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John Beard,^1,2 Tim Sladden,¹ Geoffrey Morgan,¹ Geoffrey Berry,³ Lyndon Brooks,¹ and Anthony McMichael⁴

¹Southern Cross Institute of Health Research, Southern Cross University, Lismore, New South Wales, Australia; ²Northern Rivers University Department of Rural Health, University of Sydney, Lismore, New South Wales, Australia; ³School of Biostatistics, University of Sydney, Lismore, New South Wales, Australia; ⁴National Centre for Epidemiology and Population Health, Australian National University, Canberra, Australian Capital Territory, Australia

Abstract

We compared mortality of 1,999 outdoor staff working as part of an insecticide application program during 1935-1996 with that of 1,984 outdoor workers not occupationally exposed to insecticides, and with the Australian population. Surviving subjects also completed a morbidity questionnaire. Mortality was significantly higher in both exposed and control subjects compared with the Australian population. The major cause was mortality from smoking-related diseases. Mortality was also significantly increased in exposed subjects for a number of conditions that do not appear to be the result of smoking patterns. Compared with the general Australian population, mortality over the total study period was increased for asthma [standardized mortality ratio (SMR) = 3.45 ; 95% confidence interval (CI) , 1.39-7.10] and for diabetes (SMR = 3.57 ; 95% CI, 1.16-8.32 for subjects working < 5 years) . Mortality from pancreatic cancer was more frequent in subjects exposed to 1,1,1-trichloro-2,2-bis(p-chlorophenyl) ethane (SMR = 5.27 ; 95% CI, 1.09-15.40 for subjects working < 3 years) . Compared with the control population, mortality from leukemia was increased in subjects working with more modern chemicals (standardized incidence ratio = 20.90 ; 95% CI, 1.54-284.41 for myeloid leukemia in the highest exposure group) . There was also an increase in self-reported chronic illness and asthma, and lower neuropsychologic functioning scores among surviving exposed subjects when compared with controls. Diabetes was reported more commonly by subjects reporting occupational use of herbicides. These findings lend weight to other studies suggesting an association between adverse health effects and exposure to pesticides. Key words: asthma, cohort study, DDT, diabetes, leukemia, neoplasms, pancreatic cancer, pesticides. Environ Health Perspect 111:724-730 (2003) .