockvilleUSA

Personalised recommendations