A cohort study of banana plantation workers in the French West Indies: first mortality analysis (2000–2015)
Chlordecone, an organochlorine insecticide, was widely used in the French West Indies banana plantations. We set up a cohort of banana plantation workers who worked between 1973 and 1993, the period of authorized use of chlordecone. Vital status and causes of death were collected from French national registries. Workers were followed up from 1 January 2000 to 31 December 2015. Cause-specific mortality in the cohort was compared to that of the general population of the French West Indies by computing standardized mortality ratios (SMRs). A total of 11,112 workers (149,526 person-years, 77% men) were included in the mortality analysis, and 3647 deaths occurred over the study period. There was a slight deficit in all-cause mortality, which was statistically significant in men (SMR = 0.93, 95% CI 0.89–0.96), but not in women (SMR = 0.96, 95% CI 0.89–1.04). All-cancer mortality did not differ significantly from that of the general population (men: SMR = 0.96, 95% CI 0.90–1.03; women: SMR = 1.04, 95% CI 0.89–1.21). Significant excesses of deaths were observed for stomach cancer in women (SMR = 1.94, 95% CI 1.24–2.89) and pancreatic cancer in women farm owners (SMR = 2.31, 95% CI 1.06–4.39). Mortality from prostate cancer was similar to that of the general population in the whole cohort (SMR = 1.00; 95% CI 0.89–1.13) and non-significantly elevated among farm workers (SMR = 1.10, 95% CI 0.87–1.36). Non-significant increases in mortality were also observed for lung cancer in women, leukemia in men, and non-Hodgkin lymphoma in both genders.
KeywordsBanana plantations French West Indies Occupational cohort Mortality Standardized mortality ratio (SMR) Pesticides
We are grateful to the General Social Security Funds (Caisses Générales de Sécurité Sociale) of Guadeloupe and Martinique for their collaboration. We thank Marie Barrau, Alexandra Doens, Sylvia Janky, Vanessa Jupiter, Jessica Obertan, Stéphane Renaud, and Nathalie Surville-Barland for their help in data collection.
Compliance with ethical standards
The study was approved by the Institutional Review Board of the French National Institute of Health and Medical Research (IRB-INSERM, n° 15-193) and by the French Data Protection Authority (CNIL n° DR-215-200). Access to the nominative questionnaires of the agricultural censuses was authorized by the Committee on Statistical Confidentiality of the National Institute of Statistics and Economic Studies (session 14 January 2015, n° E270).
Conflict of interest
The authors declare that they have no conflict of interest.
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