Cause-specific mortality among banana plantation workers in the French West Indies

To describe cause-specific mortality patterns of banana plantation workers in the French West Indies.

The study included 11 221 farmers and farm workers who had work in banana cultivation in the French West Indies (Guadeloupe or Martinique) between 1973 and 1993, followed up from January 1981 to December 2017. We calculated standardised mortality ratios (SMRs), causal mortality ratios (CMRs) and relative standardised mortality ratios (rSMRs) using regional reference rates.

SMR analyses showed mortality deficits in the overall mortality and for almost all causes of deaths. In contrast, analyses using CMRs revealed a significant excess in the overall mortality. The CMRs were significantly elevated for all cancers combined and for stomach cancer, colorectal cancer, prostate cancer and haematopoietic malignancies, as well as for several non-cancer causes of death, including diabetes mellitus, Parkinson's disease, Alzheimer's disease, non-ischaemic heart diseases, pneumonia and diseases of the skin and subcutaneous tissue. rSMRs were in general consistent with CMRs with regards to the direction of the association, although rSMRs were lower and in some instances not statistically significant.

The CMR approach showed an elevated mortality for several causes of death, for which work in banana farming and/or exposure to pesticides are plausible explanations.