Preventive Medicine and Public Health Area, Universidad de Alicante, 03690, Alicante, Spain.
CIBER Epidemiología y Salud Pública (CIBERESP), Madrid, Spain.
Int Arch Occup Environ Health. 2019 May;92(4):599-608. doi: 10.1007/s00420-018-1396-2. Epub 2019 Jan 2.
To compare mortality by cancer sites and by other specific causes of death, and the prevalence of risk behaviors in farmers and non-farmers in Spain.
Mortality by cause of death was calculated based on a longitudinal study with 10-years follow-up of 9.5 million men and 6 million women aged 20-64 years who were employed in 2001. The prevalence of risk behaviors was calculated from the 2001 National Health Survey in the 6464 employed men and 5573 employed women aged 20-64. The study subjects were grouped as farmers and non-farmers. For each cause of death, we estimated the ratio of age-standardized mortality rates, and for each risk behavior we estimated the age-standardized prevalence ratio in farmers versus non-farmers.
In men, the mortality rate for most cancer sites did not differ significantly between farmers and non-farmers, except for cancers of the lip, oral cavity, stomach, larynx and skin epidermoid carcinoma-which was higher in farmers-and cancers of the liver, pancreas and mesothelioma-which was lower in farmers. In contrast, farmers had a higher rate of mortality from most other diseases and from external causes of death. In women, farmers showed lower mortality from lung cancer, breast cancer and chronic lower respiratory disease, and higher mortality from external causes. The prevalence of smoking, excessive alcohol consumption, physical inactivity and obesity was higher in farmers than in non-farmers, except smoking and excessive alcohol consumption in women where prevalence was lower in farmers.
Findings are different from those found in other studies. In men, greater exposure to the sun and the higher prevalence of risk behaviors in farmers could explain their excess mortality from some cancer sites and the other causes of death. However, other factors may be behind this excess risk of mortality from these causes, given that farmers did not show higher mortality from some cancers related to smoking. In women, no differences were observed in mortality rate for majority of causes of death between farmers and non-farmers.
比较癌症部位和其他特定死因的死亡率，并比较西班牙农民和非农民的风险行为发生率。
根据一项对 950 万男性和 600 万女性进行的纵向研究，这些人在 2001 年时年龄在 20-64 岁之间，从事农业或非农工作。2001 年，对 6464 名 20-64 岁的男性和 5573 名 20-64 岁的女性进行了全国健康调查，以计算风险行为的发生率。将研究对象分为农民和非农民。对于每种死因，我们估计了年龄标准化死亡率比；对于每种风险行为，我们估计了农民与非农民之间的年龄标准化患病率比。
在男性中，除唇、口腔、胃、喉和皮肤表皮样癌（农民中发病率更高）以及肝癌、胰腺癌和间皮瘤（农民中发病率更低）外，大多数癌症部位的死亡率在农民和非农民之间没有显著差异。相比之下，农民死于大多数其他疾病和外部原因导致的死亡率更高。在女性中，农民死于肺癌、乳腺癌和慢性下呼吸道疾病的死亡率较低，而死于外部原因的死亡率较高。与非农民相比，农民的吸烟、过度饮酒、身体活动不足和肥胖的发生率更高，但女性的吸烟和过度饮酒的发生率较低。
与其他研究结果不同。在男性中，农民接触阳光更多，风险行为的发生率更高，这可能解释了他们在某些癌症部位和其他死因的死亡率过高。然而，由于农民没有表现出更高的与吸烟相关的癌症死亡率，其他因素可能导致了这些原因的死亡率过高。在女性中，农民和非农民之间大多数死因的死亡率没有差异。
