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Jobs in the agricultural sector are associated with high demands, risks, and stress for workers. Spain is of great importance for the European agricultural sector; nearly half the country’s land is dedicated to agricultural use. However, the health and mortality risks associated with agricultural work in Spain remain understudied. The aim of this study is to compare the mortality rates for male farm workers with mortality rates for males in non-agricultural occupations in Spain over a ten-year period.The prospective cohort study followed 8,695,560 male workers in Spain from 2001 to 2010. Participants in the study were selected from the 2001 census; at baseline, all participants were ages 16 to 64 years and employed in an agricultural job. Mortality data included in the present study were obtained from participants’ death certificates. For each cause of death, the age-adjusted mortality rates for farm workers and for non-farm workers was calculated per 1 00 000 person-years of follow-up. These rates were used to compare the rate ratio between male farm workers and non-farm workers.The all-cause mortality rate for farm workers was 13% greater than that of non-farm workers, with a rate radio estimate of 1.13 (95% CI: 1.11 to 1.16). For cancer deaths, the mortality rates of lip, laryngeal and skin cancer were higher and statistically significant for farm workers. Rates of death resulting from respiratory disease, circulatory disease, accident, and suicide were all significantly higher for farm workers than for non-farm workers.These results are the first obtained in Spain from a large prospective agricultural cohort. They show that male farm workers are a vulnerable population in terms of health status. Elevated rates of all-cause and specific-cause mortality in male farm workers could be associated with frequent exposure to occupational hazards, including pesticides, high temperatures, and long working hours.