Cancer Mortality Among Agricultural Workers in the State of Rio de Janeiro, Brazil Armando Meyer National School of Public Health/ Oswaldo Cruz Foundation

Background Modern agriculture and pesticide use 2.5 million ton (around 5.6 billions pounds) US$ 30 billion Pesticide use in developing countries Less than 30% Most of poisonings and death

Background Environmental and human health problems acute poisonings reproductive, neurotoxicity cancer Cancer among farmers Low general mortality Low mortality for cardiovascular diseases Low mortality for all cancers together Blair and Zahm, 1995

Background The Brazilian scenario Increasing use of pesticides 50% of all Latin America Sales

Background The Brazilian scenario LowMediumHigh Deaths/100000

Background The Brazilian scenario Southeast region 40% of all pesticide consumption in Brazil 52 kg of pesticide/worker/year

Background The Brazilian scenario Southeast region São Lourenço Valley 56 kg of pesticides/worker/year 18 kg of pesticides/worker/year

Questions Is the cancer mortality among farmworkers in this region different from that observed in the general population? For what types of cancer? Is the mortality increasing?

Nova Friburgo Rio de Janeiro City Teresópolis Sumidouro Duas Barras Cantagalo Bom Jardim Study area Study design Mortality data were obtained from the Brazilian National Mortality System ( Farmworkers (occupation codes: ) Male years old Living in 6 cities from Rio de Janeiro Approach

Nova Friburgo Rio de Janeiro City Teresópolis Sumidouro Duas Barras Cantagalo Bom Jardim Study area Reference populations Local reference Rio de Janeiro City Porto Alegre City Observed-to-expected ratio Mortality Odds Ratio (MOR) as suggested by Miettinen & Wang, 1981.

Results General Mortality ( ) 3871 deaths Cardiovascular diseases (1349; 34.8%) External causes (711; 18.4%) Cancer (410; 10.6%) 271 deaths (30-69 years old) Cancer deaths among agricultures ( yr old). Serrana Region, state of Rio de Janeiro,

Results Cancer mortality odds ratio, male agriculture workers 30–69 years old, Serrana Region, State of Rio de Janeiro, 1979–1998

Results Cancer mortality odds ratio, male agriculture workers 50–69 years old, Serrana Region, State of Rio de Janeiro, 1979–1998

Results Cancer mortality odds ratio, male agriculture workers years old, Serrana Region, State of Rio de Janeiro, 1979–1998

Summary High mortality for stomach cancer High mortality for esophagus cancer The role of alcohol and smoking Low mortality for lung cancer MORs were higher among wokers with yr old MORs were higher in the 90s