Morbidity and mortality in workers occupationally exposed to pesticides.
Utilizing cause-of-death information and responses to questionnaires addressed to survivors, mortalities and health impairments in a cohort of workers occupationally exposed to pesticides were compared to occurrences in workers not pesticide exposed, over the period 1971-1977. Seventy-two percent of 2,620 pesticide-exposed workers, and 75% of 1,049 "controls", recruited in 1971-73, were accounted for either by returned questionnaire or mortality. Disease incidence rates were studied in relation to broadly defined occupational subclasses, and to serum concentrations of organochlorine pesticides (OCl) measured at the time of recruitment. Death by accidental trauma was unusually frequent among pesticide applicators. Mortalities from cancer and arteriosclerosis were not detectably different from those observed in the controls. Among survivors, dermatitis and skin cancer were unusually common in structural pest-control operators. Internal cancer was no more frequent in the intensively pesticide-exposed workers than in the controls, but it appeared to occur at an unusually high rate in workers characterized as "possibly pesticide-exposed". There were apparent associations between high serum pesticide OCl levels measured in 1971-73 and the subsequent appearance of hypertension, arteriosclerotic cardiovascular disease, and possibly diabetes. This could imply a causal role of any of the pesticidal and other environmental stresses to which these workers were exposed. The limitations of this type of followup study are discussed.