Cohort mortality and nested case-control study of lung cancer among structural pest control workers in Florida (United States)

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Abstract
A previous report on the mortality of this cohort of Florida (United States) pest control workers found the risk of lung cancer was positively associated with the number of years licensed. An additional follow-up (1977–82) of this male cohort confirmed the excess (SMR=1.4) and the rising risk with increasing number of years licensed (SMR=2.2 among workers employed more than 20 years). A nested case-control study was undertaken to determine the effects of smoking and the type of pesticide exposure on lung cancer risk. Occupational histories and other data were obtained on 65 deceased lung cancer cases, 122 deceased controls, and 172 living controls. Interviews were conducted with next-of-kin regardless of the vital status of the subject. Odds ratios (OR) were adjusted by age and smoking. Adjustments for diet and other occupations had no effect on risk estimates and were not included in the final model. Using information from licensing records, ORs for lung cancer were greater for workers first licensed before age 40 (OR=2.4, 95 percent confidence interval [CI]=1.0–5.9 with deceased controls) and increased from 1.4 (CI=0.7–3.0) for subjects licensed 10–19 years to 2.1 (CI=0.8–5.5) for subjects licensed 20 or more years. Using living controls, an association with duration of employment was observed when years of licensure were lagged five years, but was not observed in unlagged analyses. Using information from the questionnaire, the risk of lung cancer was greater among those who worked as pest control operators than non-pest control workers. Although numbers were typically small, lung cancer risk among pest control operators was associated with reported exposure to carbamates, organophosphates, and phenoxyacetic acids and more specifically with diazinon, DDT, carbaryl, and propoxur. These results further suggest that pesticides may play a role in lung cancer risk and underscore the need for research that focuses on specific chemicals.