Mortality in agricultural workers after compensation claims for respiratory disease, pesticide illness, and injury.

The long-term mortality experience of California agricultural workers who filed workers' compensation claims for respiratory diseases, pesticide illnesses, and injuries between 1946 and 1975 was observed until 1991 and compared to U.S. death rates. The respiratory disease claimants had an elevated relative risk of 3.27 (95% CI 2.09-4.86) for mortality from nonmalignant respiratory diseases (NMRD). Emphysema mortality was particularly high, with a relative risk of 5.94 (95% CI 2.56-11.70). NMRD mortality peaked 5 to 9 years after the claims were filed (relative risk 9.83, 95% CI 4.47-18.57) and was most strongly associated with exposure to wood, rice, coffee, and flour dusts. Among the pesticide illness claimants, mortality from heart disease was slightly elevated in the subcohort with systemic pesticide illness (SMR = 1.32, 95% CI 0.86-1.94). Among the injury claimants, risk was increased for motor vehicle deaths (relative risk 1.62, 95% CI 0.74-3.08). It was concluded that respiratory disease claimants in agriculture have a significantly elevated risk of mortality from respiratory diseases and that the risk is highest (10-fold) 5-9 years after claims are filed.