Cancer mortality among municipal pest-control workers

Objectives: This epidemiological study was carried out in order to investigate the hypothesis of a relationship between cancer occurrence and occupational exposure in a population of municipal pest-control workers exposed to a wide range of pesticides and other chemicals. Methods: The study was designed as a mortality historical cohort study. The cohort comprised all subjects ever employed in a municipal pest-control service between 1979 and 1994. The follow-up period lasted from 1979 to 2000. The mortality rates of pest-control workers were compared with those of a regional population. A job exposure matrix was developed, which took into account four types of chemicals: formaldehyde, ethylene oxide, insecticides and rodenticides. Results: None of the 181 subjects of the cohort, leading to 3,107 person-years, was lost to follow-up. Thirty-nine of them died, and all the causes of deaths were ascertained. The standardized mortality ratios (SMRs) for all causes of deaths and for all cancer causes were significantly greater than unity: 1.61 (1.14-2.20) and 2.24 (1.39-3.43), respectively. Non-significant excesses were observed for most cancer sites, except for lung cancer, which had a low SMR. We obtained significant excesses for cancer in workers with more than 20 years of employment [SMR=2.42 (1.43-3.82)]. Cancer mortality tended to increase insignificantly with formaldehyde and rodenticides exposures, whereas no clear patterns were observed for ethylene oxide and insecticides. However, significant excesses were observed for the highest exposure levels of formaldehyde, insecticides and rodenticides. Conclusions: This study showed a statistically significant excess of cancer mortality in a population of municipal pest-control workers exposed to a wide variety of chemicals. These cancer sites might be related to occupational activities, since they tended to be more frequently observed when duration of employment increased.