ASTHMA MORTALITY IN CALIFORNIA, 1960-1989 - DEMOGRAPHIC PATTERNS AND OCCUPATIONAL ASSOCIATIONS

We analyzed asthma mortality rates in California during the years 1960 to 1989. Sex- and race-specific rates were stratified by age group (0 to 4, 5 to 34, 35 to 64, and 65+ yr) and for all ages directly standardized to the 1970 U.S. age distribution. Observed and expected asthma deaths were also calculated by occupation for the period 1979 to 1981 among persons aged 16 to 64 yr using data from the California Occupational Mortality Study. Asthma mortality rates were strongly associated with increasing age, but no consistent differences were observed between men and women. Mortality rates among blacks under age 65 yr were two to four times the corresponding rate among whites between 1960 and 1989, but this difference was not observed for those over age 65. Asthma mortality rates were calculated for Hispanics and Asians from 1985 to 1989. In this time period the asthma mortality rate ratios for Hispanics were 0.4 to 0.8 compared with the age-stratified rates among whites, 0.1 to 0.2 times the black rates in age categories under 65, and 0.5 times the rate for blacks ages 65 and above. Asthma mortality rates among Asians under 65 yr of age were similar to rates for whites, but for Asians 65 yr of age and over the rate ratios for males and females compared with whites were 1.8 and 1.1, respectively. A decrease of approximately 50% in asthma mortality occurred from 1960 to 1970, and a marked increase occurred between 1975 and 1989. The rate of increase since 1975 was greater in blacks than in whites and greater in females than in males. For asthma deaths in 1979 to 1981, significant increases in mortality were observed for carpenters (O/E = 3.6; 95% CI 1.6, 6.9) and police and guards (O/E = 2.9; 95% CI 1.3, 5.6). Several other occupations had increased rate ratios that did not achieve statistical significance. Further research is indicated on the association of occupational exposures and asthma mortality.