Occupational exposure to pesticides, metals, and solvents: The impact on mortality rates in the Honolulu Heart Program

Objective: To investigate the impact of occupational exposure to pesticides, metals, and solvents on mortality. Participants: Middle-aged Japanese-American men (n= 7,540) who had participated in the Honolulu Heart Program during 1965-1968. Methods: Industrial hygienists assessed participants' potential for exposure based on their primary job. Cumulative exposure scores were categorized as none, low, medium, and high. The underlying cause of death was ascertained by a physician panel. All associations were assessed using Cox proportional hazards models. Results: A total of 4, 485 deaths occurred. Compared to no exposure, pesticide exposure was significantly associated with mortality from all causes, circulatory diseases, stroke, and all cancers. Results for all-cause mortality at the 0-yr lag after risk-factor adjustment were: Low, hazard ratio (HR) = 0.85, 95% confidence interval (CI)=0.68-1.08; medium, HR = 1.18, 95% CI = 1.01-1.37; and high, HR=1.29, 95% CI=1.06-1.57; trend, p=0.002. Exposure to metals and solvents was significantly associated with mortality from all causes, cancer, and respiratory disease, and exposure to solvents was additionally associated with mortality from circulatory disease. Associations were strongest at the 15-yr lag. Conclusions: Results show that occupational exposures to pesticides, metals, and solvents during mid-life are independently associated with increased mortality, and indicate potential importance of exposures that occurred approximately 15 years prior to death.